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Persistent postural perceptual dizziness is on a spectrum in the general population

Powell, Georgina ORCID:, Derry-Sumner, Hannah, Rajenderkumar, Deepak, Rushton, Simon K. ORCID: and Sumner, Petroc ORCID: 2020. Persistent postural perceptual dizziness is on a spectrum in the general population. Neurology 94 (18) , e1929-e1938. 10.1212/WNL.0000000000009373

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Objective To examine the idea that symptoms of persistent postural perceptual dizziness (PPPD) are more common than previously assumed and lie on a spectrum in the general population, thus challenging current theories that PPPD is only a consequence of a vestibular insult. Methods We collected 2 common clinical questionnaires of PPPD (Visual Vertigo Analogue Scale [VVAS] and Situational Characteristics Questionnaire [SCQ]) in 4 cohorts: community research volunteers (n = 1941 for VVAS, n = 1,474 for SCQ); paid online participants (n = 190 for VVAS, n = 125 for SCQ); students (n = 204, VVAS only); and patients diagnosed with PPPD (n = 25). Results We found that around 9%, 4%, and 11%, respectively, of the 3 nonclinical cohorts scored above the 25th percentile patient score on 1 PPPD measure (VVAS) and 49% and 54% scored above the 25th percentile patient score on the other measure (SCQ). Scores correlated negatively with age (counter to expectation). As expected, scores correlated with migraine in 2 populations, but this only explained a small part of the variance, suggesting that migraine is not the major factor underlying the spectrum of PPPD symptoms in the general population. Conclusion We found high levels of PPPD symptoms in nonclinical populations, suggesting that PPPD is a spectrum that preexists in the population, rather than only being a consequence of vestibular insult. Atypical visuo-vestibular processing predisposes some individuals to visually induced dizziness, which is then exacerbated should vestibular insult (or more generalized insult) occur.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Additional Information: This is an open access article distributed under the terms of the Creative Commons Attribution License 4.0 (CC BY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher: American Academy of Neurology
ISSN: 0028-3878
Funders: Wellcome Trust
Date of First Compliant Deposit: 20 April 2020
Date of Acceptance: 14 November 2019
Last Modified: 03 May 2023 21:41

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