Studies and Applications of Multi-Sensory Integration Abnormalities and Neuroplasticity in PPPD

Authors

  • Zhiqing Ma

DOI:

https://doi.org/10.54097/9rzb7m44

Keywords:

Persistent Postural-Perceptual Dizziness, Multi-sensory Integration Abnormalities, Neuroplasticity, Visual Dependence

Abstract

Persistent postural-perceptual dizziness (PPPD) is a vestibular dysfunction disorder characterized by chronic non-rotatory dizziness, postural instability, and excessive sensitivity to complex visual environments. Its pathogenesis is not yet fully understood. Recent studies have shown that PPPD patients have enhanced visual dependence, abnormal vestibular and proprioceptive senses, leading to multimodal perceptual conflicts and forming a vicious cycle of "visual-anxiety-symptom aggravation". At the same time, the structural and functional plasticity of the brain regions in patients is disordered, further solidifying the abnormal perceptual patterns. This review sorts out the related research on the abnormal multisensory integration and neural plasticity changes of PPPD, aiming to reveal its important role in the chronicity of the disease and its precise treatment, with the expectation that in the future, through interdisciplinary research, the dynamic interaction relationship will be revealed, and based on neural plasticity, multi-level and individualized treatment strategies will be developed.

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References

Tang Yong, Yan Zhihui, Xue Hui, et al. Expert Consensus on Persistent Postural-Perceptual Dizziness [J]. Chinese Journal of Otolaryngology, 2021, 19(06): 992-996.

[2] Staab J P, Eckhardt-Henn A, Horii A, et al. Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the Bárány Society [J]. J Vestib Res, 2017, 27(4): 191-208.

[3] Ishizuka K, Shikino K, Yamauchi Y, et al. The Clinical Key Features of Persistent Postural Perceptual Dizziness in the General Medicine Outpatient Setting: A Case Series Study of 33 Patients [J]. Intern Med, 2020, 59(22): 2857-62.

[4] Popkirov S, Staab J P, Stone J. Persistent postural-perceptual dizziness (PPPD): a common, characteristic and treatable cause of chronic dizziness [J]. Pract Neurol, 2018, 18(1): 5-13.

[5] Senkowski D, Engel A K. Multi-timescale neural dynamics for multisensory integration [J]. Nat Rev Neurosci, 2024, 25(9): 625-42.

[6] Liu B, Shan J, Gu Y. Temporal and spatial properties of vestibular signals for perception of self-motion [J]. Front Neurol, 2023, 14: 1266513.

[7] Keshavarzi S, Velez-Fort M, Margrie T W. Cortical Integration of Vestibular and Visual Cues for Navigation, Visual Processing, and Perception [J]. Annu Rev Neurosci, 2023, 46: 301-20.

[8] Smith L J, Wilkinson D, Bodani M, et al. Cognition in vestibular disorders: state of the field, challenges, and priorities for the future [J]. Front Neurol, 2024, 15: 1159174.

[9] Zeng Z, Zhang C, Gu Y. Visuo-vestibular heading perception: a model system to study multi-sensory decision making [J]. Philos Trans R Soc Lond B Biol Sci, 2023, 378 (1886): 20220334.

[10] Mccaslin D L, Shepard N T, Hollman J H, et al. Characterization of Postural Sway in Patients With Persistent Postural-Perceptual Dizziness (PPPD) Using Wearable Motion Sensors [J]. Otol Neurotol, 2022, 43(2): e243-e51.

[11] De Vestel C, De Hertogh W, Van Rompaey V, et al. Comparison of Clinical Balance and Visual Dependence Tests in Patients With Chronic Dizziness With and Without Persistent Postural-Perceptual Dizziness: A Cross-Sectional Study [J]. Front Neurol, 2022, 13: 880714.

[12] Powell G, Penacchio O, Derry-Sumner H, et al. Visual stress responses to static images are associated with symptoms of Persistent Postural Perceptual Dizziness (PPPD) [J]. J Vestib Res, 2022, 32(1): 69-78.

