Pomper Jörn K, Rabe Saskia, Ilg Uwe, Wolpert Stephan
Tübingen Center for Dizziness and Balance Disorders, University of Tübingen, Tübingen, Germany.
Department of Neurology & Stroke, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
J Neurol. 2025 Aug 30;272(9):600. doi: 10.1007/s00415-025-13334-3.
The diagnostic value of dizziness symptom quality is limited by variability in patient self-reports. Comparing it to the experience during standardized caloric stimulation could help control for individual differences in dizziness experience and reporting. As a nonphysiological stimulus, caloric testing may serve as a proxy for acute peripheral vestibular disorder. We hypothesized that dizziness of peripheral origin would be perceived as more similar to caloric stimulation than nonperipheral dizziness.
Patients with peripheral (n = 49) and nonperipheral dizziness (n = 34) were compared. Using newly developed questionnaires, participants rated the intensity of 30 symptoms during both dizziness and caloric stimulation, compared symptom intensity between the two, and rated overall similarity.
Peripheral patients did not perceive caloric stimulation as more similar to their symptoms than nonperipheral patients. This also held for the functional dizziness subgroup (n = 14). However, exploratory analyses suggest symptom-specific group differences based on the directional intensity difference. For example, peripheral patients reported stronger spinning during their dizziness, whereas nonperipheral patients reported stronger spinning during caloric stimulation. These group differences outperformed those based on the dizziness ratings alone, which likely reflects pronounced caloric symptoms in the nonperipheral group, especially in functional dizziness, rather than stable individual differences. Peripheral patients also reported stronger caloric symptoms than controls without dizziness (n = 20). Symptom-specific group differences were not accounted for by slow-phase velocity of caloric nystagmus.
This study highlights the potential diagnostic value of comparing symptoms with caloric stimulation and provides further support for motion perception overestimation in functional dizziness.
头晕症状特征的诊断价值受患者自我报告变异性的限制。将其与标准化冷热试验期间的体验进行比较，有助于控制头晕体验和报告中的个体差异。作为一种非生理性刺激，冷热试验可作为急性外周前庭疾病的替代指标。我们假设外周性头晕比非外周性头晕在感觉上更类似于冷热刺激。
比较外周性头晕患者（n = 49）和非外周性头晕患者（n = 34）。使用新开发的问卷，参与者对头晕和冷热刺激期间30种症状的强度进行评分，比较两者之间的症状强度，并对总体相似性进行评分。
外周性头晕患者并不比非外周性头晕患者感觉冷热刺激与其症状更相似。这在功能性头晕亚组（n = 14）中也是如此。然而，探索性分析表明，基于方向性强度差异存在症状特异性的组间差异。例如，外周性头晕患者在头晕时报告有更强的旋转感，而非外周性头晕患者在冷热刺激时报告有更强的旋转感。这些组间差异比仅基于头晕评分的差异更显著，这可能反映了非外周性头晕组中明显的冷热症状，尤其是在功能性头晕中，而不是稳定的个体差异。外周性头晕患者也比无头晕的对照组（n = 20）报告有更强的冷热症状。冷热眼震慢相速度不能解释症状特异性的组间差异。
本研究强调了将症状与冷热刺激进行比较的潜在诊断价值，并为功能性头晕中运动感知高估提供了进一步支持。
Zotero 插件