Multicenter Study

. 2024 Feb;14(2):e3389.

doi: 10.1002/brb3.3389.

Clinical characteristics of persistent postural-perceptual dizziness and its visual subtype in Korean patients: A multicenter cross-sectional study

Joo Hyun Park¹, Thanh Tin Nguyen^{2

3}, Sung-Hee Kim⁴, Ji-Yun Park⁵, Seunghee Na⁶, Eun-Ju Jeon⁷, Ji Won Seo⁸, Chang Gun Cho¹, Se-Joon Oh⁹, Sung-Won Choi⁹, Kwang-Dong Choi¹⁰, Seo-Young Choi¹⁰, Ji Eun Choi¹¹, Sung-Kwang Hong¹², Won-Ho Chung¹³, Young Sang Cho¹³, Hwan Ho Lee¹⁴, Yong-Hwi An¹⁵, Kyu-Hee Han¹⁶, Hyung Lee¹⁷, Hyun Ah Kim¹⁷, Ho Yun Lee¹⁸, Jong-Dae Lee¹⁹, Se A Lee¹⁹, Sun-Young Oh²⁰

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan hospital, Goyang, South Korea.
² Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of Medicine, Jeonju, South Korea.
³ Department of Pharmacology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
⁴ Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
⁵ Department of Neurology, Ulsan University Hospital, Ulsan, South Korea.
⁶ Department of Neurology, The Catholic University, Incheon Saint Mary's Hospital, Incheon, South Korea.
⁷ Department of Otorhinolaryngology-Head and Neck Surgery, The Catholic University, Incheon Saint Mary's Hospital, Incheon, South Korea.
⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University, Samsung Changwon Hospital, Changwon, South Korea.
⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.
¹⁰ Department of Neurology, Pusan National University Hospital, Busan, South Korea.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, South Korea.
¹² Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University, Samsung Seoul Hospital, Seoul, South Korea.
¹⁴ Department of Otolaryngology-Head and Neck Surgery, Kosin University Hospital, Busan, South Korea.
¹⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Eulji University, Nowon Eulji Medical Center, Seoul, South Korea.
¹⁶ Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, South Korea.
¹⁷ Department of Neurology, Keimyung University, Keimyung University Dongsan Hospital, Daegu, South Korea.
¹⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
¹⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University, Bucheon Hospital, Bucheon, South Korea.
²⁰ Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National.

PMID: 38391108
PMCID: PMC10831130
DOI: 10.1002/brb3.3389

Multicenter Study

Clinical characteristics of persistent postural-perceptual dizziness and its visual subtype in Korean patients: A multicenter cross-sectional study

Joo Hyun Park et al. Brain Behav. 2024 Feb.

. 2024 Feb;14(2):e3389.

doi: 10.1002/brb3.3389.

Authors

Affiliations

¹ Department of Otorhinolaryngology-Head and Neck Surgery, Dongguk University Ilsan hospital, Goyang, South Korea.
² Department of Neurology, Jeonbuk National University Hospital, Jeonbuk National University School of Medicine, Jeonju, South Korea.
³ Department of Pharmacology, Hue University of Medicine and Pharmacy, Hue University, Hue, Vietnam.
⁴ Department of Neurology, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
⁵ Department of Neurology, Ulsan University Hospital, Ulsan, South Korea.
⁶ Department of Neurology, The Catholic University, Incheon Saint Mary's Hospital, Incheon, South Korea.
⁷ Department of Otorhinolaryngology-Head and Neck Surgery, The Catholic University, Incheon Saint Mary's Hospital, Incheon, South Korea.
⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University, Samsung Changwon Hospital, Changwon, South Korea.
⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, South Korea.
¹⁰ Department of Neurology, Pusan National University Hospital, Busan, South Korea.
¹¹ Department of Otorhinolaryngology-Head and Neck Surgery, Dankook University Hospital, Cheonan, South Korea.
¹² Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Sacred Heart Hospital, Anyang, South Korea.
¹³ Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University, Samsung Seoul Hospital, Seoul, South Korea.
¹⁴ Department of Otolaryngology-Head and Neck Surgery, Kosin University Hospital, Busan, South Korea.
¹⁵ Department of Otorhinolaryngology-Head and Neck Surgery, Eulji University, Nowon Eulji Medical Center, Seoul, South Korea.
¹⁶ Department of Otorhinolaryngology-Head and Neck Surgery, National Medical Center, Seoul, South Korea.
¹⁷ Department of Neurology, Keimyung University, Keimyung University Dongsan Hospital, Daegu, South Korea.
¹⁸ Department of Otorhinolaryngology-Head and Neck Surgery, Ewha Womans University Mokdong Hospital, Seoul, South Korea.
¹⁹ Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University, Bucheon Hospital, Bucheon, South Korea.
²⁰ Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National.

PMID: 38391108
PMCID: PMC10831130
DOI: 10.1002/brb3.3389

Abstract

Objectives: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder for which the Bárány Society has established diagnostic criteria. This nationwide multicenter study aims to investigate the clinical features of individuals with definite PPPD and clinical variant PPPD who do not fully meet the diagnostic criteria, with a particular focus on visual exaggeration.

Methods: Between September 2020 and September 2021, a total of 76 individuals with definite PPPD and 109 individuals with clinical variant PPPD who did not meet all three exacerbating factors outlined in Criterion B were recruited from 18 medical centers in South Korea. The study gathered information on demographic factors, clinical manifestations, balance scales, and personality assessments.

Results: Comparative analysis between groups with definite PPPD and clinical variant with visual exacerbation revealed no significant differences in sociodemographic characteristics, clinical course, dizziness impact, and specific precipitants. Only disease duration was significantly longer in definite PPPD compared with variant with visual exacerbation. However, the variant without visual exacerbation displayed significantly reduced rates of panic disorder, diminished space-motion discomfort, lesser impact of dizziness, and decreased prevalence of depression when compared with the definitive PPPD.

Conclusion: This is the first comprehensive nationwide study examining clinical features of both definite PPPD patients and its clinical variants, considering visual exacerbating factors. Differences in dizziness and personality traits emerged between definite PPPD and its potential variant without visual issues. Our results highlight the possibility of a distinct clinical variant of PPPD influenced by visual dependency.

Keywords: chronic dizziness; persistent postural-perceptual dizziness; variant; visual subtype.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

**FIGURE 1**
Flow chart represents the data acquisition.

**FIGURE 2**
Venn diagram illustrating the distribution of clinical variant persistent postural‐perceptual dizziness (PPPD) patients based on visual exacerbation.

See this image and copyright information in PMC

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Clinical characteristics of persistent postural-perceptual dizziness and its visual subtype in Korean patients: A multicenter cross-sectional study

Affiliations

Clinical characteristics of persistent postural-perceptual dizziness and its visual subtype in Korean patients: A multicenter cross-sectional study

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Conflict of interest statement

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