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Brain Advance Access originally published online on March 5, 2008
Brain 2008 131(4):1025-1034; doi:10.1093/brain/awn035
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© The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Unilateral vestibular failure suppresses cortical visual motion processing

Angela Deutschländer1, Katharina Hüfner1, Roger Kalla1, Thomas Stephan1, Thomas Dera1, Stefan Glasauer1,2, Martin Wiesmann3, Michael Strupp1 and Thomas Brandt1,2

1Department of Neurology, 2Bernstein Center for Computational Neuroscience and 3Department of Neuroradiology, Klinikum Grosshadern, Ludwig-Maximilians University, Marchioninistr. 15, 81377 Munich, Germany

Correspondence to: Angela Deutschländer, MD, Department of Neurology, Klinikum Grosshadern, Ludwig-Maximilians University, Marchioninistrasse 15, 81377 Munich, Germany E-mail: angela.deutschlaender{at}med.uni-muenchen.de

Patients with unilateral vestibular failure (UVF) experience oscillopsia (apparent motion of the visual scene) during rapid head movements due to increased retinal slip caused by vestibulo-ocular reflex impairment. Oscillopsia is always smaller than the net retinal slip and decreases over time in patients with acquired vestibular loss; this correlates with increased thresholds for visual motion detection and increased tolerance to retinal slip. We investigated the underlying cortical adaptive processes using visual motion stimulation during blood oxygen level-dependent (BOLD) fMRI. Optokinetic nystagmus was elicited in seven patients with right-sided and seven patients with left-sided unilateral vestibular neurectomy and in seven age- and gender-matched healthy controls. Patients showed diminished activation of bilateral visual cortex areas (including the motion-sensitive area MT/V5, cuneus, middle occipital, fusiform and lingual areas) and ocular motor regions compared to their controls during visual motion stimulation. Concurrent BOLD signal decreases of temporo-parietal and insular multisensory cortical areas occurred in controls and patients. The diminished activation of visual motion processing areas plausibly reflects an adaptive mechanism that suppresses distressing oscillopsia in patients with UVF and thereby stabilizes the perceived visual surroundings. This study provides for the first time neuroimaging evidence of suppressed cortical visual motion processing in patients with vestibulopathy.

Key Words: functional magnetic resonance imaging; optokinetic; motion perception

Abbreviations: BOLD, blood oxygen level-dependent; OKN, optokinetic nystagmus; UVF, unilateral vestibular failure; VOR, vestibulo-ocular reflex

Received October 4, 2007. Revised December 27, 2007. Accepted February 13, 2008.


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