Altered cerebral blood flow in patients with unilateral venous pulsatile tinnitus: an arterial spin labeling study

Objectives: Abnormal neuronal activity and functional connectivity have been reported in patients with venous pulsatile tinnitus (PT). As neuronal activity is closely coupled to regional brain perfusion, the purpose of this study was to investigate the cerebral blood flow (CBF) alterations in patients with unilateral venous PT using arterial spin labeling (ASL). Methods: This study included patients with right-sided PT between January 2018 and July 2019. A healthy control (HC) group matched 1:1 for gender and age was also recruited. All subjects underwent ASL scanning using 3.0T MRI. The correlation between altered CBF and Tinnitus Handicap Inventory (THI) score as well as PT duration was analyzed. Results Twenty-one patients with right-sided PT and 21 HCs were included. The mean PT duration of the patients was 35.9 +/- 32.2 months, and the mean THI score was 64.1 +/- 20.3. Compared with the HCs, the PT patients exhibited increased CBF in the left inferior parietal gyrus and decreased CBF in the bilateral lingual gyrus (family-wise error corrected, p < 0.05). The increased CBF in the left inferior parietal gyrus showed a positive correlation with the THI score in PT patients (r = 0.501, p = 0.021). Conclusions PT patients exhibit regional CBF alterations. The increased CBF in the left inferior parietal gyrus may reflect the severity of PT. Advances in knowledge: This study not only presents evidence for the potential neuropathology of PT from the perspective of CBF alterations but also offers a new method for investigating the neuropathological mechanism of PT.

Automated summary

This study using ASL technology found regional cerebral blood flow alterations in patients with unilateral venous pulsatile tinnitus, especially the increased CBF in the left inferior parietal gyrus may reflect the severity of tinnitus.