Neuroanatomical correlates of stroke-related dizziness and vertigo: secondary analysis from the INSPiRE-TMS trial
Abstract
Dizziness and vertigo are common and debilitating neurological symptoms among patients visiting the emergency department (ED). Possibly because the symptoms are not captured by standard stroke severity tools such as the NIHSS (National Institutes of Health Stroke Scale), their network-level neuroanatomical correlates-particularly potential supratentorial contributions-remain incompletely characterized. Therefore, we aim to investigate the neuroanatomical substrates of post-stroke dizziness and vertigo. This retrospective analysis included patients with acute ischemic stroke from the randomized controlled INSPiRE-TMS trial. Each patient underwent MRI within seven days of symptom onset, and stroke severity was assessed using the NIHSS at hospital admission. Patients were assessed for broadly defined new-onset dizziness/vertigo associated with the acute cerebrovascular event. Lesion symptom mapping (LSM) and lesion network mapping (LNM) were used to investigate associations between lesion location, functional connectivity, and dizziness/vertigo. Among 484 patients, 32% (n = 157) reported dizziness at stroke onset. Notably, dizziness was reported in 22% (77/347) of patients with supratentorial lesions, compared with 58% (80/137) of those with infratentorial lesions. Patients with dizziness were more often female (36.9% vs. 27.8%, p = 0.042) and more frequently had hemianopia (35.1% vs. 15.6%, p < 0.0001). LSM identified cerebellar clusters (left lobules VI, Crus I-II, VIIb,…
How strong is the evidence?
Evidence Hub reads this as a secondary / pooled analysis, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 484 participants or records.
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