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Structural brain changes following peripheral vestibulo-cochlear lesion may indicate multisensory compensation
  1. Christoph Helmchen1,
  2. Jan C Klinkenstein1,
  3. Alexandra Krüger2,
  4. Jan Gliemroth3,
  5. Christian Mohr4,
  6. Thurid Sander1
  1. 1Neuroimage Nord, Department of Neurology, University of Lübeck, Lübeck, Germany
  2. 2Department of Otolaryngology, University of Lübeck, Lübeck, Germany
  3. 3Department of Neurosurgery, University of Lübeck, Lübeck, Germany
  4. 4Institute of Neuroradiology, University of Lübeck, Lübeck, Germany
  1. Correspondence to Professor Christoph Helmchen, Neuroimage Nord & Department of Neurology, University Hospitals Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck D-23538, Germany; christoph.helmchen{at}


Background Do central mechanisms account for the variability of clinical recovery following peripheral vestibulo-cochlear lesions?

Objective To investigate structural (morphological) plasticity in the human brain following unilateral vestibulo-cochlear lesions which might contribute to central vestibular compensation.

Methods The authors compared regional grey matter volume (GMV) changes in patients after surgical removal of unilateral acoustic neuroma with age-matched control subjects, and hypothesised morphometric changes in the vestibular and auditory cortices which may be related to functional disability scores. Patients were examined with a battery of neuro-otological tests and clinical scores to assess vestibular and auditory disability.

Results Voxel-based morphometry was used for categorical comparison between patients and age- and gender-matched controls. GMV increase was found bilaterally in primary somatosensory cortices and motion-sensitive areas in the medial temporal gyrus (MT). Simple regression analysis revealed a GMV increase (1) in the contralesional superior temporal gyrus/posterior insula to be correlated with decreasing clinically assessed vestibular deficits; (2) in the contralesional inferior parietal lobe with decreasing functional impairment of daily living activities; and (3) in the contralesional auditory cortex (Heschl gyrus) with decreasing hearing impairment.

Conclusions These data may suggest structural cortical plasticity in multisensory vestibular cortex areas of patients with unilateral peripheral vestibulo-cochlear lesion after surgical removal of acoustic neuroma. As changes of GMV were related to vestibular function, structural brain changes may reflect central mechanisms of vestibular compensation.

  • Vestibular lesion
  • vestibular compensation
  • voxel-based morphometry
  • neurootology
  • vertigo

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  • Funding TS was supported by a research grant E04-2009 from the University of Lübeck.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the University Lübeck.

  • Provenance and peer review Not commissioned; externally peer reviewed.