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Unstable Gaze in Functional Dizziness: A Contribution to Understanding the Pathophysiology of Functional Disorders
Lena Schröder1,2,3, Dina von Werder1,2,4, Cecilia Ramaioli1
1Department of Psychosomatic Medicine and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Frontiers in Neuroscience
|August 6, 2021
Summary
Functional dizziness patients exhibit impaired gaze stabilization when internal expectations are involved, suggesting a mismatch between brain predictions and body states. This supports the perceptual dysregulation hypothesis in functional disorders.
Area of Science:
- Neuroscience
- Psychiatry
- Human Physiology
Background:
- Functional disorders lack a clear pathophysiological mechanism.
- The predictive coding theory proposes a mismatch between internal expectations and sensory body states in functional disorders.
- This mismatch may lead to perceptual dysregulation and symptom manifestation.
Purpose of the Study:
- To investigate the role of internal expectations and sensory input in gaze stabilization in functional dizziness.
- To test the hypothesis that internal expectations do not match actual body states in functional disorders.
- To explore the pathophysiology of functional dizziness through objective physiological measures.
Main Methods:
- Gaze stabilization was assessed in functional dizziness patients and healthy controls.
- Two epochs of gaze shifts were analyzed: counter-rotation (CR) epoch (internal expectations involved) and oscillation (OSC) epoch (sensory input alone).
- Comparison of gaze stabilization between groups during CR and OSC epochs.
Main Results:
- Gaze stabilization differed significantly between functional dizziness patients and controls only during the CR epoch (p=0.001).
- Functional dizziness patients showed reduced gaze stabilization during the CR epoch (p=0.036).
- No significant difference in gaze stabilization was observed during the OSC epoch (p=0.26).
Conclusions:
- Sensory-driven gaze stabilization is intact in functional dizziness.
- Deficits in internally-driven gaze stabilization are measurable in functional dizziness.
- These findings support the perceptual dysregulation hypothesis, indicating a mismatch between internal expectations and body states in functional disorders.
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