Research Article

Vestibular-limbic relationships Brain mapping

Paolo Gamba*

Published: 03/16/2018 | Volume 2 - Issue 1 | Pages: 007-013


Vestibular disorders and anxiety are closely related, probably because they share some neuronal pathways. Ageing and patient comorbidities are important facilitating factors, and multiple vascular risk factors could contribute to the onset of a vestibular syndrome called vascular vertigo. White matter lesions (WML) are often seen on magnetic resonance imaging (MRI) scans of elderly people and are related to various geriatric disorders, including dizziness. The cause of this correlation could be the disruption of neuronal networks that mediate higher vestibular cortical function. Numerous neuronal pathways link the vestibular network with limbic structures and the prefrontal cortex modulates anxiety through its connections to amygdala. The aim of the present work was to investigate the correlation between WML, amygdala and cognitive functions.

Read Full Article HTML DOI: 10.29328/journal.ida.1001006 Cite this Article


  1. Brandt T, Strupp M, Dieterich M. Towards a concept of disorders of "higher vestibular function". Front Integr Neurosci. 2014; 8: 47. Ref.:
  2. Teggi R, Caldirola D, Perna G, Bellodi L, Bussi M. Vestibular testing in patient with panic disorders and chronic dizziness. Acta Otorhinolaryngol Ital. 2007; 27: 243-247. Ref.:
  3. Simon NM, Pollack MH, Tuby KS, Stern TA. Dizziness and panic disorders: a review of the association between vestibular dysfunction and anxiety. Ann Clin Psychiatry. 1998; 10: 75-80. Ref.:
  4. Lindgren A, Roijer A, Rudling O, Norrving B, Larsson EM, et al. Cerebral lesions on magnetic resonance imaging, heart disease, and vascular risk factors in subjects without stroke. A population-based study. Stroke. 1994; 25: 929-934. Ref.:
  5. Manolio TA, Kronmal RA, Burke GL, Poirier V, O'Leary DH, et al. Magnetic resonance abnormalities and cardiovascular disease in older adults. The Cardiovascular Health Study. Stroke. 1994; 25: 318-327. Ref.:
  6. Longstreth WT Jr., Manolio TA, Arnold A, Burke GL, Bryan N, et al. Clinical correlates of white matter ļ¬ndings on cranial magnetic resonance imaging of 3301 elderly people. The Cardiovascular Health Study. Stroke. 1996; 27: 1274-1282. Ref.:
  7. Liao D, Cooper L, Cai J, Toole J, Bryan N, et al. The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: the ARIC Study. Neuroepidemiology. 1997; 16: 149-162. Ref.:
  8. Guidetti G. The role of cognitive processes in vestibular disorders. Hearing, Balance and Communication. 2013; 11: 3-35. Ref.:
  9. Monzani D, Casolari L, Guidetti G, Rigatelli M. Psychological distress and disability in patient with vertigo. J Psychosom Res. 2001; 50: 319-323. Ref.:
  10. Carmeli E. Anxiety in the Elderly Can be a Vestibular Problem. Front Public Health. 2015; 3: 216. Ref.:
  11. Colledge N, Lewis S, Mead G, Sellar R, Wardlaw J, et al. Magnetic resonance brain imaging in people with dizziness: a comparison with non-dizzy people. J Neurol Neurosurg Psychiatry. 2002; 72: 587-589. Ref.:
  12. Gufoni M, Guidetti G, Nuti D, Pagnini P, Vicini C, et al. The relationship between cognitive impairment, anxiety-depression symptoms and balance and spatial orientation complaints in the elderly. Acta Otorhinolaryngol Ital. 2005; 25: 12-21. Ref.:
  13. Guidetti G. La terapia della vertigine vascolare nella pratica ambulatoriale: esperienza multicentrica (Studio VascVert). Otorinolaringol. 2005; 55: 237-246.
  14. Maillard P, Fletcher E, Harvey D, Carmichael O, Reed B, et al. White matter hyperintensity penumbra. Stroke. 2011; 42: 1917-1922. Ref.:
  15. Kim KW, MacFall JR, Payne ME. Classification of white matter lesions on magnetic resonance imaging in elderly persons. Biol Psychiatry. 2008; 15: 273-280. Ref.:
  16. Ruckenstein MJ, Staab JP. Chronic Subjective Dizziness. Otolaryngol Clin N Am. 2009; 42: 71-77. Ref.:
