Correlation of idiopathic benign paroxysmal positional vertigo with cerebral small vessel disease

Ting Yu; Hui Zhang; Yong-Mei Yan; Yan-Ni Liu; Xiao-Feng Huang; Sen Qiao; Qi Yang; Peng Li; Ruo-Chen Jiang; Dai-Chao Ma

doi:10.1016/j.ajem.2023.09.048

Correlation of idiopathic benign paroxysmal positional vertigo with cerebral small vessel disease

Am J Emerg Med. 2023 Dec:74:140-145. doi: 10.1016/j.ajem.2023.09.048. Epub 2023 Oct 6.

Authors

Ting Yu¹, Hui Zhang¹, Yong-Mei Yan¹, Yan-Ni Liu², Xiao-Feng Huang², Sen Qiao¹, Qi Yang³, Peng Li³, Ruo-Chen Jiang⁴, Dai-Chao Ma⁵

Affiliations

¹ The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China.
² Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China.
³ Department of Radiology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China.
⁴ The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China.
⁵ The First School of Clinical Medicine, Shaanxi University of Chinese Medicine, China; Department of Neurology, Affiliated Hospital of Shaanxi University of Chinese Medicine, China. Electronic address: madaichao@hotmail.com.

PMID: 37837822
DOI: 10.1016/j.ajem.2023.09.048

Abstract

Background: Benign paroxysmal positional vertigo (BPPV) is the most prevalent form of peripheral vertigo, with vascular lesions being one of its suspected causes. The older adults are particularly vulnerable to BPPV. Cerebral small vessel disease (CSVD), on the other hand, is a clinical condition that results from damage of cerebral small vessels. Vascular involvement resulting from age-related risk factors and proinflammatory state may act as the underlying factor linking both BPPV and CSVD.

Aim: The objective of this study is to explore the potential correlation between BPPV and CSVD by examining whether individuals aged 50 and older with BPPV exhibit a greater burden of CSVD.

Materials and methods: This retrospective study included patients aged 50 years and older who had been diagnosed with BPPV. A control group consisting of patients diagnosed with idiopathic facial neuritis (IFN) during the same time period was also included. The burden of cerebral white matter hyperintensities (WMHs) was evaluated using the Fazekas scale. An ordinal regression analysis was conducted to investigate the potential correlation between BPPV and WMHs.

Results: The study included a total of 101 patients diagnosed with BPPV and 116 patients with IFN. Patients with BPPV were found to be significantly more likely (OR = 2.37, 95% CI 1.40-4.03, p = 0.001) to have a higher Fazekas score compared to the control group. Brain infarctions, hypertension, and age were all identified as significant predictors of white matter hyperplasia on MRI, with OR of 9.9 (95% CI 4.21-24.84, P<0.001), 2.86 (95% CI 1.67-5.0, P<0.001), and 1.18 (95% CI 1.13-1.22, P<0.001) respectively.

Conclusion: Our findings suggest that vascular impairment caused by age-related risk factors and proinflammatory status may be contributing factors to the development of BPPV in individuals aged 50 and above, as we observed a correlation between the suffering of BPPV and the severity of WMHs.

Keywords: Benign paroxysmal positional vertigo; Cerebral small vessel disease; Etiology; MRI; White matter hyper intensities.

MeSH terms

Age Factors
Aged
Benign Paroxysmal Positional Vertigo* / diagnosis
Benign Paroxysmal Positional Vertigo* / etiology
Cerebral Small Vessel Diseases* / complications
Cerebral Small Vessel Diseases* / diagnostic imaging
Humans
Middle Aged
Retrospective Studies
Risk Factors