Structural Cortical Brain Abnormalities in Patients with Vestibular Migraine (S51.005)

OBJECTIVE: To assess the regional distribution of gray matter (GM) abnormalities in patients with vestibular migraine (VM) using voxel-based morphometry (VBM). The correlations between regional volumetric abnormalities and clinical manifestations of the disease were also investigated. BACKGROUND: VM has been recently recognized as a migraine variant with vestibular manifestations. New advances in understanding the pathophysiology of VM have suggested a large overlap between migraine and vestibular pathways. In particular, a recent VBM study in VM has detected GM atrophy of pain and multisensory vestibular processing areas. DESIGN/METHODS: Using a 3.0 Tesla scanner, brain dual-echo and 3D T1-weighted scans were acquired from 20 patients with VM, 20 migraine patients with aura (MWA), 20 migraine patients without aura (MWoA) and 20 age-matched controls. VBM was performed using SPM8 and DARTEL (p<0.001, cluster extent 10 voxels). RESULTS: Compared to controls, all groups of migraine patients had GM atrophy of fronto-parietal regions and the cerebellum and an increased GM volume (GMV) of temporal areas. VM patients had a selective GMV increase of the left superior occipital gyrus, compared to controls and the other two groups of migraine patients. Increased GMV was detected in the right postcentral gyrus and left cerebellum in VM vs. MWoA. Compared to MWA, VM patients had an increased GMV of the red nucleus, left inferior temporal gyrus and right cerebellum. In VM patients, no correlation was found between GM abnormalities and patients’s clinical characteristic. CONCLUSIONS: Significant GMV abnormalities of multisensory vestibular cortical areas occur in VM patients. The distinctive increased volume of visual association areas in VM patients may be related to compensatory cortical plasticity of other sensory modalities.