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

Abstract

Background Persistent postural perceptual dizziness (PPPD) is a common chronic condition presenting in neurology and neuro-otology clinics. Symptoms lie on a spectrum in the general population. The cause is unknown and thought to involve interactions between visual and vestibular systems, but symptoms also correlate with anxiety and migraine. Objective To test whether PDDD symptoms are associated with reported differences in other senses (touch, hearing, smell and taste); to investigate possible mediation via anxiety or migraine; to discover the proportion of variance accountable to these non-vestibular factors. Methods We measured self-report multisensory sensitivity, anxiety, visual difficulties, visual discomfort and migraine in patients with PPPD (N = 29) and a large general population cohort (N > 1100). We used structural equation modelling to examine relationships between the factors using a step-wise approach. Results We found increased self-reported over-sensitivity in sensory domains beyond vision and balance in both patients with PPPD and non-clinical participants with more PPPD symptoms. SEM analysis revealed that anxiety partly, but not wholly, mediated this relationship. Adding visual difficulties and visual discomfort to the model allowed it to explain 50% of PPPD symptom variance. Most of the path coefficients and mediation effects in our model were unchanged between participants with and without migraine. Conclusions Our findings support the idea that PPPD is a complex neurological condition that includes broad perceptual factors, and may suggest that some brains are predisposed to generalised cross-modal sensory-overload. This may give rise to vulnerability to severe PPPD should a vestibular insult occur.

Publication DOI: https://doi.org/10.1007/s00415-020-09817-0
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > School of Psychology
College of Health & Life Sciences > Applied Health Research Group
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Funding: This study funded by Wellcome [104943/Z/14/Z] and Wellcome and Cardiff University ISSF [097824/Z/11/Z]
Full Text Link: http://europepm ... ct/med/32306170
Related URLs: https://link.sp ... 415-020-09817-0 (Publisher URL)
PURE Output Type: Article
Published Date: 2020-08
Published Online Date: 2020-04-18
Accepted Date: 2020-04-01
Authors: Powell, G
Derry-Sumner, H
Shelton, K
Rushton, S
Hedge, C (ORCID Profile 0000-0001-6145-3319)
Rajenderkumar, D
Sumner, P

Download

[img]

Version: Published Version

License: Creative Commons Attribution

| Preview

Export / Share Citation


Statistics

Additional statistics for this record