Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No.119, South 4th Ring West Road, Fengtai District, Beijing, 100070, China.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
J Neurol. 2022 Mar;269(3):1225-1235. doi: 10.1007/s00415-021-10558-x. Epub 2021 May 21.
Persistent Postural-Perceptual Dizziness (PPPD) is one of the most common types of chronic dizziness. The pathogenesis remains unclear.
This study aimed to systematically review neuroimaging literature for investigating the central mechanism of PPPD and related disorders.
PubMed, EMBASE, Medline, Cochrane, and Web of Science were searched by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles analyzing structural and functional neuroimaging features of PPPD and related disorders were selected according to eligibility criteria.
Fifteen articles, including 4 structural, 10 functional, and 1 multimodal imaging, were eligible for inclusion in this review. The whiter matter alterations in PPPD are not entirely consistent. The changes of grey matter mainly in multisensory vestibular cortices, visual cortex, cerebellum, as well as anxiety-related network. Consistent with structural imaging, functional imaging conducted during the specific tasks or in the resting state has both found abnormal functional activation and connectivity in the vestibular cortex, especially in the parieto-insular vestibular cortex (PIVC), visual cortex, cerebellum, and anxiety-related network in PPPD and related disorder.
The current review provides up-to-date knowledge and summarizes the possible central mechanism for PPPD and related disorders, and it is helpful to understanding the mechanism of PPPD.
持续性姿势-感知性头晕（PPPD）是最常见的慢性头晕类型之一。其发病机制尚不清楚。
本研究旨在系统综述神经影像学文献，以探讨 PPPD 及相关障碍的中枢机制。
根据系统评价和荟萃分析的首选报告项目，通过 PubMed、EMBASE、Medline、Cochrane 和 Web of Science 进行检索。根据纳入标准选择分析 PPPD 和相关障碍的结构和功能神经影像学特征的文章。
本综述共纳入 15 篇文章，包括 4 篇结构影像学、10 篇功能影像学和 1 篇多模态影像学。PPPD 的脑白质改变并不完全一致。灰质的变化主要在多感觉前庭皮质、视觉皮质、小脑以及与焦虑相关的网络中。与结构影像学一致，在特定任务或静息状态下进行的功能影像学研究均发现 PPPD 和相关障碍的前庭皮质，特别是顶岛前庭皮质（PIVC）、视觉皮质、小脑和与焦虑相关的网络中存在异常的功能激活和连通性。
本综述提供了最新的知识，并总结了 PPPD 及相关障碍的可能中枢机制，有助于理解 PPPD 的发病机制。
