The Association Between Head Trauma and BPPV: A Nested Case-Control Study Using a National Health Screening Cohort.

Area of Science:

• Neurology
• Otolaryngology
• Epidemiology

Background:

• Benign paroxysmal positional vertigo (BPPV) is a prevalent vestibular disorder causing severe vertigo and increasing fall risk, particularly in the elderly.
• Existing research on BPPV risk factors is often contradictory, with limited large-scale evidence.
• Head trauma is a suspected, yet not definitively established, risk factor for BPPV.

Purpose of the Study:

• To investigate potential risk factors for BPPV using a large nationwide cohort.
• To specifically examine the association between prior head trauma and the subsequent development of BPPV.
• To provide population-level evidence to inform clinical practice and preventive measures for BPPV.

Main Methods:

• A nationwide nested case-control study using Korean National Health Insurance Service-Health Screening Cohort data.
• Matched 29,467 BPPV cases with 117,868 controls based on demographics and index date.
• Employed conditional logistic regression with overlap weighting to assess the risk associated with head trauma and other factors.

Main Results:

• Head trauma was significantly associated with an increased risk of BPPV (adjusted OR 1.28, 95% CI 1.17-1.40, p < 0.001).
• The absolute risk increase attributed to head trauma was 0.82 percentage points over the follow-up period.
• This association remained consistent across most demographic and clinical subgroups, with exceptions for underweight individuals and those with high comorbidity scores.

Conclusions:

• This large-scale study provides robust evidence supporting head trauma as a significant risk factor for BPPV.
• The findings reinforce the importance of considering head trauma history in the clinical assessment of BPPV.
• The results can guide the development of targeted prevention strategies for BPPV in at-risk populations.