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Cerebellar metabolic involvement and its correlations with clinical parameters in vestibular neuritis

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Abstract

Although vestibular neuritis (VN) cortical models are described in the literature, there is lack of knowledge regarding the exclusive cerebellar involvement. The aim of the present study was to analyze, by [18F] fluorodeoxyglucose-positron emission tomography (FDG-PET)/computer tomography, regional cerebellar FDG uptake in eight right-handed VN patients (five females; three males; mean age 48 ± 7 years) during the first few days (PET0) and after 1 month (PET1) since symptoms onset. At both phases, patients underwent otoneurological examination and filled in a battery of validated questionnaires. Twenty-six cerebellar volumes of interest (VOI) were identified by the automated anatomical labeling library and normalized to thalamus FDG-PET uptake. Mean intensity within VOIs was calculated in both phases and processed by within-subjects ANOVA. A significantly lower (p < 0.005) FDG uptake distribution was found in bilateral lobules III, VI and X and in vermis 1–2, 3, 6 and 10 at PET0 as compared to PET1 and a significant higher FDG uptake distribution was found in right crus I in the same comparison. Significant (p < 0.05) positive correlations were found between Anxiety and Bucket test scores, and normalized metabolism in right crus I (at PET0) and vermis 10 (at PET1), respectively. A negative correlation was found at PET0 between slow-phase velocity scores and normalized metabolism in right lobule X. These data show relevant changes in the pattern of cerebellar metabolism that might unravel additional central aspects of early and late VN associated to bilateral cortical responses to sensory conflict during the acute VN-related controversial inflow.

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Acknowledgments

MichelAngela Studio generated Fig. 2 with airbrush simulation technique by using Photoshop Package for iOS and modified Fig. 3 by using the same software. The authors express sincerely thanks to MichelAngela Studio for skillful and creative craftsmanship in preparing illustrations.

Conflicts of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. Department of Clinical Sciences and Translational Medicine, “Tor Vergata” University, Viale Oxford, 81, 00133, Rome, Italy

    Marco Alessandrini, Alessandro Micarelli & Ernesto Bruno

  2. Department of Biomedicine and Prevention, “Tor Vergata” University, Rome, Italy

    Agostino Chiaravalloti, Barbara Di Pietro & Orazio Schillaci

  3. Department of Psychology, “La Sapienza” University and IRCCS Fondazione Santa Lucia, Rome, Italy

    Matteo Candidi

  4. Department of Hospital Physics, Karolinska Hospital, Stockholm, Sweden

    Johanna Öberg

  5. IRCCS Neuromed, Pozzilli, Italy

    Orazio Schillaci

  6. Department of Nuclear Medicine, Karolinska University Hospital, Stockholm, Sweden

    Marco Pagani

  7. Institute of Cognitive Sciences and Technologies-CNR, Rome, Italy

    Marco Pagani

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  1. Marco Alessandrini
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  2. Alessandro Micarelli
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  3. Agostino Chiaravalloti
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  5. Ernesto Bruno
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  7. Johanna Öberg
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  9. Marco Pagani
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Correspondence to Alessandro Micarelli.

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M. Alessandrini, A. Micarelli, O. Schillaci and M. Pagani contributed equally to this work.

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Alessandrini, M., Micarelli, A., Chiaravalloti, A. et al. Cerebellar metabolic involvement and its correlations with clinical parameters in vestibular neuritis. J Neurol 261, 1976–1985 (2014). https://doi.org/10.1007/s00415-014-7449-x

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  • DOI: https://doi.org/10.1007/s00415-014-7449-x

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