Recent Study Sheds New Insight on Cortical Alterations in Those with Vestibular Migraines

Vestibular migraine (VM) is one of the most common causes of vertiginous symptoms of central/neurological origin.

In 2012, the Committee for Classification of Vestibular Disorders of the Barany Society and the Migraine Classification Subcommittee of the International Headache Society (IHS) published diagnostic guidelines which included two classifications: vestibular migraine and probable vestibular migraine (Lempert et al, 2012).

These classifications, based on symptomology, not diagnostics, replaces the previously-used terms: migraine-associated vertigo/dizziness, migraine-related vestibulopathy, and migrainous vertigo. Unfortunately, traditional vestibular diagnostic evaluations are not the most useful tests to identifying VM, due to the lack of consistent findings in patients with VM. Rather vestibular diagnostics are valuable in ruling out peripheral or other causes of a patient’s symptoms.

Zhe et al (2021) recently found significant differences between subjects with VM and healthy controls in functional magnetic resonant imaging studies. Specifically, reduced grey matter volume was found in the parietoinsular vestibular cortex (PIVC), right middle frontal gyrus, and precuneus. Interestingly, the volume differences of the left PIVC were negatively correlated with patient reported Dizziness Handicap Inventory (DHI) scores.

This finding prompted the investigators to further map the functional connectivity in this region. They found an increase in functional connection between the left PIVC and the left primary somatosensory cortex (S1)/inferior parietal lobule (IPL).

Studies of this nature provide helpful insights into unlocking the complex mystery VM presents. For more information on VM classifications, please use the references below.

References

Lempert T, Olesen J, Furman J, et al. (2012) Vestibular migraine: Diagnostic criteria. J Ves Res 22(4):167-172 (accessed September 14, 2021).

Melillo G. (2021) Reduced gray matter volume seen in patients with vestibular migraine. Am J Managed Care website (accessed September 14, 2021).

Zhe X, Zhang X, Chen L, et al. (2021) Altered gray matter and functional connectivity in patients with vestibular migraine. Front Neurosci 15:683802 (accessed September 13, 2021).