Redfern Mark S, Furman Joseph M, Jacob Rolf G
Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA 15213, USA.
J Anxiety Disord. 2007;21(5):704-16. doi: 10.1016/j.janxdis.2006.09.002. Epub 2006 Oct 12.
Postural sensitivity to moving visual environments in patients with anxiety disorders was studied. We hypothesized that patients with anxiety disorders would have greater sway in response to a moving visual environment compared to healthy adults, especially if they have space and motion discomfort (SMD). Twenty-one patients with generalized anxiety without panic (NPA) and 38 patients with panic and agoraphobia (PAG) were compared to 22 healthy controls. SMD was evaluated in all subjects via questionnaire. Subjects stood on a force platform that was either fixed or rotating with the subject (i.e., sway referenced) during exposure to a sinusoidally moving visual surround. Center of pressure (COP) data were computed from force transducers in the platform as a measure of sway. Results showed that patients swayed significantly more in response to the moving visual scene compared to control subjects, with no differences between the NPA and PAG groups. SMD was a predictor of sway response in the patients: patients with high SMD swayed significantly more than both Controls and anxiety patients with low SMD. These results indicate that patients with anxiety disorders, particularly those with SMD, are more visually dependent for balance. This subgroup of patients may be amenable to treatment used for patients with balance disorders (i.e., vestibular rehabilitation) that focuses on sensory re-integration processes that address visual sensitivity.
对焦虑症患者在移动视觉环境中的姿势敏感性进行了研究。我们假设，与健康成年人相比，焦虑症患者在移动视觉环境中的摆动会更大，尤其是那些有空间和运动不适（SMD）的患者。将21名无惊恐发作的广泛性焦虑症患者（NPA）和38名伴有惊恐发作和场所恐惧症的患者（PAG）与22名健康对照者进行比较。通过问卷对所有受试者的SMD进行评估。受试者站在一个力平台上，在暴露于正弦移动的视觉环绕环境时，平台要么固定，要么与受试者一起旋转（即摆动参考）。通过平台中的力传感器计算压力中心（COP）数据，作为摆动的一种测量方法。结果显示，与对照受试者相比，患者对移动视觉场景的摆动明显更多，NPA组和PAG组之间没有差异。SMD是患者摆动反应的一个预测指标：高SMD的患者比对照组和低SMD的焦虑症患者摆动明显更多。这些结果表明，焦虑症患者，尤其是那些有SMD的患者，在平衡方面对视觉的依赖性更强。这一亚组患者可能适合采用针对平衡障碍患者的治疗方法（即前庭康复），该方法侧重于解决视觉敏感性的感觉再整合过程。
