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Wu T, Dong H, Liu Y, Cao Z, Sun L. Combination of UPLC-Q-TOF/MS and network pharmacology to reveal the mechanism of Chaihu-jia-Longgu-Muli decoction for treating vertigo with anxiety disorder. Biomed Chromatogr 2024; 38:e5881. [PMID: 38763770 DOI: 10.1002/bmc.5881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/21/2024] [Accepted: 03/25/2024] [Indexed: 05/21/2024]
Abstract
Chaihu-jia-Longgu-Muli decoction (CLMD) has been proven clinically effective in treating vertigo with anxiety disorder. However, the mechanism is not clear. This study aimed to explore the mechanism of CLMD in treating vertigo with anxiety disorder based on ultra-performance liquid chromatography-quadrupole time-of-flight/mass spectrometry (UPLC-Q-TOF/MS) and network pharmacology. UPLC-Q-TOF/MS was performed to identify the compounds in blood and the targets of compounds of CLMD in vertigo and anxiety were searched using databases. A protein-protein interaction network was built to screen the core targets. The core targets were analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses. In addition, the vertigo with anxiety rat model was used to verify the results. A total of 22 compounds were absorbed into the blood. Eighty-one potential targets associated with CLMD for vertigo with anxiety disorder were identified through network pharmacological analysis. Subsequently, GO and KEGG analysis showed that CLMD treatment for vertigo with anxiety disorder is associated with neurotransmitter levels and other pertinent physiological processes. The results of the animal experiments showed that CLMD decreased the levels of serotonin, norepinephrine and dopamine, alleviating the symptoms of vertigo and anxiety disorder in model rats. The study revealed CLMD could alleviate vertigo and anxiety symptoms through reducing the levels of neurotransmitters.
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Affiliation(s)
- Tong Wu
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Hanshuo Dong
- Dizziness Clinic, Jilin Provincial Academy of Chinese Medicine Sciences, Changchun, Jilin, China
| | - Yin Liu
- Dizziness Clinic, Jilin Provincial Academy of Chinese Medicine Sciences, Changchun, Jilin, China
| | - Zhenghua Cao
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Li Sun
- Dizziness Clinic, Jilin Provincial Academy of Chinese Medicine Sciences, Changchun, Jilin, China
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Dastgerdi ZH, Gohari N, Mehrabifard M, Seifi H, Khavarghazalani B. Effect of Vestibular Rehabilitation on Sleep Quality and Depression in the Elderly With Chronic Dizziness: A Prospective Study. J Audiol Otol 2024; 28:114-118. [PMID: 38052525 PMCID: PMC11065551 DOI: 10.7874/jao.2023.00171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/14/2023] [Accepted: 07/17/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Dizziness and the accompanying complaints, including sleep disorders and depression, are common among the elderly. This study investigated the effect of vestibular rehabilitation on complaints of dizziness, sleep problems, and the severity of depression in older people with chronic dizziness. SUBJECTS AND METHODS The study included 25 participants with chronic dizziness accompanied by comorbid sleep disturbance (Pittsburgh Sleep Quality Index [PSQI] global score >5). Participants completed the Dizziness Handicap Inventory (three sub-scales: physical, emotional, and functional), the PSQI, and the Persian version of the shortened Beck Depression Inventory (BDI-13) before and after the vestibular rehabilitation. RESULTS The findings showed that the handicap caused by dizziness, the severity of depression, and the quality of sleep in the study participants improved significantly after the intervention (p<0.05). CONCLUSIONS Vestibular rehabilitation is an effective intervention to reduce dizziness handicap, comorbid sleep disturbance, and depression.
