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Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness

Objective: To determine whether performance in a virtual spatial navigational task is poorer in persistent postural perceptual dizziness (PPPD) patients than in healthy volunteers and patients suffering other vestibular disorders. Methods: Subjects were asked to perform three virtual Morris water ma...

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Autores principales: Breinbauer, Hayo A., Contreras, Maria Daniela, Lira, Juan P., Guevara, Claudia, Castillo, Leslie, Ruëdlinger, Katherine, Muñoz, Daniel, Delano, Paul H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970195/
https://www.ncbi.nlm.nih.gov/pubmed/31998220
http://dx.doi.org/10.3389/fneur.2019.01361
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author Breinbauer, Hayo A.
Contreras, Maria Daniela
Lira, Juan P.
Guevara, Claudia
Castillo, Leslie
Ruëdlinger, Katherine
Muñoz, Daniel
Delano, Paul H.
author_facet Breinbauer, Hayo A.
Contreras, Maria Daniela
Lira, Juan P.
Guevara, Claudia
Castillo, Leslie
Ruëdlinger, Katherine
Muñoz, Daniel
Delano, Paul H.
author_sort Breinbauer, Hayo A.
collection PubMed
description Objective: To determine whether performance in a virtual spatial navigational task is poorer in persistent postural perceptual dizziness (PPPD) patients than in healthy volunteers and patients suffering other vestibular disorders. Methods: Subjects were asked to perform three virtual Morris water maze spatial navigational tasks: (i) with a visible target, (ii) then with an invisible target and a fixed starting position, and finally (iii) with an invisible target and random initial position. Data were analyzed using the cumulative search error (CSE) index. Results: While all subjects performed equally well with a visible target, the patients with PPPD (n = 19) performed poorer (p < 0.004) in the invisible target/navigationally demanding tasks (CSE median of 8) than did the healthy controls (n = 18; CSE: 3) and vestibular controls (n = 19; CSE: 4). Navigational performance in the most challenging setting allowed us to discriminate PPPD patients from controls with an area under the receiver operating characteristic curve of 0.83 (sensitivity 78.1%; specificity 83.3%). PPPD patients manifested more chaotic and disorganized search strategies, with more dispersion in the navigational pool than those of the non-PPPD groups (standard distance deviation of 0.97 vs. 0.46 in vestibular controls and 0.20 in healthy controls; p < 0.001). Conclusions: While all patients suffering a vestibular disorder had poorer navigational abilities than healthy controls did, patients with PPPD showed the worst performance, to the point that this variable allowed the discrimination of PPPD from non-PPPD patients. This distinct impairment in spatial navigation abilities offers new insights into PPPD pathophysiology and may also represent a new biomarker for diagnosing this entity.
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spelling pubmed-69701952020-01-29 Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness Breinbauer, Hayo A. Contreras, Maria Daniela Lira, Juan P. Guevara, Claudia Castillo, Leslie Ruëdlinger, Katherine Muñoz, Daniel Delano, Paul H. Front Neurol Neurology Objective: To determine whether performance in a virtual spatial navigational task is poorer in persistent postural perceptual dizziness (PPPD) patients than in healthy volunteers and patients suffering other vestibular disorders. Methods: Subjects were asked to perform three virtual Morris water maze spatial navigational tasks: (i) with a visible target, (ii) then with an invisible target and a fixed starting position, and finally (iii) with an invisible target and random initial position. Data were analyzed using the cumulative search error (CSE) index. Results: While all subjects performed equally well with a visible target, the patients with PPPD (n = 19) performed poorer (p < 0.004) in the invisible target/navigationally demanding tasks (CSE median of 8) than did the healthy controls (n = 18; CSE: 3) and vestibular controls (n = 19; CSE: 4). Navigational performance in the most challenging setting allowed us to discriminate PPPD patients from controls with an area under the receiver operating characteristic curve of 0.83 (sensitivity 78.1%; specificity 83.3%). PPPD patients manifested more chaotic and disorganized search strategies, with more dispersion in the navigational pool than those of the non-PPPD groups (standard distance deviation of 0.97 vs. 0.46 in vestibular controls and 0.20 in healthy controls; p < 0.001). Conclusions: While all patients suffering a vestibular disorder had poorer navigational abilities than healthy controls did, patients with PPPD showed the worst performance, to the point that this variable allowed the discrimination of PPPD from non-PPPD patients. This distinct impairment in spatial navigation abilities offers new insights into PPPD pathophysiology and may also represent a new biomarker for diagnosing this entity. Frontiers Media S.A. 2020-01-09 /pmc/articles/PMC6970195/ /pubmed/31998220 http://dx.doi.org/10.3389/fneur.2019.01361 Text en Copyright © 2020 Breinbauer, Contreras, Lira, Guevara, Castillo, Ruëdlinger, Muñoz and Delano. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Breinbauer, Hayo A.
Contreras, Maria Daniela
Lira, Juan P.
Guevara, Claudia
Castillo, Leslie
Ruëdlinger, Katherine
Muñoz, Daniel
Delano, Paul H.
Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness
title Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness
title_full Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness
title_fullStr Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness
title_full_unstemmed Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness
title_short Spatial Navigation Is Distinctively Impaired in Persistent Postural Perceptual Dizziness
title_sort spatial navigation is distinctively impaired in persistent postural perceptual dizziness
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970195/
https://www.ncbi.nlm.nih.gov/pubmed/31998220
http://dx.doi.org/10.3389/fneur.2019.01361
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