A Resting-State MRI Study Of Gray Matter Changes In Patients With Meniere’s Disease During Interictal Period

Objective:Meniere’s disease(MD)is a peripheral vestibular disorder with recurrent attacks of vertigo,and the specific pathogenesis and etiology of MD are still unclear.Recently,neuroimaging of patients with active MD has shown altered hippocampus functional connectivity,indicating the abnormality of central nervous system may be involved in the occurrence of vertigo in MD.In this study,VBM-DARTEL method was used to study the gray matter structural differences of patients with MD in remission in order to explore the possible relationship between the altered brain regions and vertigo in patients with MD,which might provide a new insight into the pathophysiological mechanism of MD from the perspective of neuroimaging,so as to guide clinical vestibular rehabilitation therapy and provide more effective and accurate individualized treatment for MD patients.Method:20 right-handed patients with MD(11 of left-sided lesions,5 of right-sided lesions,4 of bilateral-sided lesions)were enrolled in the otorhinolaryngology department of our hospital,and 23 normal controls(NC)matched with clinical data(sex,age,handedness,duration of education)were recruited at the same time,the Dizziness Disorder Scale Score(DHI)was used to assess the severity of vertigo in MD patients.The routine MRI and high resolution 3DT1 WI images data of two groups were scanned on Achieva Philips 3.0T magnetic resonance scanner.Then the data were processed and analyzed by SPM8 software based on Matlab platform,the gray matter volume(GMV)values of two groups were calculated.Finally,the GMV maps of the two groups were statistically compared by two-sample T test,using age、sex and total brain volume as covariables.The brain regions of significant differences in GMV were obtained via FDR multiple comparison and correction.The correlation between GMV values in abnormal brain regions and duration of disease and DHI scores was analyzed,and the ROC curve was applied to evaluate the diagnostic performance of GMV values in altered brain regions for MD.Results:There was a significant difference in GMV between the MD group and the NC group.Compared to NC,patients with MD showed gray matter atrophy in the right superior temporal gyrus,right inferior temporal gyrus and right insular gyrus,while showed increased GMV values in the left putamen,left parahippocampal gyrus and left postcentral gyrus.The GMV of the right superior temporal gyrus was negatively correlated with the DHI scores(r=-0.671,p=0.001).The ROC curve showed that the area under the curve(AUC)corresponding to the GMV values of the different brain regions was relatively higher in the left putamen(AUC=0.867),the left parahippocampal gyrus(AUC=0.935)and the left postcentral gyrus(AUC=0.904).Conclusion:The brain structure of patients with remissive MD was different compared to NC,the core brain areas involved in multisensory vestibular processing and part areas of the default-mode network(DMN)showed GMV decrease,which might be the neural mechanism of recurrent vertigo attacks and mental and emotional disorders in MD.The increased GMV related to visual,somatosensory and motor control,which indicated a shift of sensory function toward the visual and somatosensory systems,might be a compensatory mechanism for the deficiency of vestibular function.The ROC curve showed that the left putamen,left parahippocampal gyrus and left postcentral gyrus might be applied to distinguish MD patients from NC people to some extent efficiency.