Neurofunctional differences and similarities between persistent postural-perceptual dizziness and anxiety disorder

Area of Science:

• Neuroscience
• Psychiatry
• Medical Imaging

Background:

• Persistent postural-perceptual dizziness (PPPD) and anxiety disorders (ANX) share behavioral and neurological symptoms.
• A bidirectional link exists between vestibulo-spatial and anxiety neural networks.
• No prior neuroimaging studies have directly compared these patient groups.

Purpose of the Study:

• To explore neural correlate differences and similarities between PPPD and ANX groups.
• To compare findings with a healthy control group using fMRI.
• To investigate brain responses to emotional stimuli in these conditions.

Main Methods:

• fMRI scans were conducted on 63 participants (20 ANX, 14 PPPD, 16 HC-A, 13 HC-P).
• Participants viewed anxiety and dizziness-related pictures to elicit emotional responses.
• Voxel-wise t-tests and ROI analyses identified significant neural activation differences (pFDR < 0.05).

Main Results:

• PPPD and ANX groups differed from controls in anxiety, dizziness, depression, and alexithymia scores.
• PPPD patients showed increased neural responses in the vestibulo-spatial network (SMG, STG) compared to ANX and HC-P groups.
• Healthy controls exhibited enhanced neuronal responses in visual processing areas compared to both patient groups.

Conclusions:

• Neuronal responses to emotional stimuli are comparable in anxiety networks for PPPD and ANX groups.
• PPPD patients demonstrate distinct and heightened responses in vestibulo-spatial networks (SMG, STG).
• Findings suggest higher sensitivity and potentially poorer adaptation in PPPD patients to emotional triggers.