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Affiliation(s)
| | - Nasrin Gohari
- Department of Audiology, Hamadan University of Medical Sciences, Hamadan, Iran
- Hearing Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mobina Mehrabifard
- Department of Audiology, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hasti Seifi
- Department of Audiology, Isfahan University of Medical Sciences, Isfahan, Iran
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Wassermann A, Finn S, Axer H. Age-Associated Characteristics of Patients With Chronic Dizziness and Vertigo. J Geriatr Psychiatry Neurol 2022; 35:580-585. [PMID: 34338064 PMCID: PMC9210108 DOI: 10.1177/08919887211036185] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The incidence of dizziness and vertigo is increasing with age, and symptoms lead to significant limitations in daily living and to disability in older patients. METHOD Data of 1,752 patients with chronic dizziness/vertigo subjected to a tertiary care, specialized interdisciplinary vertigo center were analyzed. Age, gender, symptoms, medical diagnosis, and Dizziness Handicap Inventory (DHI) were collected based on a questionnaire and analysis of associated patient records. The patients were assigned to 3 age groups (< 41, 41-65, and > 65 years). RESULTS 33.7% of the patients were older than 65 years. Frequency of symptoms and DHI score increased with age. Older patients reported less frequently about coexisting symptoms such as nausea, headache, tinnitus, ear pressure, and visual impairment. Multisensory deficit, central vertigo, bilateral vestibulopathy, and benign paroxysmal positional vertigo were diagnosed increasingly with age, while persistent postural-perceptual dizziness and vestibular migraine were diagnosed in the younger age groups. CONCLUSION In the diagnostic work-up of older patients age-specific characteristics of dizziness/vertigo have to be considered. The older patient generally is more impaired by the symptoms but possibly will not report typical diagnosis-defining symptoms.
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Affiliation(s)
- Alexander Wassermann
- Department of Neurology, Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Sigrid Finn
- Department of Neurology, Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hubertus Axer
- Department of Neurology, Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany,Hubertus Axer, Department of Neurology, Jena University Hospital, Am Klinikum 1, D-07747 Jena, Germany.
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Prell T, Finn S, Axer H. How Healthcare Utilization Due to Dizziness and Vertigo Differs Between Older and Younger Adults. Front Med (Lausanne) 2022; 9:852187. [PMID: 35252281 PMCID: PMC8889010 DOI: 10.3389/fmed.2022.852187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 11/21/2022] Open
Abstract
Background Vertigo and dizziness are common in older adults. We describe self-reported healthcare utilization because of dizziness and vertigo in older adults attending a tertiary care specialized vertigo center. Methods Data from 765 patients (45% were ≥60 years old) with chronic dizziness and vertigo who attended a daycare multimodal treatment program were recorded. Data included sociodemographic parameters, dizziness-related characteristics, the Body Sensations Questionnaire (BSQ), the Agoraphobic Cognitions Questionnaire (ACQ), and the Hospital Anxiety and Depression Scale (HADS). Also, healthcare utilization, including (1) physician and clinical services, (2) hospitalizations in the year before consulting the vertigo center, (3) prescription of drugs and other professional services were included. Descriptive statistics, exploratory data analysis, and regression models were used. Results Intensity of dizziness was similar in both age groups, however, distress due to dizziness was more severe in younger persons. Dizziness symptoms lasted longer in older adults than in younger persons. Older adults had a somatic diagnosis (74.6 vs. 35.0%) more frequently and reported more falls (37.2 vs. 28.5%) than younger individuals. Anxiety about bodily sensations was higher in younger patients (mean BSQ1 = 9.33 ± 5.6) than in older patients (mean BSQ1 = 6.72 ± 5.4). Older persons had fewer depressive symptoms (mean HADS depression = 5.8 ± 3.6 vs. 6.5 ± 4.1) and less anxiety (mean HADS anxiety = 5.7 ± 3.7 vs. 7.8 ± 4.1) than younger individuals. Younger people were more frequently hospitalized (24.4%) than older adults (16.3%) in the year before consulting the vertigo center. Also, younger patients and patients with non-somatic etiologies had considerably more consultations with healthcare providers than older patients. Older adults received less medication (50.3%), less physiotherapy (41%), and less psychological therapy (11.6%) for vertigo than younger people (59.7, 52.2, 20.4%, respectively). Conclusion Age-associated differences in healthcare utilization were defined in selected patients attending a specialized vertigo center. Since dizziness is frequently a heterogeneous disorder requiring interdisciplinary care, its diagnostic and therapeutic work-up must be improved for older patients with dizziness.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany
