Skip to content
2000
image of Preliminary Analysis of White Matter Fiber Tracts in Elderly Patients with Chronic Dizziness Using Automated Fiber Quantification

Abstract

Introduction

Dizziness is one of the most common symptoms in elderly patients. In this study, we investigated changes in white matter fiber bundles in elderly patients with chronic dizziness using Automated Fiber Quantification (AFQ) to explore correlations with clinical manifestations and to provide novel insights for diagnosis.

Methods

This prospective study consecutively enrolled patients aged ≥60 years with varying degrees of white matter hyperintensities (WMH) on cranial MRI from May 2023 to October 2024. Participants were divided into a dizziness group and a non-dizziness group. Clinical data were collected for both cohorts. WMH severity and distribution were graded using the Fazekas scale, while AFQ tracked 18 cerebral white matter tracts. Between-group differences in fractional anisotropy (FA) and mean diffusivity (MD) were analyzed using independent samples t-tests.

Results

A total of 42 elderly patients were enrolled, including 24 in the dizziness group (mean age: 65.71 ± 5.46 years; 12 males, 50.0%) and 18 in the non-dizziness group (mean age: 65.56 ± 4.49 years; 7 males, 38.9%). Multivariate logistic regression revealed a significant association between deep white matter hyperintensities (DWMH) and chronic unexplained dizziness (OR = 8.285, 95% CI = 1.355–50.636, = 0.022). AFQ demonstrated significantly reduced FA in the dizziness group within the left corticospinal tract, the greater occipital fasciculus, the left inferior fronto-occipital fasciculus, and the left arcuate fasciculus ( < 0.01). Conversely, MD was elevated in the left corticospinal tract, the large callosal clamp, the left and right inferior fronto-occipital fasciculi, the left superior longitudinal fasciculus, and the right arcuate fasciculus ( < 0.01).

Discussion

Our findings highlight that DWMH are closely linked to chronic dizziness in the elderly, and AFQ enables precise localization of microstructural damage in specific white matter tracts. These neuroimaging findings provide novel insights into the pathological mechanisms underlying chronic dizziness and offer potential imaging markers for clinical diagnosis. However, the cross-sectional design and single-center sample limit the generalization of the results, emphasizing the need for further multicenter longitudinal studies.

Conclusion

DWMH correlates with chronic dizziness in elderly patients. AFQ can identify the degree and location of white matter microstructural damage, providing new insights for clinical diagnosis and treatment.

© 2026 Bentham Science Publishers
Loading

Article metrics loading...

/content/journals/cnr/10.2174/0115672026406713251201063504
2026-01-15
2026-01-26

  • From This Site

    /content/journals/cnr/10.2174/0115672026406713251201063504
    dcterms_title,dcterms_subject,pub_keyword
    -contentType:Contributor -contentType:Concept -contentType:Institution
    10
    5
Loading full text...

Full text loading...

