Toupet Michel, Van Nechel Christian, Hautefort Charlotte, Heuschen Sylvie, Duquesne Ulla, Cassoulet Anne, Bozorg Grayeli Alexis
Otolaryngology Department, Dijon University Hospital, Université Bourgogne-Franche Comté, Dijon, France.
Centre d'Explorations Fonctionnelles Otoneurologiques, Paris, France.
Front Neurol. 2019 Feb 13;10:69. doi: 10.3389/fneur.2019.00069. eCollection 2019.
The aim of this study was to investigate the relation between visual and vestibular hypersensitivity, and Depersonalization/Derealization symptoms in patients with chronic dizziness. 319 adult patients with chronic dizziness for more than 3 months (214 females and 105 males, mean age: 58 years, range: 13-90) were included in this prospective cross-sectional study. Patients underwent a complete audio-vestibular workup and 3 auto questionnaires: Hospital Anxiety and Depression (HAD), Depersonalization/Derealization Inventory (DDI), and an in-house questionnaire (Dizziness in Daily Activity, DDA) assessing 9 activities with a score ranging from 0 (no difficulty) to 10 (maximal discomfort) and 11 (avoidance) to detect patients with visual and vestibular hypersensitivity (VVH, a score > 41 corresponding to mean + 1 standard deviation). DDI scores were higher in case of VVH (6.9 ± 6.79, = 55 vs. 4.2 ± 4.81, = 256 without VVH, < 0.001, unpaired test), migraine (6.1 ± 6.40, = 110 vs. 4.0 ± 4.42, = 208no migraine, < 0.001, unpaired test), and motion sickness (6.8 ± 5.93, = 41 vs. 4.4 ± 5.11, = 277 no motion sickness, < 0.01, unpaired test). Women scored DDI higher than men (5.1 ± 5.42, = 213 vs. 3.9 ± 4.91, = 105, respectively, < 0.05, unpaired test). DDI scores were also related to depression and anxiety. DDI score was also higher during spells than during the basal state. During chronic dizziness, Depersonalization/Derealization symptoms seem to be related to anxiety and depression. Moreover, they were prominent in women, in those with visual and vestibular hypersensitivity, migraine, and motion sickness.
本研究旨在探讨慢性头晕患者视觉和前庭超敏反应与人格解体/现实解体症状之间的关系。319例慢性头晕超过3个月的成年患者（214例女性和105例男性，平均年龄：58岁，范围：13 - 90岁）纳入了这项前瞻性横断面研究。患者接受了全面的听-前庭检查以及3份自动问卷：医院焦虑抑郁量表（HAD）、人格解体/现实解体量表（DDI），以及一份内部问卷（日常活动中的头晕，DDA），该问卷评估9项活动，评分范围从0（无困难）到10（最大不适）以及11（避免），以检测视觉和前庭超敏反应患者（VVH，评分>41对应于均值 + 1标准差）。有VVH的患者DDI评分更高（6.9±6.79，n = 55，而无VVH的患者为4.2±4.81，n = 256，P<0.001，非配对检验），偏头痛患者（6.1±6.40，n = 110，而无偏头痛的患者为4.0±4.42，n = 208，P<0.001，非配对检验），以及晕动病患者（6.8±5.93，n = 41，而无晕动病的患者为4.4±5.11，n = 277，P<0.01，非配对检验）。女性的DDI评分高于男性（分别为5.1±5.42，n = 213和3.9±4.91，n = 105，P<0.05，非配对检验）。DDI评分也与抑郁和焦虑有关。发作期间的DDI评分也高于基础状态时。在慢性头晕期间，人格解体/现实解体症状似乎与焦虑和抑郁有关。此外，这些症状在女性、有视觉和前庭超敏反应者、偏头痛患者以及晕动病患者中更为突出。
