Vestibular cortex assessment using DTI & MRS complemented by rotatory chair technique in vestibulopathy patients with normal appearing brain MRI

Abstract

Purpose: To evaluate the role of DTI & MRS complemented by rotatory chair technique in vestibular cortex assessment in vestibulopathy patients with normal brain MRI. Patient & method: The study was carried on 40 persons, 15 control group and 25 study group. Their age ranging from (50–75) years, they all subjected to Conventional MRI, Diffusion tensor imaging and MRS of the right operculum. Results: 5 cases gave very low gain with immeasurable phase and symmetry. They show abnormal MRI finding and were excluded from our study, 20 cases showed low gain with measurable levels of phase & symmetry. 15 cases show high level of asymmetry with DTI results as follow decreased FA in cerebellar peduncle (3 cases) right operculum (7 cases) denoting central affection, 5 cases showed normal DTI making it most probably peripheral vestibular affection variable level of asymmetry were seen in 5 patients, combined decreased FA in cerebellar peduncles & right operculum with thinning of the CST (2 cases), combined decreased FA in cerebellar peduncles & right operculum without thinning of the CST (1 cases), right operculum affection associated with thinning of the CST (2 case). Decreased NAA & NAA/Cr was seen in 5 patients. Conclusion: Combined radiological & audiological examinations are advised for evaluation of the problematic vestibulopathy to differentiate whether the cause is central and/or peripheral injury. Keywords: DTI, Vestibulopathy, Fraction anisotropy