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Altered spontaneous brain activity and functional connectivity in persistent postural-perceptual dizziness
Jinghan Qin1,2, Weitao Wang1,2,3, Liya Shen2
1Encephalopathy Department, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
Frontiers in Neurology
|July 30, 2026
Summary
Persistent postural-perceptual dizziness (PPPD) involves widespread brain network dysfunction affecting balance, vision, and emotion. This study reveals altered brain activity and connectivity in PPPD patients, highlighting a distributed network disorder.
Area of Science:
- Neuroscience
- Medical Imaging
- Vestibular Disorders
Background:
- Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder.
- Symptoms include dizziness and postural instability exacerbated by posture, motion, and visual stimuli.
- Limited comprehensive resting-state fMRI evidence exists for PPPD.
Purpose of the Study:
- Investigate spontaneous brain activity and functional connectivity in PPPD patients.
- Identify neuroimaging markers associated with PPPD symptoms.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) on 21 PPPD patients and 23 controls.
- Assessed regional spontaneous activity (low-frequency fluctuations) and local synchronization (regional homogeneity).
- Performed seed-based functional connectivity analyses using insula, anterior cingulate cortex, and precuneus as seeds.
Main Results:
- PPPD patients exhibited altered spontaneous activity in cerebellum, cortical, and subcortical regions, including motor areas.
- Abnormal functional connectivity was found between insula, basal ganglia, prefrontal cortex, and other brain regions.
- Clinical correlations showed associations between disease duration, handicap, anxiety, cognitive performance, and functional brain changes.
Conclusions:
- PPPD involves distributed functional abnormalities in brain networks crucial for vestibular, visual, emotional, and motor processing.
- These abnormalities may underlie persistent dizziness, postural instability, and anxiety in PPPD.
- PPPD is characterized by disrupted visual-vestibular-postural integration and maladaptive neural reorganization.