| | - Sigrid Finn
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hubertus Axer
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
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Prell T, Wassermann A, Zipprich HM, Finn S, Axer H. Impact of Common Dizziness Associated Symptoms on Dizziness Handicap in Older Adults. Front Neurol 2022; 12:801499. [PMID: 34975741 PMCID: PMC8718649 DOI: 10.3389/fneur.2021.801499] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/29/2021] [Indexed: 01/19/2023] Open
Abstract
Background: A cross-sectional observational study was designed to determine the impact of dizziness associated symptoms on the dizziness handicap inventory (DHI) in older adults (≥60 years). Methods: In total, 785 individuals referred to a multidisciplinary dizziness unit were assessed. Participants completed self-report questionnaires with general questions about symptoms of dizziness as well as the DHI. The DHI subscores (physical, functional, emotional) were calculated. Medical diagnoses were collected from the medical records of the patients. One-way MANOVA and networking analysis were used to analyze the impact of dizziness associated symptoms on dizziness handicap. Results: Most patients reported swaying dizziness (60.6%) and feeling of unsteadiness (59.8%) with substantial overlap between the types of dizziness. Most frequent dizziness associated symptoms were ear noise/tinnitus, visual problems, and nausea/vomiting. Network analysis revealed that visual disturbances, headache, and hearing impairment were associated with higher DHI and explained 12% of the DHI variance in the linear regression. In the one-way MANOVA visual problems and headache had an effect on all three DHI subscores, while hearing impairment was associated with the functional and emotional subscores of DHI. Conclusion: Distinct dizziness associated symptoms have substantial impact on dizziness handicap in older adults. A multifactorial assessment including these symptoms may assist in tailoring therapies to alleviate dizziness handicap in this group.
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Affiliation(s)
- Tino Prell
- Department of Geriatrics, Halle University Hospital, Halle, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Alexander Wassermann
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hannah M Zipprich
- Center for Healthy Ageing, Jena University Hospital, Jena, Germany.,Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Sigrid Finn
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
| | - Hubertus Axer
- Department of Neurology, Jena University Hospital, Friedrich Schiller University, Jena, Germany.,Center for Vertigo and Dizziness, Jena University Hospital, Jena, Germany
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Increased Risk of Neurodegenerative Dementia after Benign Paroxysmal Positional Vertigo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910553. [PMID: 34639856 PMCID: PMC8507776 DOI: 10.3390/ijerph181910553] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/05/2021] [Accepted: 10/05/2021] [Indexed: 11/25/2022]
Abstract
The aim of the present study was to estimate the risk of dementia in patients with benign paroxysmal positional vertigo (BPPV), using a population cohort. Data from the Korean National Health Insurance Service-National Sample Cohort for the population ≥60 years of age from 2002 to 2013 were collected. A total of 11,432 individuals with dementia were matched for age, sex, income, region of residence, hypertension, diabetes, and dyslipidemia with 45,728 individuals comprising the control group. The crude (simple) and adjusted odds ratios (ORs) of dementia in BPPV patients were analyzed using non-conditional logistic regression analyses. Subgroup analyses were conducted according to age and sex. A history of BPPV characterized 5.3% (609/11,432) of the dementia group and 2.6% (1,194/45,728) of the control group (p < 0.001). The adjusted OR of dementia for BPPV was 1.14 (95% CI = 1.03–1.26, p = 0.009). In subgroup analyses according to age and sex, males had higher ORs of dementia for BPPV. BPPV increases the risk of dementia in the 60 years of age or older population.
