Cerebral perfusion abnormalities in patients with persistent postural-perceptual dizziness (PPPD): a SPECT study

Na, Seunghee; Im, Jooyeon Jamie; Jeong, Hyeok; Lee, Eek‐Sung; Lee, Tae-Kyeong; Chung, Yong‐An; Song, In‐Uk

doi:10.1007/s00702-018-1948-3

Cited by 17 publications

(31 citation statements)

References 40 publications

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“…Actually, 78% of our CD group patients met the diagnostic criteria for PPPD, when retrospectively applied the criteria. In PPPD patients, frontal lobe rCBF has been reported to be decreased [ 28 ], in contrast to our findings where increased frontal lobe rCBF in patients with CD was observed. Decreased frontal lobe activity in chronic subjective dizziness whose clinical characteristics largely overlap with PPPD [ 13 , 17 ] has also been indicated by functional MRI [ 33 ].…”

Section: Discussioncontrasting

confidence: 99%

“…3 ). A decrease in rCBF in vestibular-related cortices was also reported earlier in PPPD patients who had no active vestibular disorders [ 28 ]. Decreased activity in these vestibular-related cortices in chronic dizziness without currently active vestibular imbalance, such as PPPD, is thought to reflect an abnormal adaptation in which the priority shifts from vestibular information to other sensory information in processing spatial orientation information [ 3 ].…”

Section: Discussionsupporting

confidence: 78%

“…However, despite the presence of slightly more left-sided lesions, increased rCBF in the insula was seen predominantly on the left side of the MI group patients' cortices. Although the dominance of the human vestibular cortex is suggested to be in the right (non-dominant) hemisphere [ 24 ], left-side dominant activity changes in vestibular related cortices were reported in patients with chronic dizziness [ 27 , 28 ]; however, in such cases, the activities were not increased but decreased. Vestibular signal processing in vestibular-related cortices seemed to occur on both sides.…”

Section: Discussionmentioning

confidence: 99%

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Cerebral perfusion changes in chronic dizziness: A single-photon emission computed tomography study

et al. 2021

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Background and purpose Dizziness may persist even after the causative vestibular imbalance subsides. Although the precise mechanism of chronic dizziness is unknown, various cerebral activity changes associated with it have been reported. To understand its mechanism in the absence of the causative vestibular imbalance, we compared cerebral changes in chronic dizziness with and without persistent vestibular imbalance. Methods Between September 2014 and March 2020, we examined regional cerebral blood flow (rCBF) in 12 patients having chronic post-lateral medullary infarction dizziness with persistent brainstem vestibular imbalance and 23 patients having chronic dizziness without currently active vestibular imbalance using single-photon emission computed tomography (SPECT) with 99m Technetium-ethyl cysteinate dimer. Further, we analyzed the SPECT images using a voxel-based group comparison. Results We observed a decreased rCBF in the occipital lobe and increased rCBF in the medial and inferior parts of the temporal lobe in patients having chronic dizziness with and without active vestibular imbalance compared to healthy controls. However, only patients having chronic dizziness without active vestibular imbalance exhibited increased rCBF in the frontal lobe, including the orbitofrontal cortex. Conclusion This is the first study to highlight the difference in rCBF changes between patients having chronic dizziness with and without active vestibular imbalance. Decreased occipital lobe activity and increased medial and inferior temporal lobe activity may be related to keeping dizziness perception triggered regardless of the presence or absence of active vestibular imbalance, whereas increased frontal lobe activity may explain the dizziness background to persist after the disappearance of vestibular imbalance.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

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Cerebral perfusion changes in chronic dizziness: A single-photon emission computed tomography study

et al. 2021

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“…Our study also found that MCI patients with dizziness showed hypoperfusion in the left lateral orbital and right middle frontal cortices compared with patients without dizziness. Our findings are in line with findings from previous studies of altered connectivity concerning the frontal cortices and decreased rCBF in multifocal frontal areas in patients with functional dizziness [ 14 , 17 , 18 ]. These changes are expected to be consequences of compensation for dizziness as patients use their reserve or a maladaptation toward a weighting of sensory inputs other than vestibular stimuli.…”

Section: Discussionsupporting

confidence: 93%

“…Interestingly, vestibular rehabilitation improved both dizziness severity and cognitive function in patients with intractable dizziness [ 12 ]. Furthermore, previous neuroimaging studies have shown alterations in brain metabolism, brain connectivity, and cortical thickness in areas involved in cognitive function among patients with various vestibular disorders, including chronic vestibular failure, bilateral vestibular failure, and PPPD [ 13 , 14 , 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Altered Regional Cerebral Blood Perfusion in Mild Cognitive Impairment Patients with Dizziness

Jeong

et al. 2020

Diagnostics

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Dizziness is a common symptom among the general population, especially in the elderly. Previous studies have reported that dizziness may be associated with various cognitive functions including memory impairment. However, few studies have investigated the neural correlates of dizziness in patients with cognitive impairment. The aim of this study was to examine regional cerebral blood flow (rCBF) in mild cognitive impairment (MCI) patients with or without dizziness using single photon emission computed tomography (SPECT). A total of 50 patients with MCI were recruited. All participants underwent technetium-99m ethyl cysteinate dimer brain SPECT and a neuropsychological battery and completed the Dizziness Handicap Inventory (DHI). Participants were divided into a dizziness group (DHI ≥ 1, n = 18) and a non-dizziness group (DHI = 0, n = 32). Voxel wise differences in rCBF between the groups were estimated. SPECT analysis revealed decreased rCBF in the left superior temporal gyrus, left lateral orbital gyrus, and right middle frontal gyrus in the dizziness group compared with the non-dizziness group (p < 0.005). No significant clusters of increased rCBF were observed in the dizziness group compared with the non-dizziness group. Results of the neuropsychological tests showed a significant difference in Controlled Oral Word Association Test performance between MCI patients with and without dizziness. In conclusion, MCI patients with dizziness showed multifocal frontal and left temporal hypoperfusion compared with patients without dizziness. Our results suggest that hypoperfusion in the frontal and temporal cortices might be reflecting the negative impact of dizziness in MCI patients.

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Persistent Postural-Perceptual Dizziness

Staab

2023

Disorders of the Vestibular System

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Cerebral perfusion abnormalities in patients with persistent postural-perceptual dizziness (PPPD): a SPECT study

Cited by 17 publications

References 40 publications

Cerebral perfusion changes in chronic dizziness: A single-photon emission computed tomography study

Cerebral perfusion changes in chronic dizziness: A single-photon emission computed tomography study

Altered Regional Cerebral Blood Perfusion in Mild Cognitive Impairment Patients with Dizziness

Persistent Postural-Perceptual Dizziness

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