Visually-induced dizziness is associated with sensitivity and avoidance across all senses

Area of Science:

• Neuroscience
• Clinical Psychology
• Audiology

Background:

• Persistent postural perceptual dizziness (PPPD) is a prevalent chronic condition affecting neurology and neuro-otology clinics.
• Its etiology remains unknown, though it involves visual and vestibular system interactions, and correlates with anxiety and migraine.

Purpose of the Study:

• To assess the association between PPPD symptoms and self-reported differences in other senses (touch, hearing, smell, taste).
• To investigate potential mediation of these associations by anxiety or migraine.
• To determine the proportion of PPPD symptom variance attributable to non-vestibular factors.

Main Methods:

• Self-reported multisensory sensitivity, anxiety, visual difficulties, visual discomfort, and migraine were measured in 29 PPPD patients and over 1100 general population participants.
• Structural equation modeling (SEM) was employed in a step-wise approach to analyze the relationships between these factors.

Main Results:

• Increased self-reported sensory over-sensitivity beyond vision and balance was observed in both PPPD patients and non-clinical individuals with higher PPPD symptom scores.
• SEM analysis indicated that anxiety partially mediated the relationship between sensory over-sensitivity and PPPD symptoms.
• The inclusion of visual difficulties and discomfort explained 50% of the variance in PPPD symptoms, with minimal impact from migraine status.

Conclusions:

• PPPD is a complex neurological disorder influenced by widespread perceptual factors.
• Findings suggest a predisposition in some individuals to generalized cross-modal sensory overload, potentially increasing vulnerability to severe PPPD after a vestibular insult.