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Lopes AL, Lemos SMA, Figueiredo PHS, Gonçalves DU, Santos JN. Lian gong as a Therapeutic Treatment Option in Primary Care for Patients with Dizziness: A Randomized Controlled Trial. Int Arch Otorhinolaryngol 2021; 25:e509-e516. [PMID: 34737821 PMCID: PMC8558947 DOI: 10.1055/s-0040-1718956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 08/23/2020] [Indexed: 11/08/2022] Open
Abstract
Introduction Dizziness is one of the most common reasons for seeking primary health care. Vestibular rehabilitation (VR) is a conventional treatment method for peripheral balance disorders that effectively decreases symptoms. Lian gong [LG] is believed to benefit patients with dizziness and to reduce the impact of the condition on quality of life by stimulating visual fixation, attention, body balance, and neuroplasticity. Objective The present study aimed to evaluate the effects of LG on the impact of dizziness on quality of life and fear of falling in primary health care patients. Methods This was a two-arm, parallel randomized clinical trial that included 36 patients with dizziness not caused by central changes. After specific medical evaluations and indications for treatment, the participants were randomly assigned to 3 groups: the LG group ( n = 11), the VR group ( n = 11), and the control group ( n = 14). The interventions were conducted collectively over a period of 12 weeks. Results Lian gong reduced the influence of dizziness on quality of life in physical (1.8 points, 95% confidence interval [CI]: 0.2-3.4), functional (4.0 points, 95% CI: 2.1-5.9), and emotional domains of quality of life (4.4 points, 95% CI: 1.7-7.2), with no differences compared with VR. There were similar concerns among the groups about the risk of falling. Conclusion Lian gong was shown to be an effective balance rehabilitation strategy to reduce the impact of dizziness on quality of life, with similar results to those of VR.
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Affiliation(s)
- Aline Lamas Lopes
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Fonoaudiológicas, Belo Horizonte, MG, Brazil
| | - Stela Maris Aguiar Lemos
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Fonoaudiológicas, Belo Horizonte, MG, Brazil
| | - Pedro Henrique Scheidt Figueiredo
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Diamantina, MG, Brazil
| | - Denise Utsch Gonçalves
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Fonoaudiológicas, Belo Horizonte, MG, Brazil
| | - Juliana Nunes Santos
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Fonoaudiológicas, Belo Horizonte, MG, Brazil
- Department of Physiotherapy, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Faculdade de Ciências Biológicas e da Saúde, Diamantina, MG, Brazil
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Wolf J, Sattel H, Limburg K, Lahmann C. From illness perceptions to illness reality? Perceived consequences and emotional representations relate to handicap in patients with vertigo and dizziness. J Psychosom Res 2020; 130:109934. [PMID: 31972479 DOI: 10.1016/j.jpsychores.2020.109934] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 01/11/2020] [Accepted: 01/11/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Vertigo and dizziness (VD) are frequent symptoms that can occur due to various structural pathologies or due to functional impairment. Independent of their aetiology, the symptoms are often associated with physical and psychological burden which manifests in severe handicap in more than half of the patients. It is suggested that illness perceptions, the patients' cognitive and emotional concept of their disease, most likely impact the degree of handicap. For patients with VD, however, this relation of illness perceptions and handicap is so far not well understood. This study aimed to investigate the relation of illness perceptions and handicap for patients with VD. METHODS In a cross-sectional study design, n = 419 patients with VD were examined (53.7% female, age 53.5 ± 15.5 years). Participants underwent neurological and psychiatric examinations as well as a comprehensive assessment using self-report questionnaires. RESULTS Illness perceptions, specifically perceived consequences and emotional representations showed a moderate correlation with VD related handicap (r(419) = 0.62, p < .001). Our regression model including symptom severity, psychiatric comorbidity, and aspects of cognitive and emotional illness perceptions accounted for 52% of the variance in VD related handicap. In a moderation analysis, this relation did not differ significantly in patients with functional VD symptoms. CONCLUSION Findings of the present study provide evidence for the relevance of illness perceptions to handicap in patients with VD symptoms.
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Affiliation(s)
- Johannes Wolf
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-Universität Freiburg, Hauptstraße 8, 79104 Freiburg, Germany.
