Effect of canalith repositioning on resting-state brain functional connectivity in patients with benign paroxysmal positional vertigo.
Frontiers in neurology January 1, 2025 Wenjia He, Xinyu Lyu, Hui Zhang et al.
In people with benign paroxysmal positional vertigo (BPPV), resting-state functional connectivity (FC) between brain regions involved in vestibular, motor, and sensory processing is abnormally elevated compared to healthy controls. After a canalith repositioning maneuver, whole-brain average FC strength decreased significantly, and connectivity between specific region pairs—including prefrontal cortex, occipital cortex, middle temporal gyrus, motor cortex, and somatosensory cortex—returned to normal levels. Clinical symptoms also improved: the Dizziness Handicap Inventory score dropped by 23.4% and the Visual Analogue Scale score showed a significant reduction. The findings suggest BPPV involves compensatory enhancement of the vestibulo-sensorimotor network, and that repositioning therapy restores pathologically enhanced FC to normal, supporting functional near-infrared spectroscopy as a potential objective biomarker for evaluating BPPV neural mechanisms and treatment efficacy.