[13] Chang T P, Hong Y C, Schubert M C. Visual vertigo and motion sickness is different between persistent postural-perceptual dizziness and vestibular migraine [J]. Am J Otolaryngol, 2024, 45(4): 104321.

[14] Storm R, Krause J, Blüm S K, et al. Visual and vestibular motion perception in persistent postural-perceptual dizziness (PPPD) [J]. J Neurol, 2024, 271(6): 3227-38.

[15] Yagi C, Morita Y, Yamagishi T, et al. Gaze instability after exposure to moving visual stimuli in patients with persistent postural-perceptual dizziness [J]. Front Hum Neurosci, 2022, 16: 1056556.

[16] Kobel M J, Wagner A R, Oas J G, et al. Characterization of Vestibular Perception in Patients with Persistent Postural-Perceptual Dizziness [J]. Otol Neurotol, 2024, 45(1): 75-82.

[17] Helmchen C, Blüm S K, Storm R, et al. Postural motion perception during vestibular stimulation depends on the motion perception threshold in persistent postural-perceptual dizziness [J]. J Neurol, 2024, 271(8): 4909-24.

[18] Jáuregui-Renaud K, Cabrera-Pereyra R, Miguel-Puga J A, et al. Graviception Uncertainty, Spatial Anxiety, and Derealization in Patients with Persistent Postural-Perceptual Dizziness [J]. J Clin Med, 2024, 13(22).

[19] Yagi C, Morita Y, Kitazawa M, et al. Head Roll-Tilt Subjective Visual Vertical Test in the Diagnosis of Persistent Postural-Perceptual Dizziness [J]. Otol Neurotol, 2021, 42(10): e1618-e24.

[20] Kobel M J, Wagner A R, Merfeld D M. Recurrence quantification analysis of postural sway in patients with persistent postural perceptual dizziness [J]. Front Rehabil Sci, 2023, 4: 1142018.

[21] Ichijo K, Oka M, Koda K, et al. Analysis of postural stability using foam posturography in patients with persistent postural-perceptual dizziness [J]. J Vestib Res, 2024, 34(2-3): 133-44.

[22] Varangot-Reille C, Pezzulo G, Thacker M. The fear-avoidance model as an embodied prediction of threat [J]. Cogn Affect Behav Neurosci, 2024, 24(5): 781-92.

[23] Tramontano M, Paolocci G, Piatti D, et al. Dynamic postural stability, symmetry, and smoothness of gait in patients with persistent postural-perceptual dizziness [J]. J Vestib Res, 2024: 9574271241295615.

[24] Shibata D, Namiki T, Higuchi R. Identification of a mislabeled fixed specimen by DNA analysis [J]. Am J Surg Pathol, 1990, 14(11): 1076-8.

[25] Grosch M, Lindner M, Bartenstein P, et al. Dynamic whole-brain metabolic connectivity during vestibular compensation in the rat [J]. Neuroimage, 2021, 226: 117588.

[26] Faralli A, Dagna F, Albera A, et al. Modifications of perineuronal nets and remodelling of excitatory and inhibitory afferents during vestibular compensation in the adult mouse [J]. Brain Struct Funct, 2016, 221(6): 3193-209.

[27] Lee R X, Huang J J, Huang C, et al. Plasticity of cerebellar Purkinje cells in behavioral training of body balance control [J]. Front Syst Neurosci, 2015, 9: 113.

[28] Allum J H, Honegger F. Recovery times of stance and gait balance control after an acute unilateral peripheral vestibular deficit [J]. J Vestib Res, 2016, 25(5-6): 219-31.

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Published

29-03-2026

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Articles

How to Cite

Ma, Z. (2026). Studies and Applications of Multi-Sensory Integration Abnormalities and Neuroplasticity in PPPD. International Journal of Biology and Life Sciences, 13(3), 111-114. https://doi.org/10.54097/9rzb7m44