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Karina Limburg
- Department of Psychology, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Claas Lahmann
- Department of Psychosomatic Medicine and Psychotherapy, Albert-Ludwigs-Universität Freiburg, Hauptstraße 8, 79104 Freiburg, Germany
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Silva EMTD, Lima Filho BFD, Dias VDN, Diniz Júnior J, Sousa AGPD, Gazzola JM. Biopsychosocial factors associated with complaints of dizziness in older adults with Type 2 Diabetes Mellitus. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2020. [DOI: 10.1590/1981-22562020023.190192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To analyze the biopsychosocial factors associated with complaints of dizziness in older adults with Type 2 Diabetes Mellitus. Methods: A cross-sectional, descriptive study with a sample selected for convenience was performed in a university hospital. The participants were individuals aged 60 years or older diagnosed with type 2 Diabetes Mellitus. Patients were assessed using a multidimensional survey, containing sociodemographic, clinical-functional, psycho-psychological and cognitive data. The Mini-Mental State Exam and the Short Geriatric Depression Scale (GDS-15) were used to screen for cognitive deficits and depressive symptoms, respectively, and the Timed Up and Go Test was used to assess mobility. Data analysis was performed using the Chi-square and Mann-Whitney tests. Results: The sample consisted of 157 older adults of whom 45.22% complained of dizziness. There was a statistically significant association between dizziness and the variables: female sex, being unmarried, a low level of education, a negative self-perception of general health and vision, complaints of pain in the lower limbs, a fear of falling, a tendency to fall, cognitive impairment and psychological symptoms. Conclusion: Knowledge of the factors associated with the complaint of dizziness in older adults with DM2 allows improved targeting of prevention, assessment and intervention actions, in order to minimize the occurrence of falls, maintain or optimize functional capacity and cognitive skills, and thus improve quality of life.
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Pothier DD, Shah P, Quilty L, Ozzoude M, Dillon WA, Rutka JA, Gerretsen P. Association Between Catastrophizing and Dizziness-Related Disability Assessed With the Dizziness Catastrophizing Scale. JAMA Otolaryngol Head Neck Surg 2019; 144:906-912. [PMID: 30128545 DOI: 10.1001/jamaoto.2018.1863] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Catastrophizing is a maladaptive thought process that involves irrational fear and worry about anticipated or actual symptoms. Although clinically relevant, the role of catastrophizing in patients with chronic dizziness or imbalance has not yet been explored to our knowledge. Objectives To validate a measure of dizziness catastrophizing and to assess its association with dizziness-related disability compared with other negative affect constructs (eg, anxiety and depression). Design, Setting, and Participants For this retrospective medical record review, the Dizziness Catastrophizing Scale (DCS), a dizziness-specific catastrophizing assessment tool, was adapted from the previously validated Pain Catastrophizing Scale. Psychometric evaluation of the DCS was performed. In addition, the associations of dizziness catastrophizing and positive and negative affectivity with dizziness-related disability were assessed using structural equation modeling and regression analyses. Data were collected using a retrospective medical record review from April 27, 2010, to June 25, 2014. The dates of analysis were June 3 to August 15, 2017. The setting was the Multidisciplinary Neurotology Clinic at the Toronto General Hospital (Toronto, Ontario, Canada). Participants were 457 adult outpatients with dizziness or imbalance who were referred to the clinic. Main Outcomes and Measures Psychometric properties of the DCS and its association with dizziness-related disability, as measured with the Dizziness Handicap Inventory. Results Among 457 patients (mean [SD] age, 53.4 [15.4] years; 154 [33.7%] male), the DCS demonstrated good convergent (r = 0.78, P < .001) and discriminant validity (r = -0.40, P < .001) with the negative and positive affectivity, respectively; internal consistency (α = .95); and test-retest reliability (intraclass correlation coefficient, 0.92; P < .001 at the 95% CI). An exploratory dimension reduction analysis revealed a single latent component of the DCS. The results of the structural equation modeling and regression analyses revealed that dizziness catastrophizing, although associated with negative affectivity (eg, symptoms of anxiety and depression), was independently associated with dizziness-related disability (standardized β = 0.378; P < .001). Furthermore, a strong association was found between catastrophizing and dizziness-related disability across different dizziness-related diagnoses (r ≥ 0.6; P < .001). Conclusions and Relevance In this study, the DCS was a valid and reliable measure for evaluating catastrophic thinking in patients with dizziness, which was independently associated with dizziness-related disability. Future studies should investigate the influence of alleviating symptoms of catastrophizing on functional outcomes in patients with dizziness or imbalance, the results of which will help guide novel approaches to the clinical care of patients with chronic dizziness.
