Structural brain changes following peripheral vestibulo-cochlear lesion may indicate multisensory compensation

Christoph Helmchen (1) , Jan C. Klinkenstein (1) , Alexandra Krüger (2) , Jan Gliemroth (3) , Christian Mohr (4) , Thurid Sander (1)

1 Dept. Neurology, University Luebeck
2 ENT Dept. , University Luebeck
3 Dept.of Neurosurgery, University Hospital Schleswig-Holstein
4 Institute of Neuroradiology, University Luebeck

Background: Do central mechanisms account for the variability of clinical recovery following peripheral vestibulo-cochlear lesions? Objective: To investigate structural (morphological) plasticity in the human brain following unilateral vestibulo-cochlear lesions which might contribute to central vestibular compensation. Methods: We compared regional grey matter volume (GMV) changes in patients after surgical removal of unilateral acoustic neuroma with age-matched control subjects. We hypothesized morphometric changes in the vestibular and auditory cortices which may be related to functional disability scores. Patients were examined with a battery of neuro-otological tests and clinical scores to assess vestibular and auditory disability. Results: Voxel-based morphometry (VBM) was used for categorical comparison between patients and age- and gender- matched controls. GMV increase was found bilaterally in primary somatosensory cortices and motion sensitive areas in the medial temporal gyrus (MT). Simple regression analysis revealed GMV increase (i) in the contralesional superior temporal gyrus / posterior insula to be correlated with decreasing clinically assessed vestibular deficits; (ii) in the contralesional inferior parietal lobe with decreasing functional impairment of daily living activities; and (iii) in the contralesional auditory cortex (Heschl gyrus) with decreasing hearing impairment. Conclusions: These data may suggest structural cortical plasticity in multisensory vestibular cortex areas of patients with unilateral peripheral vestibulo-cochlear lesion after surgical removal of acoustic neuroma. As changes of GMV were related to vestibular function structural brain changes may reflect central mechanisms of vestibular compensation.

Mots clés: NEUROOTOLOGY; VERTIGO

Christoph Helmchen, Jan C. Klinkenstein, Alexandra Krüger, Jan Gliemroth, Christian Mohr, et al.. Structural brain changes following peripheral vestibulo-cochlear lesion may indicate multisensory compensation. Journal of Neurology, Neurosurgery and Psychiatry, 2010, 82 (3), pp.309. ⟨10.1136/jnnp.2010.204925⟩. ⟨hal-00570140⟩