Patients with persistent postural-perceptual dizziness show warning
signs early on
New study finds that patients with an onset of vestibular balance
disorder symptoms show early signs of it getting worse

Date:
March 9, 2022
Source:
Nagoya City University
Summary:
People who suffer from persistent postural-perceptual dizziness
(PPPD) experience unsteadiness, non-spinning vertigo and
dizziness. These symptoms are exacerbated by movement, upright
posture, and visual stimuli. In a new study, scientists have tried
to find out if these exacerbating factors are present in the period
before PPPD is diagnosed.

They found that patients developing PPPD are likely to have them
early on after the onset of balance disorder symptoms.



FULL STORY ========================================================================== People who suffer from persistent postural-perceptual dizziness (PPPD) experience unsteadiness, non-spinning vertigo and dizziness. These
symptoms are exacerbated by movement, upright posture, and visual
stimuli. In a new study, scientists have tried to find out if
these exacerbating factors are present in the period before PPPD is
diagnosed. They found that patients developing PPPD are likely to have
them early on after the onset of balance disorder symptoms.


==========================================================================
The vestibular system, which is the link between the inner ear
and the brain, helps the body maintain its balance. When people
experience vestibular symptoms, i.e., symptoms of balance disorder,
it can develop into persistent postural-perceptual dizziness (PPPD),
a chronic disorder where patients experience dizziness and non-spinning vertigo, particularly during moving, maintaining an upright posture,
and when exposed to complex visual stimuli.

However, not all individuals suffering from vestibular symptoms go on to develop PPPD, and it is not clear if people showing exacerbating factors
for PPPD tend to develop PPPD or not.

Recently, a research team comprising Assistant Professor Kayoko Kabaya,
Dr.

Masaki Kondo, Dr. Shinichi Iwasaki, and other researchers from Nagoya City University, Japan, analyzed medical records of patients who were tested
for vestibular symptoms for the first time to identify predictive factors
for developing PPPD later on, and explore the possibility that patients
showing exacerbating factors early on are more likely to develop chronic
PPPD following the onset of vestibular symptoms. "PPPD is often severe
and resistant to treatment. We believe that it is important to provide preventive interventions before PPPD develops, and wanted to identify the characteristics of patients who are prone to PPPD," explains Dr. Kabaya,
the lead author of the study. This paper was published in the journal Laryngoscope Investigative Otolaryngology.

In their study, the severity of the symptoms experienced by the patients
was evaluated using the Niigata PPPD Questionnaire (NPQ), which involved questions on the exacerbating factors (upright posture, movement,
and visual stimulation). Additionally, the perception of handicap due
to dizziness was evaluated using a self-assessment scale called "The
Dizziness Handicap Inventory." The patients were then followed up for more
than 3 months, and the NPQ scores of patients developing PPPD during the follow-up were compared with that of patients who did not develop PPPD.

More than half of the patients reported experiencing exacerbating factors shortly after the vestibular symptoms, worsening their symptoms. About
10% of these patients developed PPPD during the follow-up period, and
the exacerbating factors were found to have a more severe effect on
the vestibular symptoms in these patients. Notably, the NPQ scores of
those who developed PPPD were significantly higher than that of those
who did not.

"Our results suggest that patients who develop PPPD are likely to have
its exacerbating factors at the early stages of the disease following
the onset of vestibular symptoms," says Dr. Kabaya.

With these findings, the researchers are optimistic that their study
could help establish preventive measures against the disease. "PPPD is
a disease that causes long-term social loss and occurs following acute vestibular symptoms.

Based on our finding that patients with exacerbating factors during acute vestibular symptom are more likely to develop PPPD, our study could
encourage the development of intervention protocols for such patients
before they develop PPPD," says Dr. Kabaya.


========================================================================== Story Source: Materials provided by Nagoya_City_University. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Kayoko Kabaya, Hitomi Tamai, Akina Okajima, Toshiya Minakata, Masaki
Kondo, Meiho Nakayama, Shinichi Iwasaki. Presence of
exacerbating factors of persistent perceptual‐postural
dizziness in patients with vestibular symptoms at initial
presentation. Laryngoscope Investigative Otolaryngology, 2022;
DOI: 10.1002/lio2.735 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220309104501.htm

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