ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Otology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1681447
Effect of canalith repositioning on resting-state brain functional connectivity in patients with benign paroxysmal positional vertigo
Provisionally accepted
- 1College of Public Health, North China University of Science and Technology, Tangshan, China
- 2People's Liberation Army Air Force Special Medical Center, Beijing, China
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Objective: To compare the characteristics of resting-state functional connectivity (FC) before and after repositioning therapy in patients with benign paroxysmal positional vertigo (BPPV) using functional near-infrared spectroscopy (fNIRS). Methods: Fifty BPPV patients and fifty healthy controls were enrolled. Oxygenated hemoglobin (HbO) concentration changes during resting-state were recorded using fNIRS. The experimental group underwent Dizziness Handicap Inventory (DHI), Visual Analogue Scale (VAS) assessments, and 10-minute resting-state fNIRS scans before and after repositioning therapy; the control group received baseline scans only. FC strength of the whole brain and specific regions of interest (ROIs) was analyzed using correlation coefficients. Results: fNIRS analysis revealed significantly elevated FC strength between the middle temporal gyrus (MTG) and both the motor cortex (MC) and somatosensory cortex (SC) in BPPV patients at baseline compared to healthy controls ( p < 0.05); after canalith repositioning, the whole-brain average FC strength in patients significantly decreased. Connectivity strength decreased synchronously in the following ROI pairs: prefrontal cortex (PFC)-occipital cortex (OC) , PFC-MTG, PFC-MC, OC-MC, OC-SC, MTG-MC, and MTG-SC, and brain network parameters returned to normal levels post-repositioning. Clinical indicators improved simultaneously: the total DHI score decreased by 23.4% ( p < 0.05), and the VAS score showed a significant reduction. Conclusion: BPPV involves compensatory enhancement of the vestibulo-sensorimotor network. Canalith repositioning eliminates abnormal vestibular input and restores pathologically enhanced FC to normal levels. This supports fNIRS as a potential objective neuroimaging biomarker for evaluating BPPV neural mechanisms and treatment efficacy.
Keywords: benign paroxysmal positional vertigo, functional near-infrared spectroscopy, Canalith repositioning maneuver, resting-state, functional connectivity
Received: 07 Aug 2025; Accepted: 23 Sep 2025.
Copyright: © 2025 He, Lu, Zhang, Wang, Zhai and Jin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Zhanguo Jin, ccjzg@126.com
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