†These authors contributed equally.
Both the central and peripheral vestibular systems contribute to the pathogenesis of vestibular migraine, although the mechanism of vestibular migraine remains unclear. To assess central and peripheral vestibular system damage in vestibular migraine and explore the underlying mechanism we performed vestibular function tests, including a caloric test, spontaneous, gaze-evoked nystagmus and saccadic, pursuit and optokinetic eye movements to evaluate the involvement of the central and/or peripheral vestibular system in subjects with acute vestibular migraine episodes. It was found that both peripheral and central vestibular systems were damaged in vestibular migraine patients with the number of subjects with central deficits significantly larger than those with peripheral deficits. The cerebellum, especially the vestibule cerebellum, is the most important part of the central vestibular system. Locculus and paraflocculus are essential structures of cerebellar circuitry controlling vestibular nuclei and oculomotor functions and are anatomically linked with the "migraine pathway". Purkinje cells are the only source of cerebellar output and it innervates inhibitory action. Therefore, we examined the effect of the electric stimulation on paraflocculus Purkinje cells by using a specific electrical stimulation of trigeminal ganglia to induce a migraine-like phenomenon in animal part. Moreover, electrophysiological recordings showed that parafloccular Purkinje cells of rats underwent electrical stimulation of trigeminal ganglia resulted in partial inhibition. It is suggested that Purkinje cells in the paraflocculus could be inhibited after the occurrence of migraine episode and this inhibition may be an important factor leading to vestibular migraine.