Persistent postural-perceptual dizziness: A functional neuro-otologic disorder

Yagi, Chihiro; Kimura, Akira; Horii, Arata

doi:10.1016/j.anl.2023.12.008

Cited by 5 publications

(5 citation statements)

References 63 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Integrated Research Approachesmentioning

confidence: 99%

“…Promoting interdisciplinary research that integrates neurology, otolaryngology, psychiatry, and rehabilitation sciences is imperative for advancing our understanding of PPPD [32]. The collaboration of experts from these diverse disciplines contributes nuanced perspectives to elucidate the multifaceted nature of PPPD comprehensively [32]. An interdisciplinary approach facilitates a holistic exploration of PPPD, considering not only its physiological underpinnings but also its psychological and rehabilitative aspects [32].…”

Section: Integrated Research Approachesmentioning

confidence: 99%

“…The collaboration of experts from these diverse disciplines contributes nuanced perspectives to elucidate the multifaceted nature of PPPD comprehensively [32]. An interdisciplinary approach facilitates a holistic exploration of PPPD, considering not only its physiological underpinnings but also its psychological and rehabilitative aspects [32]. This collaborative synergy of expertise is crucial for deciphering the complexities of PPPD and holds the potential to generate innovative, patient-centered interventions [32].…”

Section: Integrated Research Approachesmentioning

confidence: 99%

“…An interdisciplinary approach facilitates a holistic exploration of PPPD, considering not only its physiological underpinnings but also its psychological and rehabilitative aspects [32]. This collaborative synergy of expertise is crucial for deciphering the complexities of PPPD and holds the potential to generate innovative, patient-centered interventions [32]. Encouraging interdisciplinary research is instrumental in fostering transformative breakthroughs that not only enhance our understanding of PPPD but also elevate the standard of care provided to individuals contending with this challenging condition [32].…”

Section: Integrated Research Approachesmentioning

confidence: 99%

“…Advances in neuroimaging techniques have revolutionized researchers to explore structural and functional brain changes associated with PPPD [32]. Functional magnetic resonance imaging (fMRI) has been instrumental in uncovering structural changes in the brains of individuals with PPPD [33].…”

Section: Neuroimaging Studiesmentioning

confidence: 99%

See 4 more Smart Citations

Persistent Challenges: A Comprehensive Review of Persistent Postural-Perceptual Dizziness, Controversies, and Clinical Complexities

Madrigal,

Herrón-Arango,

Bedoya

et al. 2024

Cureus

View full text Add to dashboard Cite

Persistent postural-perceptual dizziness (PPPD) is a chronic and disabling disorder characterized by persistent dizziness, unsteadiness, and imbalance. It often arises without an identifiable cause and is exacerbated by upright posture, active or passive movement, and exposure to moving or complex visual stimuli. This complex pathophysiology and the psychological dimensions of its symptomatology pose a significant challenge to clinicians. PPPD presents diagnostic challenges and a lack of standardized treatment options, underscoring the need for multidisciplinary approaches encompassing pharmacotherapy, vestibular rehabilitation, and psychological interventions for effective management. Bridging the gaps in understanding PPPD requires collaborative efforts across disciplines, emphasizing integrated research approaches and patient support networks to enhance care and improve outcomes. This review explores the challenges, controversies, and clinical complexities of PPPD, highlighting the importance of a patientcentered approach.

show abstract

Section: Integrated Research Approachesmentioning

confidence: 99%

Section: Integrated Research Approachesmentioning

confidence: 99%

Section: Integrated Research Approachesmentioning

confidence: 99%

Section: Integrated Research Approachesmentioning

confidence: 99%

Section: Neuroimaging Studiesmentioning

confidence: 99%

See 3 more Smart Citations

Persistent Challenges: A Comprehensive Review of Persistent Postural-Perceptual Dizziness, Controversies, and Clinical Complexities

Madrigal,

Herrón-Arango,

Bedoya

et al. 2024

Cureus

View full text Add to dashboard Cite

show abstract

Is Vestibular Rehabilitation as Effective for Persistent Postural-Perceptual Dizziness as for Chronic Unilateral Vestibular Hypofunction?

