Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies
Persistent postural-perceptual dizziness (PPPD), defined in 2017, is a vestibular disorder characterized by chronic dizziness that is exacerbated by upright posture and exposure to complex visual stimuli. This review focused on recent neuroimaging studies that explored the pathophysiological mechani...
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doaj-cfc1c5ef509f4a03afe2ec75862ec7ae2021-09-26T00:28:55ZengMDPI AGJournal of Clinical Medicine2077-03832021-09-01104274427410.3390/jcm10184274Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging StudiesIole Indovina0Luca Passamonti1Viviana Mucci2Giuseppe Chiarella3Francesco Lacquaniti4Jeffrey P. Staab5Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, ItalyDepartment of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UKLaboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, ItalyUnit of Audiology, Department of Experimental and Clinical Medicine, Magna Græcia University, 88100 Catanzaro, ItalyLaboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, 00179 Rome, ItalyDepartments of Psychiatry and Psychology and Otorhinolaryngology—Head and Neck Surgery, Mayo Clinic, Rochester, MN 55905, USAPersistent postural-perceptual dizziness (PPPD), defined in 2017, is a vestibular disorder characterized by chronic dizziness that is exacerbated by upright posture and exposure to complex visual stimuli. This review focused on recent neuroimaging studies that explored the pathophysiological mechanisms underlying PPPD and three conditions that predated it. The emerging picture is that local activity and functional connectivity in multimodal vestibular cortical areas are decreased in PPPD, which is potentially related to structural abnormalities (e.g., reductions in cortical folding and grey-matter volume). Additionally, connectivity between the prefrontal cortex, which regulates attentional and emotional responses, and primary visual and motor regions appears to be increased in PPPD. These results complement physiological and psychological data identifying hypervigilant postural control and visual dependence in patients with PPPD, supporting the hypothesis that PPPD arises from shifts in interactions among visuo-vestibular, sensorimotor, and emotional networks that overweigh visual over vestibular inputs and increase the effects of anxiety-related mechanisms on locomotor control and spatial orientation.https://www.mdpi.com/2077-0383/10/18/4274persistent postural-perceptual dizzinessphobic postural vertigochronic subjective dizzinessvisually induced dizzinessvisual dependencyneuroimaging |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Iole Indovina Luca Passamonti Viviana Mucci Giuseppe Chiarella Francesco Lacquaniti Jeffrey P. Staab |
spellingShingle |
Iole Indovina Luca Passamonti Viviana Mucci Giuseppe Chiarella Francesco Lacquaniti Jeffrey P. Staab Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies Journal of Clinical Medicine persistent postural-perceptual dizziness phobic postural vertigo chronic subjective dizziness visually induced dizziness visual dependency neuroimaging |
author_facet |
Iole Indovina Luca Passamonti Viviana Mucci Giuseppe Chiarella Francesco Lacquaniti Jeffrey P. Staab |
author_sort |
Iole Indovina |
title |
Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies |
title_short |
Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies |
title_full |
Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies |
title_fullStr |
Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies |
title_full_unstemmed |
Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies |
title_sort |
brain correlates of persistent postural-perceptual dizziness: a review of neuroimaging studies |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-09-01 |
description |
Persistent postural-perceptual dizziness (PPPD), defined in 2017, is a vestibular disorder characterized by chronic dizziness that is exacerbated by upright posture and exposure to complex visual stimuli. This review focused on recent neuroimaging studies that explored the pathophysiological mechanisms underlying PPPD and three conditions that predated it. The emerging picture is that local activity and functional connectivity in multimodal vestibular cortical areas are decreased in PPPD, which is potentially related to structural abnormalities (e.g., reductions in cortical folding and grey-matter volume). Additionally, connectivity between the prefrontal cortex, which regulates attentional and emotional responses, and primary visual and motor regions appears to be increased in PPPD. These results complement physiological and psychological data identifying hypervigilant postural control and visual dependence in patients with PPPD, supporting the hypothesis that PPPD arises from shifts in interactions among visuo-vestibular, sensorimotor, and emotional networks that overweigh visual over vestibular inputs and increase the effects of anxiety-related mechanisms on locomotor control and spatial orientation. |
topic |
persistent postural-perceptual dizziness phobic postural vertigo chronic subjective dizziness visually induced dizziness visual dependency neuroimaging |
url |
https://www.mdpi.com/2077-0383/10/18/4274 |
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