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Persistent Imbalance and Dizziness Syndromes: Latest Advances and Prospects
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Persistent Imbalance and Dizziness Syndromes: Latest Advances and Prospects

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 11051

Special Issue Editor

Dr. Iole Indovina

E-Mail Website
Guest Editor
1. Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98125 Messina, Italy
2. Laboratory of Neuromotor Physiology, Istituto di Ricovero e Cura a Carattere Scientifico Fondazione Santa Lucia, 00179 Rome, Italy
Interests: physiology of the vestibular system; vestibular disorders; PPPD

Special Issue Information

Dear Colleagues,

Dizziness without a clearly identifiable cause affects a large portion of patients attending neurotology units. In 2017 the Committee for Classification of Vestibular Disorders of the International Society for Neuro-otology unified four of these disorders (chronic subjective dizziness, visually induced dizziness, phobic postural vertigo, and space and motion discomfort) under the definition of persistent postural perceptual dizziness (PPPD). This disorder manifests with persistent dizziness, unsteadiness, and swaying or rocking (non-spinning) vertigo.  PPPD can be triggered by illnesses that cause vestibular symptoms (for example vestibular neuritis), but persistent dizziness typically emerges after the acute episode resolves. On the other hand, Mal de Debarquement Syndrome (MdDS) is persistent dizziness that emerges especially after landing from a trip. A bobbing, rocking and swaying sensation persists particularly after sea travels but may also have a spontaneous onset, i.e. in absence of the causing factor related to passive motion exposure during the trip.

This special issue  will be collecting original contributions and review articles about the recentmost advances on these functional vestibular disorders with the intent of improving  the understanding of their pathophysiology and therapeutical basis.

Dr. Iole Indovina
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Vestibular
  • Persistent Postural Perceptual Dizziness(PPPD)
  • Visual Vertigo
  • Mal de Debarquement Syndrome(MdDS)

Published Papers (3 papers)

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Research

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8 pages, 381 KiB  
Article
Vertigo as One of the Symptoms of Lyme Disease
by Klaudia Sowula, Joanna Szaleniec, Mateusz Dworak, Maria Przeklasa, Małgorzata Maraj, Piotr Ceranowicz and Jerzy Tomik
J. Clin. Med. 2021, 10(13), 2814; https://doi.org/10.3390/jcm10132814 - 25 Jun 2021
Cited by 3 | Viewed by 2183
Abstract
Objectives: The aim of the study was to evaluate the frequency of vertigo symptoms and potential labyrinth damage in patients with diagnosed Lyme disease (LD). LD can affect the vestibulocochlear nerve, leading to hearing loss and vertigo/dizziness. Material and Methods: The study included [...] Read more.
Objectives: The aim of the study was to evaluate the frequency of vertigo symptoms and potential labyrinth damage in patients with diagnosed Lyme disease (LD). LD can affect the vestibulocochlear nerve, leading to hearing loss and vertigo/dizziness. Material and Methods: The study included a group of 38 patients between the ages of 20 and 77, who were hospitalized due to vertigo/dizziness between 2018 and 2019. All of the patients underwent a detailed medical interview and an otolaryngological and neurological examination, including video electronystagmography (VENG), in addition to audiological and diagnostic tests. Additionally, ELISA and Western blot tests were performed to confirm the diagnosis of LD. Results: In 20 patients (53%), the Romberg trial was positive (p < 0.001). The degree of vestibular dysfunction as shown by the VENG test was associated with the rate of hearing loss as confirmed by the Auditory Brainstem Response (ABR) test (p = 0.011), and it mainly concerned high-frequency sounds (p = 0.014). Conclusion: Vertigo can be a symptom of LD. It is often associated with labyrinth and hearing-organ damage, which can imply that the inner ear or nerve VIII is dysfunctional in the course of this disease. Antibiotic therapy is effective in reducing otoneurological symptoms. Full article
(This article belongs to the Special Issue Persistent Imbalance and Dizziness Syndromes: Latest Advances and Prospects)
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15 pages, 612 KiB  
Article
A Randomized Controlled Trial Evaluating Integrative Psychotherapeutic Group Treatment Compared to Self-Help Groups in Functional Vertigo/Dizziness
by Karina Limburg, Katharina Radziej, Heribert Sattel, Peter Henningsen, Marianne Dieterich, Thomas Probst, Rachel Dale and Claas Lahmann
J. Clin. Med. 2021, 10(10), 2215; https://doi.org/10.3390/jcm10102215 - 20 May 2021
Cited by 5 | Viewed by 2443
Abstract
We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG). Adult patients with functional [...] Read more.
We tested the efficacy of an integrative psychotherapeutic group treatment (IPGT) in reducing vertigo/dizziness-related impairment along with depression, anxiety, and somatization by conducting a randomized controlled superiority trial comparing IPGT to self-help groups moderated by a clinical psychologist (SHG). Adult patients with functional vertigo and dizziness symptoms were randomly allocated to either the IPGT or SHG as active control group. Outcomes were assessed at baseline (t0), after treatment lasting 16 weeks (t1), and 12 months after treatment (t2). A total of 81 patients were assigned to IPGT and 78 patients were assigned to SHG. Vertigo-related impairment was reduced in both conditions (IPGT: t0–t1: d = 1.10, t0–t2: d = 1.06; SHG: t0–t1: d = 0.86, t0–t2: d = 1.29), showing the efficiency of both IPGT and SHG. Clinically relevant improvements were also obtained for depression in both groups. Linear mixed model analyses revealed no differences between groups for all outcomes (effect of group for the primary outcome: b = −1.15, SE = 2.13, t = −0.54, p = 0.59). Attrition rates were higher in SHG (52.6%) than in IPGT (28.4%). Both conditions improved primary and secondary outcomes while IPGT was better accepted by patients than SHG. Trial registration: ClinicalTrials.gov, Identifier: NCT02320851. Full article
(This article belongs to the Special Issue Persistent Imbalance and Dizziness Syndromes: Latest Advances and Prospects)
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Review

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19 pages, 29252 KiB  
Review
Brain Correlates of Persistent Postural-Perceptual Dizziness: A Review of Neuroimaging Studies
by Iole Indovina, Luca Passamonti, Viviana Mucci, Giuseppe Chiarella, Francesco Lacquaniti and Jeffrey P. Staab
J. Clin. Med. 2021, 10(18), 4274; https://doi.org/10.3390/jcm10184274 - 21 Sep 2021
Cited by 19 | Viewed by 5551
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Persistent Imbalance and Dizziness Syndromes: Latest Advances and Prospects)
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