ABSTRACT
Persistent postural-perceptual dizziness（PPPD） is the most common chronic vestibular disease, the clinical manifestation is dizziness, unstable and non-rotational dizziness for three months or more. And the symptom is exacerbated by upright posture, active or passive movement, and complex visual stimuli. In addition, PPPD is a functional disease, so routine vestibular function tests and imaging tests are often negative. According to the diagnostic criteria established by the Barany Association, the diagnosis of PPPD often relies on history. This article provides a review of PPPD-related questionnaires.
Subject(s)
Humans , Dizziness/diagnosis , Vertigo/diagnosis , Vestibular Diseases/diagnosis , Surveys and QuestionnairesABSTRACT
Abstract Introduction Persistent postural-perceptual dizziness (PPPD) is a functional vestibular disorder characterized by chronic dizziness, unsteadiness, and hypersensitivity to motion. Preexisting anxiety disorders and neurotic personality traits confer vulnerability to PPPD. High anxiety during acute vertigo or dizziness incites it. A functional magnetic resonance imaging (fMRI) study of chronic subjective dizziness found unexpectedly hypoactive responses to vestibular stimulation in cortical regions that integrate threat assessment and spatial perception. Objective This fMRI study used non-moving, but emotionally charged visual stimuli to investigate the brain's activity of PPPD patients and control subjects. Methods The participants included 16 women with PPPD and 16 age-matched women who recovered completely from acute episodes of vertigo or dizziness capable of triggering PPPD. Brain responses to positive, neutral, and negative figures from the International Affective Picture System were measured with fMRI and compared between the groups. Dizziness handicap, anxiety, and depression were assessed with validated questionnaires. Results Between group analyses: Participants with PPPD showed reduced activity in anterior cingulate cortex and increased activity in left angular gyrus in response to negative versus positive stimuli, which was not observed in recovered individuals. Within group analyses: Participants with PPPD had increased activity in visuospatial areas (parahippocampal gyrus, intraparietal sulcus) in negative versus positive and negative versus neutral contrasts, whereas recovered individuals had increased activity in anxiety regions (amygdala, orbitofrontal cortex). Conclusion Patients with PPPD may be more attuned to spatial elements than to the content of emotionally charged visual stimuli.
ABSTRACT
Objective@#To investigate the characteristics of neuropsychological factors in patients with persistent postural-perceptual dizziness(PPPD) and provide the basis for the psychosomatic comprehensive treatment.@*Methods@#Cartel Personality Test (16PF), Symptom Checklist 90 (SCL-90), HAMA, HDMD, SAS and SDS were used to evaluate personality and mental state in patients with PPPD(PPPD group, n=65) and control group(n=63). Dizziness handicap inventory(DHI) was used to evaluate the degree of vertigo.The correlation analysis was carried out between the DHI scores and 16-PF, SCL-90 factor scores.@*Results@#(1)16PF factor scores: the factor scores of assertiveness(8.50±1.84), excitability (6.59±1.73), boldness (7.46±1.78), sensitivity (7.25±1.79), doubtfulness (6.55±1.74), fantasy(6.20±1.60), anxiety(7.67±1.61) and tension(6.81±1.67)in PPPD group were higher than those in the control group, and the differences were statistically significant (all P<0.05). The gregariousness (4.38±1.65), intelligence (4.51±1.67), stability (3.51±1.75), independence (4.39±1.56) and self-discipline (4.70±1.82) factor scores in PPPD group were lower than those in the control group, and the differences were statistically significant (all P<0.05). (2)SCL-90 factor scores: the factor scores of somatization(1.62±0.40), anxiety (1.64±0.56), interpersonal sensitivity (1.79±0.42), terrifying(1.71±0.53), total points(150.77±21.60), total average score (1.62±0.51) in PPPD group were higher than those in control group (all P<0.05). There were no differences in obsessive-compulsive (1.50±0.55), depression (1.45±0.44), hostility (1.69±0.60), paranoia (1.76±0.53), somatization (1.42±0.49) and psychotic (1.29±0.35) between PPPD group and the control group (all P>0.05). (3)The factor scores of HAMA(9.08±1.77) and SAS(37.88±2.96)in patients with PPPD were higher than that in the control group, and the differences were statistically significant (all P<0.05). There was no significant difference in HAMD (6.19±2.82) and SDS (36.36±4.71) scores between PPPD group and control group (all P>0.05). (4)The DHI scores were positively correlated with assertiveness, sensitivity, tension and doubtfulness factors of 16PF.The DHI scores were positively correlated with somatization, interpersonal sensitivity, anxiety and terrifying factors of SCL-90.@*Conclusion@#Patients with persistent postural-perceptual dizziness suffer from personality changes, mental disorders and anxiety disorder.
ABSTRACT
Objective To investigate the characteristics of neuropsychological factors in patients with persistent postural-perceptual dizziness(PPPD) and provide the basis for the psychosomatic comprehen-sive treatment. Methods Cartel Personality Test (16PF),Symptom Checklist 90 ( SCL-90),HAMA,HD-MD,SAS and SDS were used to evaluate personality and mental state in patients with PPPD(PPPD group,n=65) and control group(n=63). Dizziness handicap inventory(DHI) was used to evaluate the degree of ver-tigo. The correlation analysis was carried out between the DHI scores and 16-PF,SCL-90 factor scores. Re-sults (1)16PF factor scores:the factor scores of assertiveness(8. 50±1. 84),excitability (6. 59±1. 73), boldness (7. 46±1. 78),sensitivity (7. 25±1. 79),doubtfulness (6. 55±1. 74),fantasy(6. 20±1. 60),anxie-ty(7. 67±1. 61) and tension(6. 81±1. 67) in PPPD group were higher than those in the control group,and the differences were statistically significant ( all P<0. 05). The gregariousness (4. 38± 1. 65), intelligence (4. 51±1. 67),stability (3. 51±1. 75),independence (4. 39±1. 56) and self-discipline (4. 70±1. 82) fac-tor scores in PPPD group were lower than those in the control group,and the differences were statistically sig-nificant (all P<0. 05). ( 2) SCL-90 factor scores:the factor scores of somatization ( 1. 62 ± 0. 40),anxiety (1. 64±0. 56),interpersonal sensitivity ( 1. 79 ± 0. 42),terrifying ( 1. 71 ± 0. 53),total points ( 150. 77 ± 21. 60),total average score (1. 62±0. 51) in PPPD group were higher than those in control group (all P< 0. 05). There were no differences in obsessive-compulsive (1. 50±0. 55),depression (1. 45±0. 44),hostility (1. 69±0. 60),paranoia (1. 76±0. 53),somatization (1. 42±0. 49) and psychotic ( 1. 29±0. 35) between PPPD group and the control group (all P>0. 05). ( 3) The factor scores of HAMA( 9. 08±1. 77) and SAS (37. 88±2. 96)in patients with PPPD were higher than that in the control group,and the differences were statistically significant (all P<0. 05). There was no significant difference in HAMD (6. 19±2. 82) and SDS (36. 36±4. 71) scores between PPPD group and control group (all P>0. 05). (4)The DHI scores were posi-tively correlated with assertiveness,sensitivity,tension and doubtfulness factors of 16PF. The DHI scores were positively correlated with somatization,interpersonal sensitivity,anxiety and terrifying factors of SCL-90. Con-clusion Patients with persistent postural-perceptual dizziness suffer from personality changes,mental disor-ders and anxiety disorder.
ABSTRACT
Objective To explore the assessment methods of persistent postural-perceptual dizziness(PPPD).Methods A total of 39 patients with PPPD were enrolled as PPPD group,compare with 36 cases with unilateral sudden sensorineural hearing loss(SSHL) with vertigo.The clinic data,DHI/NEO-FFI/SSRC,auditory and vestibular function(bithermal caloric test,vestibular evoked myogenic potential)tests were collected for all the subjects and compared between groups.Results There were statistical differences between two groups in DHI/NEO-FFI/ SSRC (P＜0.05).13 cases of PPPD with mild or moderate sensorineural hearing loss,36 cases of SSHL with severe or extremely severe sensorineural hearing loss;double temperature test and VEMP normal derivation rates of PPPD were significantly higher than SSHL (P＜0.05).Conclusion Neurotic and introverted personality traits are found to be risk factors for PPPD.Patients with PPPD are prone to anxiety.PPPD has a great impact on the social activities and life quality of patients.