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  • Predictors of persistent postural-perceptual dizziness (PPPD) and similar forms of chronic dizziness precipitated by peripheral vestibular disorders: a systematic review

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Neuropsychiatry
Systematic review
Predictors of persistent postural-perceptual dizziness (PPPD) and similar forms of chronic dizziness precipitated by peripheral vestibular disorders: a systematic review
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  • Published on: 9 August 2024
    Re: Predictors of persistent postural-perceptual dizziness (PPPD) and similar forms of chronic dizziness precipitated by peripheral vestibular disorders: a systematic review
    • VISHAK MS, Otorhinolaryngologist Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) ,Pondicherry,India

    Dear Editor,
    I read with interest the recent systematic review by Trinidade et al. on predictors of persistent postural-perceptual dizziness (PPPD) following peripheral vestibular disorders (1). The authors provided a thoughtful synthesis of the literature and identified key psychological factors associated with PPPD development. However, I believe the review overlooked some relevant evidence regarding additional predictors and pathophysiological mechanisms of chronic dizziness.
    Specifically, the authors did not discuss the potential role of cervical spine dysfunction and somatosensory abnormalities as PPPD risk factors. Several studies have identified exaggerated cervical spine proprioceptive signals and impaired cervical graviceptive processing in patients with PPPD (2). Additionally, there is evidence that migraine and migraine-related vestibulopathy may predispose individuals to developing chronic subjective dizziness after acute peripheral vestibular events (3,4). Investigation of these factors may provide further insight into PPPD pathophysiology.
    Moreover, the authors focused their review on peripheral vestibular disorders as PPPD triggers. However, central vestibular disorders like vestibular migraine can also lead to PPPD, especially among those with pre-existing migraine. (5) A review incorporating evidence from central vestibular precipitants could offer a more comprehensive view of PPPD development.
    In summary, while Trinidade et al. pre...

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    Conflict of Interest:
    None declared.