Joanna Wardlaw (United Kingdom)
University of Edinburgh Centre for Clinical Brain SciencesAuthor Of 1 Presentation
FRONTAL WHITE MATTER INTEGRITY AND IDIOPATHIC DIZZINESS IN CEREBRAL SMALL VESSEL DISEASE
- Richard T. Ibitoye (United Kingdom)
Abstract
Background and Aims:
Three in ten older people (>60 years) complain of persistent dizziness which often remains unexplained despite specialist assessment and vestibular tests. The pathophysiology of such idiopathic dizziness in older people has remained unclear. We investigated if idiopathic dizziness was associated with vascular injury to white matter tracts relevant to balance or vestibular self-motion perception in sporadic small vessel disease.
Methods:
We prospectively recruited 38 vestibular clinic patients with idiopathic dizziness (median 77 years) and 36 asymptomatic controls (median 76 years) who underwent clinical, cognitive, balance, gait and vestibular assessments, and structural and diffusion brain MRI.
Results:
Patients had more vascular risk factors, poorer balance and worse executive cognitive function in association with greater white matter hyperintensity in frontal deep white matter, and lower fractional anisotropy in the genu of the corpus callosum and the right inferior longitudinal fasciculus. Tracts with lower fractional anisotropy in idiopathic dizziness overlapped with those in which lower fractional anisotropy correlated with worse balance across participants. More vestibular symptoms correlated with worse balance in patients. Vestibulo-ocular reflex and perceptual vestibular function was similar in patients and controls, though a white matter network involved in vestibular perception had lower connectivity in patients.
Conclusions:
Our results show a relationship between lower microstructural integrity in frontal balance-relevant white matter tracts in cerebral small vessel disease, poorer balance and idiopathic dizziness. This suggests cerebral small vessel disease may be involved in the pathogenesis of dizziness in some older people.