持续性姿势-知觉性头晕（PPPD）患者在引发异常自我运动感知的各种视觉运动刺激下的脑激活
Brain activation in persistent postural-perceptual dizziness (PPPD) in response to various visual motion stimuli eliciting abnormal egomotion perception.
文献信息
| PMID | 42815133 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Renana Storm |
| 作者单位 | University of Luebeck, Department of Neurology, Ratzeburger Allee 160, 23538 Lübeck, Germany; University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538 Lübeck, Germany; Center of Brain, Behavior and Metabolism (CBBM), Marie-Curie-Straße, 23562 Luebeck, Germany. Electronic address: renana.storm@uni-luebeck.de. |
| 期刊 | NeuroImage. Clinical |
| SCI 分区 | Q1 |
| IF | 4.6 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
背景： 持续性姿势-知觉性头晕（PPPD）患者会感知到与异常自我运动或视觉运动感知相关的不稳感。我们测试了PPPD患者和健康受试者（HC）在施加各种视觉运动刺激（VS）时的功能性脑激活改变。
方法： 使用3种VS视频检查了32名PPPD患者和35名年龄、性别匹配的HC的功能性脑激活：过山车前排乘坐（过山车，ROL）、光流（流场，FF）和无声黑白电影（电影，MOV）。固定中心目标作为静息（REST）条件。每次试验后，记录视觉诱导的自我运动感知水平。
结果： 患者对VS诱导的自我运动评分高于HC（ROL > FF > MOV）。所有参与者的脑激活在3种VS类型之间不同：ROL引发罗兰多盖（OP）和岛叶激活，FF引发小脑激活，MOV引发扣带回皮层和额盖激活。所有VS的全脑激活在患者视觉皮层中更大。感兴趣区（ROI）分析揭示了前庭处理区域中相反的组相关激活模式：患者的激活在ROL和FF期间更大，但在MOV期间更低。OP2、岛叶和蚓垂的激活随着PPPD残疾程度和姿势摇摆（FF）的增加而变大。VS诱发的脑激活与自我运动感知无关。
结论： 患者在VS期间视觉皮层激活更大，支持异常视觉依赖这一PPPD核心特征的概念。然而，它似乎与异常自我运动感知无关。前庭处理区域的激活模式表明，患者对VS类型的区分比HC更强。这些区域中与VS相关的激活随着PPPD相关残疾而变大，支持对视觉自我运动诱导刺激的异常反应准备。
英文摘要
BACKGROUND: Patients with persistent postural-perceptual dizziness (PPPD) perceive unsteadiness associated with abnormal ego- or visual motion perception. We tested for altered functional brain activation of PPPD patients and healthy subjects (HC) while applying various visual motion stimuli (VS).
METHODS: Functional brain activation of 32 PPPD patients and 35 age- and gender-matched HC was examined using 3 types of VS-videos: a rollercoaster front row ride (rollercoaster, ROL), optic flow (flowfield, FF), and a silent black-and-white movie (movie, MOV). Fixation of a centered target was used as REST condition. After each trial, the level of visually induced egomotion perception was recorded.
RESULTS: Patients rated VS-induced egomotion larger than HC (ROL > FF > MOV). Brain activation differed between the 3 types of VS for all participants: ROL elicited activation in the Rolandic operculum (OP) and insula, FF in the cerebellum, and MOV in the cingulate cortex and frontal operculum. Whole brain activation for all VS was larger in the patients' visual cortex. Region of interest (ROI) analysis revealed opposite group-related activation patterns in vestibular processing areas: patient's activation was larger during ROL and FF but lower during MOV. Activation in OP2, insula, and uvula became larger with increasing PPPD-handicap and postural sway (FF). VS-evoked brain activation was not correlated with egomotion perception.
CONCLUSIONS: The larger activation in the patients' visual cortex during VS supports the notion of abnormal visual dependence, a core feature of PPPD. However, it does not seem to be related to abnormal egomotion perception. Activation patterns of vestibular processing areas suggest that patients differentiate between VS types stronger than HC. VS-related activation in these areas became larger with PPPD-related disability, supporting an abnormal readiness to respond to visual egomotion-inducing stimuli.