References

  1. Neuhauser H.K. The epidemiology of dizziness and vertigo. Handb. Clin. Neurol. 2016 137 67 82 10.1016/B978‑0‑444‑63437‑5.00005‑4 27638063
    [Google Scholar]
  2. Stroke and Vertigo Branch of Chinese Stroke Association, Vertigo Professional Committee of Neurology Physicians Branch of Chinese Medical Doctor Association Ju Y Multidisciplinary expert consensus on the diagnosis and treatment of dizziness/vertigo in the elderly (2021). Chinese Journal of Geriatrics 2021 40 10 13 10.3760/cma.j.issn.0254‑9026.2021.10.001
    [Google Scholar]
  3. Zamyslowska-Szmytke E. Politanski P. Jozefowicz-Korczynska M. Dizziness handicap inventory in clinical evaluation of dizzy patients. Int. J. Environ. Res. Public Health 2021 18 5 2210 10.3390/ijerph18052210 33668099
    [Google Scholar]
  4. Zhang L. Wang Y. Li J. Vertigo as a clinical marker for vertebrobasilar stroke: A retrospective cohort study. Biomedicines 2022 10 11 2830 36359352
    [Google Scholar]
  5. Wang H. Chen X. Zhao Y. Prognostic significance of posterior circulation ischemia in acute ischemic stroke. Stroke Res. Treat. 2023 2023 5487192
    [Google Scholar]
  6. Bronstein A.M. Kattah J. Vascular neuro-otology: Vestibular transient ischemic attacks and chronic dizziness in the elderly. Curr. Opin. Neurol. 2024 37 1 59 65 10.1097/WCO.0000000000001229 38032270
    [Google Scholar]
  7. Fazekas F. Chawluk J.B. Alavi A. Hurtig H.I. Zimmerman R.A. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am. J. Roentgenol. 1987 149 2 351 356 10.2214/ajr.149.2.351 3496763
    [Google Scholar]
  8. Rensma S.P. van Sloten T.T. Launer L.J. Stehouwer C.D.A. Cerebral small vessel disease and risk of incident stroke, dementia and depression, and all-cause mortality: A systematic review and meta-analysis. Neurosci. Biobehav. Rev. 2018 90 164 173 10.1016/j.neubiorev.2018.04.003 29656031
    [Google Scholar]
  9. Wardlaw J.M. Smith C. Dichgans M. Small vessel disease: Mechanisms and clinical implications. Lancet Neurol. 2019 18 7 684 696 10.1016/S1474‑4422(19)30079‑1 31097385
    [Google Scholar]
  10. Smith E.E. Seshadri S. Beiser A. Metabolic syndrome and brain white matter integrity in community-dwelling elders. Neurology 2019 92 11 e1234 e1243
    [Google Scholar]
  11. Lee H.J. Kim J.S. Park J.H. White matter hyperintensities, cognitive function, and metabolic syndrome in older adults: A cross-sectional study. J. Gerontol. A Biol. Sci. Med. Sci. 2021 76 5 864 870
    [Google Scholar]
  12. Cerchiai N. Mancuso M. Navari E. Giannini N. Casani A.P. Aging with cerebral small vessel disease and dizziness: The importance of undiagnosed peripheral vestibular disorders. Front. Neurol. 2017 8 241 10.3389/fneur.2017.00241 28626444
    [Google Scholar]
  13. Ibitoye R.T. Castro P. Cooke J. A link between frontal white matter integrity and dizziness in cerebral small vessel disease. Neuroimage Clin. 2022 35 103098 10.1016/j.nicl.2022.103098 35772195
    [Google Scholar]
  14. Chen J. Zhang H. Xu F. Correlation between unexplained dizziness and cerebral small vessel disease in the elderly. Chin J Pract Neurol Dis 2022 25 06 736 740
    [Google Scholar]
  15. Grant M. Liu J. Wintermark M. Bagci U. Douglas D. Current state of diffusion-weighted imaging and diffusion tensor imaging for traumatic brain injury prognostication. Neuroimaging Clin. N. Am. 2023 33 2 279 297 10.1016/j.nic.2023.01.004 36965946
    [Google Scholar]
  16. Liu S. Liu Y. Xu X. Accelerated cardiac diffusion tensor imaging using deep neural network. Phys. Med. Biol. 2023 68 2 025008 10.1088/1361‑6560/acaa86 36595239
    [Google Scholar]
  17. Yi J.U. Xiquan Z.H.A.O. A review: The diagnostic and therapeutic ideas and methods of chronic dizziness. J Stroke Neurol Dis 2023 40 11 963 966
    [Google Scholar]