  17. Ott A, Breteler MM, van Harskamp F, Stijnen T, Hofman A. Incidence and risk of dementia. The Rotterdam study. Am J Epidemiol. 1998; 147: 574-580. Ref.:
  18. Vermeer SE, Prins ND, den Heijer T, Hofman A, Koudstaal PJ, et al. Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med. 2003; 348: 1215-1222. Ref.:
  19. Matsusue E, Sugihara S, Fujii S, Ohama E, Kinoshita T, et al. White matter changes in elderly people: MR-pathologic correlations. Magn Reson Med Sci. 2006; 5: 99-104. Ref.:
  20. de Leeuw FE, de Groot JC, Bots ML, Witteman JC, Oudkerk M, et al. Carotid atherosclerosis and cerebral white matter lesions in a population based magnetic resonance imaging study. J Neurol. 2000; 247: 291-296. Ref.:
  21. Debette S, Markus HS. The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2010; 341: c3666. Ref.:
  22. Benisty S, Gouw AA, Porcher R, Madureira S, Hernandez K, et al. Location of lacunar infarcts correlates with cognition in a sample of non-disabled subjects with age-related white-matter changes: the LADIS study. J Neurol Neurosurg Psychiatry. 2009; 80: 478-483. Ref.:
  23. Gong L, Liu XY, Fang M. Recent progress on small vessel disease with cognitive impairment. Int J Clin Exp Med. 2015; 8: 7701-7709. Ref.:
  24. Wardlaw JM, Smith EE, Biessels GJ, Cordonnier C, Fazekas F, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. Lancet Neurol. 2013; 12: 822-838. Ref.:
  25. Baloh RW, Yue Q, Socotch TM, Jacobson KM. White matter lesions and disequilibrium in older people. I. Case-control comparison. Arch Neurol. 1995; 52: 970-974. Ref.:
  26. Ahmad H, Cerchiai N, Mancuso M, Casani AP, Bronstein AM. Are white matter abnormalities associated with "unexplained dizziness"?. J Neurol Sci. 2015; 358: 428-431. Ref.:
  27. Mattana P, Mannello F, Ferrari P, Augus GB. Vascular pathologies and inflammation: the anti-inflammatory properties of Sulodexide. J Vasc Endovasc Surg. 2012; 19: 1-7. Ref.:
  28. McGaugh JL. The amygdala modulates the consolidation of memories of emotionally arousing experiences. Annu Rev Neuroaci. 2004; 27: 1-28. Ref.:
  29. Fioresco SB, Tse MT. Dopaminerg regulation of inhibitory and excitatory transmission in the basolateral amygdala-prefrontal cortical pathway. J Neurosci. 2007; 27: 2045-2057. Ref.:
  30. Britton JC, Taylor SF, Sudheimer KD, Liberzon I. Facial expressionsand complex IAPS pictures: common and differential networks. Neuroimage. 2006; 31: 906-919. Ref.:
  31. Doyère V, Debiec J, Monfils MH, Schafe GE, Le Doux JE. Synapse-specific reconsolidation of distinct fear memories in the latral amygdala. Nat Neurosci. 2007; 10: 4-6. Ref.:
  32. Nader K, Schafe GE, Le Doux JE. Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval. Nature. 2000; 406: 722-726. Ref.:
  33. Whalen PJ, Kagan J, Cook RG, Davis FC, Kim H, et al. Human amygdala responsivity to masked fearful eye whites. Science. 2004; 306: 2061. Ref.:
  34. Kilts CD, Egan G, Gideon DA, Ely TD, Hoffman JM. Dissociable neural pathways are involved in the recognition of emotion in static and dynamic facial expressions. Neuroimage. 2003; 18: 156-168. Ref.:
  35. Morrys JS, Friston Kj, Buchel C, Frith CD, Young AW, et al. A neuromodulatory role for the human amygdala in processing emotional facial expressions. Brain. 1998; 121: 47-57. Ref.:
  36. Kilts CD, Kelsey JE, Knight B, Ely TD, Bowman FD, et al. The neuronal correlates of social anxiety disorder and response to pharmacotherapy. Neuropsychopharmacology. 2006; 31: 2243-2253. Ref.:
  37. Brandt T, Dieterich M. The vestibular cortex. Its locations, functions, and disorders. Ann N Y Acad Sci. 1999; 871: 293-312. Ref.:
  38. Marcelli V, Esposito F, Aragri A, Furia T, Riccardi P, et al. Spatio-temporal pattern of vestibular information processing after brief caloric stimulation. Eur J Radiol. 2009; 70: 312-316. Ref.:
  39. Kim B, Kim JH, Kim MK, Lee KS, Kim Y, et al. Frontal white matter alterations in short-term medicated panic disorder patients without comorbid conditions: a diffusion tensor imaging study. PLoS One. 2014; 9: e95279. Ref.: