TY - JOUR
T1 - Brain correlates of persistent postural-perceptual dizziness
T2 - A review of neuroimaging studies
AU - Indovina, Iole
AU - Passamonti, Luca
AU - Mucci, Viviana
AU - Chiarella, Giuseppe
AU - Lacquaniti, Francesco
AU - Staab, Jeffrey P.
N1 - Funding Information:
Funding: I.I., F.L., and V.M. were supported by the Italian Ministry of Health (IRCCS Fondazione Santa Lucia Ricerca Corrente and RF-2019-12369194). J.P.S. and I.I. were supported by the U.S. Department of Defense Congressionally Directed Medical Research Program (grant number W81XWH1810760 PT170028). L.P. was funded by the U.K. Medical Research Council (MRC) (grant number MR/ P01271X/1).
Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/9
Y1 - 2021/9
N2 - Persistent postural-perceptual dizziness (PPPD), defined in 2017, is a vestibular disorder characterized by chronic dizziness that is exacerbated by upright posture and exposure to complex visual stimuli. This review focused on recent neuroimaging studies that explored the pathophysio-logical mechanisms underlying PPPD and three conditions that predated it. The emerging picture is that local activity and functional connectivity in multimodal vestibular cortical areas are decreased in PPPD, which is potentially related to structural abnormalities (e.g., reductions in cortical folding and grey-matter volume). Additionally, connectivity between the prefrontal cortex, which regulates attentional and emotional responses, and primary visual and motor regions appears to be increased in PPPD. These results complement physiological and psychological data identifying hypervigilant postural control and visual dependence in patients with PPPD, supporting the hypothesis that PPPD arises from shifts in interactions among visuo-vestibular, sensorimotor, and emotional networks that overweigh visual over vestibular inputs and increase the effects of anxiety-related mechanisms on locomotor control and spatial orientation.
AB - Persistent postural-perceptual dizziness (PPPD), defined in 2017, is a vestibular disorder characterized by chronic dizziness that is exacerbated by upright posture and exposure to complex visual stimuli. This review focused on recent neuroimaging studies that explored the pathophysio-logical mechanisms underlying PPPD and three conditions that predated it. The emerging picture is that local activity and functional connectivity in multimodal vestibular cortical areas are decreased in PPPD, which is potentially related to structural abnormalities (e.g., reductions in cortical folding and grey-matter volume). Additionally, connectivity between the prefrontal cortex, which regulates attentional and emotional responses, and primary visual and motor regions appears to be increased in PPPD. These results complement physiological and psychological data identifying hypervigilant postural control and visual dependence in patients with PPPD, supporting the hypothesis that PPPD arises from shifts in interactions among visuo-vestibular, sensorimotor, and emotional networks that overweigh visual over vestibular inputs and increase the effects of anxiety-related mechanisms on locomotor control and spatial orientation.
KW - Chronic subjective dizziness
KW - Neuroimaging
KW - Persistent postural-perceptual dizziness
KW - Phobic postural vertigo
KW - Visual dependency
KW - Visually induced dizziness
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U2 - 10.3390/jcm10184274
DO - 10.3390/jcm10184274
M3 - Review article
AN - SCOPUS:85115149362
SN - 2077-0383
VL - 10
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
IS - 18
M1 - 4274
ER -