White Matter Hyperintensities (WMH) and clinical outcome after vestibular neuritis

ABSTRACT

Objectives

Identification of patients at high risk for chronic dizziness after Vestibular Neuritis (VN) would allow these patients to be the target of focused therapies. However, there is a discrepancy between studies with regard to which factors best predict symptom recovery. The present study provides a comprehensive evaluation of Vestibular Neuritis and the major predictors for the development of chronic vestibular insufficiency.

Methods

All subjects (n = 54) with acute vestibular neuritis admitted to the Department of Neurology of Beijing Luhe Hospital affiliated to Capital Medical University from 2018 to 2020 were retrospectively identified . Forty-three subjects who received a 4-test battery as well as 3.0T brain MRI, were included in the study. Patients were divided into two groups: Group 1 with complete recovery and Group 2 without recovery, as determined by symptoms 3 months after the VN episode. In addition, we recruited 21 healthy subjects to characterize the profiles of acute VN .

Results

The total WMH score negatively correlated with a clinical recovery (Phi coefficient = −0.808, p value = 0.000). Statistical regression for predicting the outcome of clinical recovery using cerebral white matter changes as an independent variable was significant (p = 0.004). However, clinical recovery was not associated with the nerve divisions (Phi coefficient = 0.108, p = 0.492), age (p = 0.247) and the grade of nystagmus (p = 0.797)   .

Conclusions

A 4-test battery provides essential information to identify vestibular nerve dysfunction. Cerebral white matter change on MRI was predictive of chronic vestibular insufficiency after vestibular neuritis.

KEYWORDS:

• Vestibular neuritis
• chronic vestibular insufficiency
• vertigo

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.

Notes on contributors

Huimin Fan

Huimin Fan, an attending physician of department of Neurology, Beijing Luhe Hospital, Capital Medical University, She graduated from Capital Medical University. She mainly focus on the clinical and research work of the vertigo diseases and cerebral small vessel diseases.

Jing Feng, an associate chief physician of department of Neurology, Beijing Luhe Hospital, Capital Medical University, has been engaged in the research of the vertigo diseases.

Jing Feng

Jing Feng, an associate chief physician of department of Neurology, Beijing Luhe Hospital, Capital Medical University, has been engaged in the research of the vertigo diseases.

Melissa Wills

Melissa Wills, a medical student at Wayne State University School of Medicine (USA), and student researcher within the Department of Neurosurgery. She obtained her Bachelor of Science at the University of Notre Dame (USA).

Liying Wang

Liying Wang, a medical technician of department of Neurology, Beijing Luhe Hospital, Capital Medical University. She has long been engaged in the analyses and carry out the vestibular function test.

Xiaomeng Chen

Xiaomeng Chen, a medical residents of department of Neurology, Beijing Luhe Hospital, Capital Medical University. She has been engaged in the research of the vertigo diseases.

Xiaokun Geng

Xiaokun Geng, a chief physician, and the department chairman of Neurology, Beijing Luhe Hospital, Capital Medical University. He has engaged in neurovascular intervention and the mechanism of cerebral and drug protection in stroke. In the past five years, he has published more than 80 SCI, which are all in mainstream academic journals exerting international influence in his professional field.

Yuchuan Ding

Yuchuan Ding is a professor of Neurosurgery, Wayne State University School of Medicine (USA) where he is a principal investigator of the Merit Review Award (I01RX-001964-01) from the US Department of Veterans Affairs Rehabilitation R&D Service. In the past five years, he has published more than 150 SCI, which are all in mainstream academic journals exerting international influence in his professional field.