  18. Peluso E.T. Quintana M.I. Ganança F.F. Anxiety and depressive disorders in elderly with chronic dizziness of vestibular origin. Rev. Bras. Otorrinolaringol. 2016 82 2 209 214 26515771
    [Google Scholar]
  19. Zhao H. Liu Z. Wei W. Clinical study on the relationship between severity of cerebral small vessel disease and dizziness. Chin J Evid-Based Cardiovasc Med 2017 9 12 1433 1435
    [Google Scholar]
  20. Prell T. Mendorf S. Axer H. Tolerance to dizziness intensity increases with age in people with chronic dizziness. Front. Neurol. 2022 13 934627 10.3389/fneur.2022.934627 35911923
    [Google Scholar]
  21. Dimitriadis P.A. Saad M. Igra M.S. White matter lesions in magnetic resonance imaging of the brain in 56 patients with visual vertigo. J. Laryngol. Otol. 2018 132 6 550 553 10.1017/S0022215118000701 30019667
    [Google Scholar]
  22. Ahmad H. Cerchiai N. Mancuso M. Casani A.P. Bronstein A.M. Are white matter abnormalities associated with “unexplained dizziness”? J. Neurol. Sci. 2015 358 1-2 428 431 10.1016/j.jns.2015.09.006 26412160
    [Google Scholar]
  23. Alber J. Alladi S. Bae H.J. White matter hyperintensities in vascular contributions to cognitive impairment and dementia (VCID): Knowledge gaps and opportunities. Alzheimers Dement. 2019 5 1 107 117 10.1016/j.trci.2019.02.001 31011621
    [Google Scholar]
  24. Ghanavati T. Smitt M.S. Lord S.R. Deep white matter hyperintensities, microstructural integrity and dual task walking in older people. Brain Imaging Behav. 2018 12 5 1488 1496 10.1007/s11682‑017‑9787‑7 29297156
    [Google Scholar]
  25. van der Holst H.M. Tuladhar A.M. Zerbi V. White matter changes and gait decline in cerebral small vessel disease. Neuroimage Clin. 2018 17 731 738 10.1016/j.nicl.2017.12.007 29270357
    [Google Scholar]
  26. Smith L.J. Wilkinson D. Bodani M. Surenthiran S.S. Cognition in vestibular disorders: State of the field, challenges, and priorities for the future. Front. Neurol. 2024 15 1159174 10.3389/fneur.2024.1159174 38304077
    [Google Scholar]
  27. Promjunyakul N. Dodge H.H. Lahna D. Baseline NAWM structural integrity and CBF predict periventricular WMH expansion over time. Neurology 2018 90 24 e2119 e2126 10.1212/WNL.0000000000005684 29769375
    [Google Scholar]
  28. Kirsch V. Keeser D. Hergenroeder T. Structural and functional connectivity mapping of the vestibular circuitry from human brainstem to cortex. Brain Struct. Funct. 2016 221 3 1291 1308 10.1007/s00429‑014‑0971‑x 25552315
    [Google Scholar]
  29. Kaski D. Rust H.M. Ibitoye R. Arshad Q. Allum J.H.J. Bronstein A.M. Theoretical framework for “unexplained” dizziness in the elderly: The role of small vessel disease. Prog Brain Res 2019 248 225 40 10.1016/bs.pbr.2019.04.009] 31239134
    [Google Scholar]
  30. Pasi M. van Uden I.W.M. Tuladhar A.M. de Leeuw F.E. Pantoni L. White matter microstructural damage on diffusion tensor imaging in cerebral small vessel disease. Stroke 2016 47 6 1679 1684 10.1161/STROKEAHA.115.012065 27103015
    [Google Scholar]
/content/journals/cnr/10.2174/0115672026406713251201063504
Loading
Preliminary Analysis of White Matter Fiber Tracts in Elderly Patients with Chronic Dizziness Using Automated Fiber Quantification
Bentham Science Publishers ; https://doi.org/10.2174/0115672026406713251201063504
/content/journals/cnr/10.2174/0115672026406713251201063504
/content/journals/cnr/10.2174/0115672026406713251201063504
Loading

Data & Media loading...


  • Article Type:     Research Article
Keywords: Chronic dizziness ; neuroimaging markers ; cerebral small vessel disease ; automated fiber quantification ; white matter hyperintensities ; diffusion tensor imaging

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error
Please enter a valid_number test