Predictors of persistent postural-perceptual dizziness (PPPD) and similar forms of chronic dizziness precipitated by peripheral vestibular disorders: a systematic review.

IF 8.7 1区 医学 Q1 CLINICAL NEUROLOGY
Aaron Trinidade, Verónica Cabreira, Joel A Goebel, Jeffrey P Staab, Diego Kaski, Jon Stone
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引用次数: 6

Abstract

Background: The literature on predictors of persistent postural-perceptual dizziness (PPPD) following peripheral vestibular insults has not been systematically reviewed.

Methods: We systematically reviewed studies on predictors of PPPD and its four predecessors (phobic postural vertigo, space-motion discomfort, chronic subjective dizziness and visual vertigo). Investigations focused on new onset chronic dizziness following peripheral vestibular insults, with a minimum follow-up of 3 months. Precipitating events, promoting factors, initial symptoms, physical and psychological comorbidities and results of vestibular testing and neuroimaging were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results: We identified 13 studies examining predictors of PPPD or PPPD-like chronic dizziness. Anxiety following vestibular injury, dependent personality traits, autonomic arousal and increased body vigilance following precipitating events and visual dependence, but not the severity of initial or subsequent structural vestibular deficits or compensation status, were the most important predictors of chronic dizziness. Disease-related abnormalities of the otolithic organs and semi-circular canals and age-related brain changes seem to be important only in a minority of patients. Data on pre-existing anxiety were mixed.

Conclusions: After acute vestibular events, psychological and behavioural responses and brain maladaptation are the most likely predictors of PPPD, rather than the severity of changes on vestibular testing. Age-related brain changes appear to have a smaller role and require further study. Premorbid psychiatric comorbidities, other than dependent personality traits, are not relevant for the development of PPPD.

外周前庭疾病引起的持续性体位性知觉性头晕(PPPD)和类似形式的慢性头晕的预测因素:一项系统综述。
背景:关于外周前庭损伤后持续性体位性知觉头晕(PPPD)的预测因素的文献尚未得到系统综述。方法:我们系统地回顾了PPPD及其四个前身(恐惧性体位性眩晕、空间运动不适、慢性主观眩晕和视觉眩晕)的预测因素的研究。调查的重点是外周前庭损伤后新发的慢性头晕,随访时间至少为3个月。根据系统评价和荟萃分析指南的首选报告项目,提取诱发事件、促进因素、初始症状、身体和心理合并症以及前庭测试和神经成像的结果。结果:我们确定了13项研究,研究PPPD或PPPD样慢性头晕的预测因素。前庭损伤后的焦虑、依赖性人格特征、自主神经唤醒和突发事件后身体警惕性的提高以及视觉依赖是慢性头晕的最重要预测因素,而不是最初或随后的前庭结构缺陷或补偿状态的严重程度。耳石器官和半圆形管的疾病相关异常以及与年龄相关的大脑变化似乎只有在少数患者中很重要。关于先前存在的焦虑的数据喜忧参半。结论:急性前庭事件后,心理和行为反应以及大脑适应不良最有可能预测PPPD,而不是前庭测试变化的严重程度。与年龄相关的大脑变化似乎作用较小,需要进一步研究。除依赖性人格特征外,病态前期精神病合并症与PPPD的发展无关。
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来源期刊
CiteScore
15.70
自引率
1.80%
发文量
888
审稿时长
6 months
期刊介绍: The Journal of Neurology, Neurosurgery & Psychiatry (JNNP) aspires to publish groundbreaking and cutting-edge research worldwide. Covering the entire spectrum of neurological sciences, the journal focuses on common disorders like stroke, multiple sclerosis, Parkinson’s disease, epilepsy, peripheral neuropathy, subarachnoid haemorrhage, and neuropsychiatry, while also addressing complex challenges such as ALS. With early online publication, regular podcasts, and an extensive archive collection boasting the longest half-life in clinical neuroscience journals, JNNP aims to be a trailblazer in the field.
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