Yamato,

Yagi,

Kimura

et al. 2024

Otol Neurotol

View full text Add to dashboard Cite

Objective To compare the feasibility and outcomes of vestibular rehabilitation (VR) for persistent postural-perceptual dizziness (PPPD) with those for chronic unilateral vestibular hypofunction (UVH). Study Design Prospective study. Setting Tertiary referral center. Patients Nineteen consecutive patients with chronic UVH lasting for >3 months and 15 with PPPD. Interventions The VR program consisted of gaze stabilization exercises, static or dynamic balance exercises and gait training, and habituation exercises that exposed patients to a provocative stimulus. Patients were asked to perform VR for at least 20 min a day. Main Outcome Measures Status of VR (i.e., continuation/discontinuation) and outcomes were assessed 1 month after the introduction of VR using the Dizziness Handicap Inventory for handicaps in daily life due to dizziness, the Niigata PPPD Questionnaire (NPQ) for symptom exacerbations of PPPD, and the Hospital Anxiety and Depression Scale for anxiety and depression. Results No patients in the chronic UVH group discontinued VR, whereas six patients in the PPPD group discontinued VR owing to symptom exacerbations, showing a significant difference. VR did not decrease any symptom scale, except for the NPQ-motion subscore, in patients with PPPD who continued VR, whereas it decreased all clinical symptom scales, except for the NPQ-motion subscore, in patients with chronic UVH. Conclusions Patients with PPPD had a higher rate of VR discontinuation than those with chronic UVH, and VR was less effective in patients with PPPD who even continued treatment than in those with chronic UVH. Therefore, VR on PPPD should be optimized.

show abstract

Psychological Variables Mediate Symptoms in Persistent Postural-Perceptual Dizziness (PPPD): A Cross-Sectional Self-Report Study

Sereda,

Lam,

Hazar

et al. 2024

Preprint

View full text Add to dashboard Cite

Background: Persistent Postural-Perceptual Dizziness (PPPD) is a prevalent long-term functional neurological disorder characterised by non-spinning vertigo, perceived instability, and visual motion sensitivity. Current diagnostic criteria inadequately incorporate psychological variables widely associated with PPPD symptom onset and maintenance. Objectives: This study explored PPPD-specific psychological variables to differentiate PPPD patients from healthy controls and, exploratorily, from Bilateral Vestibulopathy (BVP) patients. We evaluated these variables as potential treatment targets through mediation analysis. Our aim was to inform more precise diagnostic criteria and guide targeted interventions for PPPD. Methods: We conducted a cross-sectional study with 164 participants, including 59 diagnosed cases of PPPD, 16 cases of BVP, and 89 healthy controls. Participants completed a series of questionnaires assessing negative illness perception, balance vigilance, anxiety, visual sensitivity, dizziness and other related metrics. Results: Psychological variables, particularly anxiety, cognitive fusion, and justice appraisal significantly mediated the relationship between key PPPD symptoms (dizziness, visual sensitivity, and balance vigilance) and PPPD diagnosis compared to healthy controls. Logistic regression suggested psychological differences between PPPD and BVP, but limited BVP sample size constrained generalisability. Between PPPD and healthy controls, psychological variables significantly improved classification accuracy compared to measures of dizziness alone. Conclusion: Incorporating psychological variables in the diagnosis and management of PPPD could enhance the understanding of the disorder and may aid in developing better-targeted interventions. The study supports revising existing diagnostic criteria to include validated psychological assessments and highlights the potential of treatments addressing cognitive and emotional aspects of PPPD to improve patient outcomes.

show abstract

Persistent postural-perceptual dizziness: A functional neuro-otologic disorder

Cited by 5 publications

References 63 publications

Persistent Challenges: A Comprehensive Review of Persistent Postural-Perceptual Dizziness, Controversies, and Clinical Complexities

Persistent Challenges: A Comprehensive Review of Persistent Postural-Perceptual Dizziness, Controversies, and Clinical Complexities

Is Vestibular Rehabilitation as Effective for Persistent Postural-Perceptual Dizziness as for Chronic Unilateral Vestibular Hypofunction?

Psychological Variables Mediate Symptoms in Persistent Postural-Perceptual Dizziness (PPPD): A Cross-Sectional Self-Report Study

Contact Info

Product

Resources

About