Altered brain metabolism in vestibular migraine: comparison of interictal and ictal findings.

BACKGROUND: Vestibular symptoms/signs frequently coexist with migraine, but the mechanisms of migraine-related vestibular dysfunction remain to be elucidated. This study aimed to determine altered brain metabolism in vestibular migraine. METHODS: Two patients with vestibular migraine underwent (18)F-fluorodeoxy glucose (FDG) positron-emission tomography (PET) during and between attacks of vestibular migraine in addition to detailed neurotological evaluation. We analyzed the regional brain metabolism of the patients in comparison with that of age-matched healthy controls in each patient. We also compared ictal with interictal FDG PET using a subtraction method. RESULTS: During the attacks, both patients showed an activation of the bilateral cerebellum and frontal cortices, and deactivation of the bilateral posterior parietal and occipitotemporal areas. One patient also showed hypermetabolism in the dorsal pons and midbrain, right posterior insula, and right temporal cortex while the other patient had an additional activation of the left temporal cortex. Compared with interictal images, ictal PET showed increased metabolism in the bilateral cerebellum, frontal cortices, temporal cortex, posterior insula, and thalami. CONCLUSION: During the attacks of vestibular migraine, the increased metabolism in the temporo-parieto-insular areas and bilateral thalami indicates activation of the vestibulo-thalamo-cortical pathway, and decreased metabolism in the occipital cortex may represent reciprocal inhibition between the visual and vestibular systems.

Comparative assessment of parametric neuroreceptor mapping approaches based on the simplified reference tissue model using [¹¹C]ABP688 PET.

In recent years, several linearized model approaches for fast and reliable parametric neuroreceptor mapping based on dynamic nuclear imaging have been developed from the simplified reference tissue model (SRTM) equation. All the methods share the basic SRTM assumptions, but use different schemes to alleviate the effect of noise in dynamic-image voxels. Thus, this study aimed to compare those approaches in terms of their performance in parametric image generation. We used the basis function method and MRTM2 (multilinear reference tissue model with two parameters), which require a division process to obtain the distribution volume ratio (DVR). In addition, a linear model with the DVR as a model parameter (multilinear SRTM) was used in two forms: one based on linear least squares and the other based on extension of total least squares (TLS). Assessment using simulated and actual dynamic [(11)C]ABP688 positron emission tomography data revealed their equivalence with the SRTM, except for different noise susceptibilities. In the DVR image production, the two multilinear SRTM approaches achieved better image quality and regional compatibility with the SRTM than the others, with slightly better performance in the TLS-based method.