The cerebellar-vestibular predisposition to anxiety disorders

To test for a cerebellar-vestibular (CV) predisposition to anxiety disorder, 402 consecutively referred subjects with varying anxiety symptoms were separated into eight DSM-III--R diagnostic categories and evaluated for CV dysfunction, using neurological and electronystagmographic (ENG) examinations. Of the total sample, 94% evidenced CV-dysfunction on the basis of two or more abnormal neurological or ENG parameters per subject. All DSM-III--R diagnostic anxiety-disorder categories contained a high percentage of abnormal neurological and ENG parameters, regardless of the size of the subsample. Moreover, each DSM-III--R subsample of anxiety disorders contained additional coexisting symptoms of anxiety sufficient to overlap with and form the basis for diagnosis of most other DSM-III--R anxiety-disorder categories. Such findings suggested that anxiety disorders, regardless of surface descriptions and DSM-III--R category, have a common denominator with varying symptom-shaping mechanisms and that this denominator is significantly CV-based. Although the above findings do not justify cause and effect convictions, they have provided crucial insights leading to (1) a proposed functional classification based on underlying determining mechanisms rather than on descriptions of symptoms, (2) a possible relationship between anxiety and learning disorders, and (3) a new method of treating these disorders by means of CV-stabilizing medications in conjunction with traditional approaches. Needless to say, independent and controlled studies, including comparisons with "normal" persons, are required for both validation and elucidation of those specific determining vs compensatory mechanisms and related diagnostic parameters crucial for symptom formation.