Cargando…
Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression
Combining magnetic resonance imaging (MRI) sequences that permit the determination of vestibular nerve angulation (NA = change of nerve caliber or direction), structural nerve integrity via diffusion tensor imaging (DTI), and exclusion of endolymphatic hydrops (ELH) via delayed gadolinium-enhanced M...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9813125/ https://www.ncbi.nlm.nih.gov/pubmed/36255522 http://dx.doi.org/10.1007/s00415-022-11399-y |
_version_ | 1784863865179209728 |
---|---|
author | Kierig, Emilie Gerb, Johannes Boegle, Rainer Ertl-Wagner, Birgit Dieterich, Marianne Kirsch, Valerie |
author_facet | Kierig, Emilie Gerb, Johannes Boegle, Rainer Ertl-Wagner, Birgit Dieterich, Marianne Kirsch, Valerie |
author_sort | Kierig, Emilie |
collection | PubMed |
description | Combining magnetic resonance imaging (MRI) sequences that permit the determination of vestibular nerve angulation (NA = change of nerve caliber or direction), structural nerve integrity via diffusion tensor imaging (DTI), and exclusion of endolymphatic hydrops (ELH) via delayed gadolinium-enhanced MRI of the inner ear (iMRI) could increase the diagnostic accuracy in patients with vestibular paroxysmia (VP). Thirty-six participants were examined, 18 with VP (52.6 ± 18.1 years) and 18 age-matched with normal vestibulocochlear testing (NP 50.3 ± 16.5 years). This study investigated whether (i) NA, (ii) DTI changes, or (iii) ELH occur in VP, and (iv) to what extent said parameters relate. Methods included vestibulocochlear testing and MRI data analyses for neurovascular compression (NVC) and NA verification, DTI and ELS quantification. As a result, (i) NA increased NVC specificity. (ii) DTI structural integrity was reduced on the side affected by VP (p < 0.05). (iii) 61.1% VP showed mild ELH and higher asymmetry indices than NP (p > 0.05). (iv) “Disease duration” and “total number of attacks” correlated with the decreased structural integrity of the affected nerve in DTI (p < 0.001). NVC distance within the nerve’s root-entry zone correlated with nerve function (Roh = 0.72, p < 0.001), nerve integrity loss (Roh = − 0.638, p < 0.001), and ELS volume (Roh = − 0.604, p < 0.001) in VP. In conclusion, this study is the first to link eighth cranial nerve function, microstructure, and ELS changes in VP to clinical features and increased vulnerability of NVC in the root-entry zone. Combined MRI with NVC or NA verification, DTI and ELS quantification increased the diagnostic accuracy at group-level but did not suffice to diagnose VP on a single-subject level due to individual variability and lack of diagnostic specificity. |
format | Online Article Text |
id | pubmed-9813125 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-98131252023-01-06 Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression Kierig, Emilie Gerb, Johannes Boegle, Rainer Ertl-Wagner, Birgit Dieterich, Marianne Kirsch, Valerie J Neurol Original Communication Combining magnetic resonance imaging (MRI) sequences that permit the determination of vestibular nerve angulation (NA = change of nerve caliber or direction), structural nerve integrity via diffusion tensor imaging (DTI), and exclusion of endolymphatic hydrops (ELH) via delayed gadolinium-enhanced MRI of the inner ear (iMRI) could increase the diagnostic accuracy in patients with vestibular paroxysmia (VP). Thirty-six participants were examined, 18 with VP (52.6 ± 18.1 years) and 18 age-matched with normal vestibulocochlear testing (NP 50.3 ± 16.5 years). This study investigated whether (i) NA, (ii) DTI changes, or (iii) ELH occur in VP, and (iv) to what extent said parameters relate. Methods included vestibulocochlear testing and MRI data analyses for neurovascular compression (NVC) and NA verification, DTI and ELS quantification. As a result, (i) NA increased NVC specificity. (ii) DTI structural integrity was reduced on the side affected by VP (p < 0.05). (iii) 61.1% VP showed mild ELH and higher asymmetry indices than NP (p > 0.05). (iv) “Disease duration” and “total number of attacks” correlated with the decreased structural integrity of the affected nerve in DTI (p < 0.001). NVC distance within the nerve’s root-entry zone correlated with nerve function (Roh = 0.72, p < 0.001), nerve integrity loss (Roh = − 0.638, p < 0.001), and ELS volume (Roh = − 0.604, p < 0.001) in VP. In conclusion, this study is the first to link eighth cranial nerve function, microstructure, and ELS changes in VP to clinical features and increased vulnerability of NVC in the root-entry zone. Combined MRI with NVC or NA verification, DTI and ELS quantification increased the diagnostic accuracy at group-level but did not suffice to diagnose VP on a single-subject level due to individual variability and lack of diagnostic specificity. Springer Berlin Heidelberg 2022-10-18 2023 /pmc/articles/PMC9813125/ /pubmed/36255522 http://dx.doi.org/10.1007/s00415-022-11399-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Communication Kierig, Emilie Gerb, Johannes Boegle, Rainer Ertl-Wagner, Birgit Dieterich, Marianne Kirsch, Valerie Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
title | Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
title_full | Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
title_fullStr | Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
title_full_unstemmed | Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
title_short | Vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
title_sort | vestibular paroxysmia entails vestibular nerve function, microstructure and endolymphatic space changes linked to root-entry zone neurovascular compression |
topic | Original Communication |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9813125/ https://www.ncbi.nlm.nih.gov/pubmed/36255522 http://dx.doi.org/10.1007/s00415-022-11399-y |
work_keys_str_mv | AT kierigemilie vestibularparoxysmiaentailsvestibularnervefunctionmicrostructureandendolymphaticspacechangeslinkedtorootentryzoneneurovascularcompression AT gerbjohannes vestibularparoxysmiaentailsvestibularnervefunctionmicrostructureandendolymphaticspacechangeslinkedtorootentryzoneneurovascularcompression AT boeglerainer vestibularparoxysmiaentailsvestibularnervefunctionmicrostructureandendolymphaticspacechangeslinkedtorootentryzoneneurovascularcompression AT ertlwagnerbirgit vestibularparoxysmiaentailsvestibularnervefunctionmicrostructureandendolymphaticspacechangeslinkedtorootentryzoneneurovascularcompression AT dieterichmarianne vestibularparoxysmiaentailsvestibularnervefunctionmicrostructureandendolymphaticspacechangeslinkedtorootentryzoneneurovascularcompression AT kirschvalerie vestibularparoxysmiaentailsvestibularnervefunctionmicrostructureandendolymphaticspacechangeslinkedtorootentryzoneneurovascularcompression |