Vestibular nucleus-thalamus-cortex pathway abnormalities persist in patients with chronic unilateral vestibulopathy after the establishment of vestibular static compensation

Background: After vestibular impairment, the body undergoes static and dynamic compensation. Static compensation is characterized by the resolution of spontaneous nystagmus, indicating rebalanced bilateral vestibular nuclei activity. It remains unclear whether ascending vestibular projections remain abnormal thereafter. This study investigated abnormal functional activity along vestibular nucleus-thalamus-cortex projection pathways in chronic unilateral vestibulopathy (CUVP) after static compensation using degree centrality (DC) and functional connectivity (FC) analyses. Methods: In total, 25 CUVP patients and 25 age- and sex-matched healthy controls underwent resting-state functional magnetic resonance imaging (fMRI). The DC analysis identified abnormal functional activity in vestibular nucleus-thalamus-cortex pathways, particularly in the subcortical structures. The seed-based FC analyses used eight seeds (the bilateral vestibular nuclei, and the bilateral pulvinar, mediodorsal, and ventrolateral ventral thalamic regions) with 10,000 non-parametric permutations and a cluster-level family-wise error rate (FWER)-corrected threshold of P