Subtypes of Persistent Postural-Perceptual Dizziness.
Subtypes of Persistent Postural-Perceptual Dizziness.
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DOI：
10.3389/fneur.2021.652366
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发表时间：
2021
影响因子：
3.4
通讯作者：
Horii A
中科院分区：
文献类型：
--
作者：
Yagi C;Morita Y;Kitazawa M;Yamagishi T;Ohshima S;Izumi S;Takahashi K;Horii A
背景：持续性体位-知觉头晕（PPPD）是一种持续性慢性前庭综合征，可因直立姿势/行走、主动或被动运动以及暴露于运动或复杂的视觉刺激而加重。PPPD有四种前兆：恐惧性体位性眩晕、空间运动不适、视觉眩晕和慢性主观性头晕。这四种疾病具有共同的临床特征，构成PPPD诊断标准的基础。符号学上的相似性并不一定意味着PPPD是一个单一的实体。但是，如果PPPD不是单一的疾病，而是四种前体的复合，则可以根据每种前体的特征进行细分。目的：为了检验PPPD是否为单一疾病，我们尝试对PPPD进行分型。方法：118例未经治疗的PPPD患者被纳入研究，他们填写了Niigata PPPD问卷（NPQ），该问卷包含12个关于PPPD加重因素的问题。对患者对NPQ的回答进行因子分析，并利用因子分析揭示的因素对PPPD患者进行聚类分析。为了验证我们的聚类分类，我们使用方差分析来评估聚类差异。对人口统计数据、诱发性疾病、头晕障碍量表、医院焦虑和抑郁量表以及若干前庭测试进行了多重比较分析，以表征每个聚类。结果：因子分析揭示了NPQ加重因素中的三个潜在因素。视觉刺激加重（视觉因子）占问卷总方差的47.4%。行走/主动运动（主动运动因子）和被动运动/站立（被动运动/站立因子）分别占12.0%和7.67%的方差。聚类分析显示三种类型：视觉显性亚型（n = 49）；主动运动主导型（n = 20）；混合亚型（n = 39）。主动运动优势型患者年龄明显大于视觉优势型患者。在其他人口统计学数据或常规前庭检查中，各亚型间无显著差异。结论：PPPD最常见的主要加重因素为视觉因素。PPPD可分为三种亚型。传统的前庭测试未能指出每种亚型的特征。
Background: Persistent postural-perceptual dizziness (PPPD) is a persistent chronic vestibular syndrome exacerbated by upright posture/walking, active or passive motion, and exposure to moving or complex visual stimuli. PPPD has four precursors: phobic postural vertigo, space-motion discomfort, visual vertigo, and chronic subjective dizziness. These four diseases share clinical features that form the basis of the diagnostic criteria for PPPD. Semiological similarities do not necessarily mean that PPPD is a single entity. However, if PPPD is not a single disorder but just a composite of four precursors, it may be subdivided according to the characteristics of each precursor. Objective: To test whether PPPD is a single disorder, we attempted a subtyping of PPPD. Methods: One-hundred-eight untreated patients with PPPD were enrolled in the study, who filled out the Niigata PPPD Questionnaire (NPQ) that consists of 12 questions on exacerbating factors for PPPD. A factor analysis of the patients' answers to the NPQ and a subsequent cluster analysis of the patients with PPPD using factors revealed by the factor analysis were performed. To validate our cluster classification, cluster differences were assessed using analysis of variance. Multiple comparison analyses were performed on demographical data, precipitating diseases, the Dizziness Handicap Inventory, the Hospital Anxiety and Depression Scale, and several vestibular tests to characterize each cluster. Results: Factor analysis revealed three underlying factors among the exacerbating factors in the NPQ. Exacerbation by visual stimuli (visual factor) accounted for 47.4% of total variance in the questionnaire. Exacerbation by walking/active motion (active-motion factor) and by passive motion/standing (passive-motion/standing factor) accounted for 12.0 and 7.67% of variance, respectively. Cluster analysis revealed three clusters: the visual-dominant subtype (n = 49); the active motion-dominant subtype (n = 20); and the mixed subtype (n = 39). The patients in the active motion-dominant subtype were significantly older than those in the visual-dominant subtype. There were no significant differences among the subtypes in other demographical data or conventional vestibular tests. Conclusions: The most common main exacerbating factor of PPPD was the visual factor. PPPD may be categorized into three subtypes. Conventional vestibular tests failed to point the characteristics of each subtype.
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影响因子：
3.7
作者：
Cousins, Sian;Cutfield, Nicholas J.;Bronstein, Adolfo M.
通讯作者：
Bronstein, Adolfo M.
影响因子：
3.4
作者：
Riccelli R;Passamonti L;Toschi N;Nigro S;Chiarella G;Petrolo C;Lacquaniti F;Staab JP;Indovina I
通讯作者：
Indovina I
DOI：
10.1016/s0003-438x(05)82354-0
发表时间：
2005-11-01
期刊：
Annales d'oto-laryngologie et de chirurgie cervico faciale : bulletin de la Societe d'oto-laryngologie des hopitaux de Paris
影响因子：
--
作者：
Ionescu, E;Dubreuil, C;Ferber-Viart C, C
通讯作者：
Ferber-Viart C, C
影响因子：
2.6
作者：
Staab, JP;Ruckenstein, MJ;Amsterdam, JD
通讯作者：
Amsterdam, JD
影响因子：
2.3
作者：
Staab, Jeffrey P.;Eckhardt-Henn, Annegret;Horii, Arata;Jacob, Rolf;Strupp, Michael;Brandt, Thomas;Bronstein, Adolfo
通讯作者：
Bronstein, Adolfo