Goto Fumiyuki, Wasano Koichiro, Masuda Kanako, Yamanobe Yoshiharu, Mizuno Kohei, Uoshima Riichi, Yagi Chihiro, Horii Arata
Otolaryngology - Head and Neck Surgery, Tokai University School of Medicine, Isehara, JPN.
Otolaryngology - Head and Neck Surgery, Tokai University, Isehara, JPN.
Cureus. 2025 Aug 12;17(8):e89886. doi: 10.7759/cureus.89886. eCollection 2025 Aug.
Introduction This study investigated postural instability in patients with persistent postural-perceptual dizziness (PPPD) in response to moving visual stimuli, using posturography to assess visual-ratio-derived sway responses. While visual factors exacerbate symptoms, the neural mechanisms remain unclear. Methods We studied six individuals with PPPD, six healthy controls (HCs), and 35 patients with various vestibular dysfunctions lasting more than three months. Using posturography, we measured sway area with eyes open and closed for 60 seconds. Participants fixated on visual stimuli for 60 secs: a checkerboard, vertical stripes, or optic flow. Measurements were taken during stimulation, calculating visual ratios (VRs) with open eyes. Results No significant pre- or post-stimuli differences in sway area were found. However, VR was significantly higher in PPPD patients compared to other disease groups, indicating increased instability during visual stimuli, consistent with visually induced dizziness. Conclusion Postural instability during moving visual stimuli suggests a potential objective diagnostic tool for PPPD. These findings offer insights into the neural mechanisms of PPPD symptom exacerbation by visual stimuli and support the utility of visual-stimulus-based posturography as an adjunctive diagnostic tool for PPPD.
引言 本研究通过姿势描记法评估视觉比率衍生的摇摆反应，调查持续性姿势-感知性头晕（PPPD）患者对移动视觉刺激的姿势不稳情况。虽然视觉因素会加重症状，但其神经机制仍不清楚。方法 我们研究了6名PPPD患者、6名健康对照者（HCs）以及35名患有持续超过3个月的各种前庭功能障碍的患者。使用姿势描记法，我们测量了睁眼和闭眼60秒时的摇摆面积。参与者注视视觉刺激60秒：棋盘格、垂直条纹或视流。在刺激期间进行测量，计算睁眼时的视觉比率（VRs）。结果 在摇摆面积方面，刺激前和刺激后均未发现显著差异。然而，与其他疾病组相比，PPPD患者的VR显著更高，表明在视觉刺激期间不稳定性增加，这与视觉诱发的头晕一致。结论 移动视觉刺激期间的姿势不稳提示PPPD可能有潜在的客观诊断工具。这些发现为视觉刺激加重PPPD症状的神经机制提供了见解，并支持基于视觉刺激的姿势描记法作为PPPD辅助诊断工具的实用性。
