AUTHOR=Devantier Louise , Hansen Allan K. , Mølby-Henriksen Jens-Jacob , Pedersen Michael , Borghammer Per , Ovesen Therese , Magnusson Måns 

TITLE=Cortical Activity During an Attack of Ménière's Disease—A Case Report

JOURNAL=Frontiers in Neurology

VOLUME=Volume 12 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.669390

DOI=10.3389/fneur.2021.669390

ISSN=1664-2295

ABSTRACT=Background 
Menière's disease (MD) is a chronic peripheral vestibular disease with recurrent episodes of vertigo accompanied by fluctuating hearing loss with hyperacusis, tinnitus and aural fullness in the affected ear. There are several unanswered fundamental questions regarding MD, one of these being cortical activity during a MD attack.  However, it is not possible to plan an investigation in an episodic disease as MD.
Objective
To visualize cortical activity during an attack of MD.  
Method
A 18F-FDG PET scans was used to visualize cortical activity in a 62 years old male suffering from definite MD. Two 18F-FDG PET scan were performed. One to show activity during the attack and one to show normal baseline brain activity 7 days after the attack. 
Results
A number of low-magnitud fluctuations in the 18F-FDG FDG uptake were found in 18F-FDG PET examination following the MD attack compared to the patient’s own baseline 18F-FDG FDG scan.  Across both hemispheres no significant changes were seen. However, reduced activity of low magnitude was observed in most of the orbitofrontal, frontal cortices as well as Heschl’s gyrus and insula. 
Conclusion
This is the first neuroimaging showing alteration of brain activity during an attack in a patient with MD. Although, no strong focal alterations was seen. It is noteworthy that the decreased activity observed was in the insula and Heschl’s gyrus that can be perceived as core areas for processing information from the labyrinth. It is also of interest that decrease activity rather than hyperactivity was observed.