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

Powell, Georgina, Derry-Sumner, Hannah, Shelton, Katherine, Rushton, Simon, Hedge, Craig, Rajenderkuma, Deepak and Sumner, Petroc 2020. Visually-induced dizziness is associated with sensitivity and avoidance across all senses. Journal of Neurology 267 , pp. 2260-2271. 10.1007/s00415-020-09817-0

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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.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Cardiff University Brain Research Imaging Centre (CUBRIC)
Publisher: Springer Verlag
ISSN: 0340-5354
Funders: Wellcome Trust
Date of First Compliant Deposit: 8 April 2020
Date of Acceptance: 1 April 2020
Last Modified: 03 Aug 2020 13:54
URI: http://orca-mwe.cf.ac.uk/id/eprint/130895

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