Journal
BRAIN
Volume 142, Issue -, Pages 606-616Publisher
OXFORD UNIV PRESS
DOI: 10.1093/brain/awy355
Keywords
vestibular migraine; vestibular thresholds; visual motion adaptation; visuo-vestibular interaction
Categories
Funding
- UK Medical Research Council [MR/J004685/1]
- National Institute for Health Research (NIHR) Imperial Biomedical Research Centre
- MRC (UK)
- NIHR (UK)
- NIHR Imperial Biomedical Research Centre
- EPSRC
- MRC [MR/P006493/1, MR/J004685/1] Funding Source: UKRI
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Vestibular migraine is among the commonest causes of episodic vertigo. Chronically, patients with vestibular migraine develop abnormal responsiveness to both vestibular and visual stimuli characterized by heightened self-motion sensitivity and visually-induced dizziness. Yet, the neural mechanisms mediating such symptoms remain unknown. We postulate that such symptoms are attributable to impaired visuo-vestibular cortical interactions, which in turn disrupts normal vestibular function. To assess this, we investigated whether prolonged, full-field visual motion exposure, which has been previously shown to modulate visual cortical excitability in both healthy individuals and avestibular patients, could disrupt vestibular ocular reflex and vestibular-perceptual thresholds of self-motion during rotations. Our findings reveal that vestibular migraine patients exhibited abnormally elevated reflexive and perceptual vestibular thresholds at baseline. Following visual motion exposure, both reflex and perceptual thresholds were significantly further increased in vestibular migraine patients relative to healthy controls, migraineurs without vestibular symptoms and patients with episodic vertigo due to a peripheral inner-ear disorder. Our results provide support for the notion of altered visuo-vestibular cortical interactions in vestibular migraine, as evidenced by vestibular threshold elevation following visual motion exposure.
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