Abstract / Summary
Abstract Background Vestibular migraine (VM) is a common cause of recurrent vertigo and dizziness, yet the structural network alterations associated with its clinical burden remain incompletely understood. While previous neuroimaging studies have implicated sensory, vestibular and pain-related brain regions in VM, whether these abnormalities extend to the whole-brain white-matter connectome is unclear. Methods Thirty-four VM patients and 34 healthy controls (HC) underwent brain MRI including diffusion tensor imaging (DTI). White matter structural networks were reconstructed using deterministic tractography with the 90-region Automated Anatomical Labeling atlas. Between-group comparisons were performed on global and nodal network properties, and network-based statistical analysis was used to identify altered structural subnetworks. Partial correlation analyses assessed associations between altered network metrics and clinical variables. Results Both groups exhibited small-world organization. Compared with HC, VM patients showed lower local efficiency and clustering coefficient. Altered nodal properties involved vestibular, pain-related, default mode, visual, and subcortical regions, including the thalamus, anterior cingulate gyrus, angular gyrus, and putamen. Network-based statistical analysis identified abnormal subnetworks including the lingual gyrus, middle occipital gyrus, precuneus, hippocampus, thalamus, and putamen. Conclusions Vestibular migraine is associated with distributed white matter network reorganization involving vestibular, pain-processing, default mode, visual, and subcortical systems. These structural findings complement and extend prior functional evidence, suggesting that vestibular migraine involves system-level disruption of brain network architecture rather than dysfunction of a single region. Clinical trial number Not applicable.