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Affiliation(s)
- David D Pothier
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Parita Shah
- Multimodal Imaging Group, Research Imaging Centre, The Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | - Lena Quilty
- Multimodal Imaging Group, Research Imaging Centre, The Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Miracle Ozzoude
- Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - Wanda A Dillon
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John A Rutka
- Department of Otolaryngology-Head and Neck Surgery, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Philip Gerretsen
- Multimodal Imaging Group, Research Imaging Centre, The Centre for Addiction and Mental Health, Toronto, Ontario, Canada.,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, The Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.,Centre for Mental Health, University Health Network, Toronto, Ontario, Canada
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Staibano P, Lelli D, Tse D. A retrospective analysis of two tertiary care dizziness clinics: a multidisciplinary chronic dizziness clinic and an acute dizziness clinic. J Otolaryngol Head Neck Surg 2019; 48:11. [PMID: 30857559 PMCID: PMC6413454 DOI: 10.1186/s40463-019-0336-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Accepted: 03/05/2019] [Indexed: 02/07/2023] Open
Abstract
Background Vertigo remains a diagnostic challenge for primary care, emergency, and specialist physicians. Multidisciplinary clinics are increasingly being employed to diagnose and manage patients with dizziness. We describe, for the first time in Canada, the clinical characteristics of patients presenting with chronic and acute dizziness to both a multidisciplinary chronic dizziness clinic (MDC) and a rapid access dizziness (RAD) clinic at The Ottawa Hospital (TOH). Methods We performed a retrospective review of all patients presenting to the MDC and RAD clinics at TOH from July 2015 to August 2017. Results Overall, 211 patients (median age: 61 years old) presented to the RAD clinic and 292 patients (median age: 55 years old) presented to the MDC. In the RAD clinic, 63% of patients had peripheral dizziness, of which 55% had BPPV, and only one patient had functional dizziness. Interestingly, only 25% of RAD diagnoses were concordant with emergency department diagnoses; moreover, only 33% of RAD patients had HiNTS completed, while 44% had CT scans, of which only one scan had an abnormal finding. Prior to assessment, all patients in the MDC had an unclear cause of dizziness. 28% of patients had vestibular dizziness and 21% had functional dizziness, of which 43% had persistent postural perceptual dizziness. Moreover, 12% of patients with functional dizziness also suffered from comorbid severe anxiety and depression. Conclusions Dizziness is a heterogeneous disorder that necessitates multidisciplinary care, and clinics targeting both the acute and chronic setting can improve diagnostic accuracy, ensure appropriate diagnostic testing, and facilitate effective care plans for patients with dizziness.
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Affiliation(s)
- Phillip Staibano
- Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Lelli
- Division of Neurology, Department of Internal Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Darren Tse
- Department of Otolaryngology-Head & Neck Surgery, University of Ottawa, The Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, ON, K1Y 4E9, Canada.
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Silva EMTD, Barbosa ALDA, Mantello EB, Azoni CAS, Gazzola JM. Relationship between dizziness and learning difficulties in schoolchildren: an integrative review. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/20192117518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: this study aims to verify the level of scientific evidence on the relationship between dizziness and academic achievement in childhood. Methods: the study was performed using the following search terms: dizziness, vertigo, child, learning, spelling, learning skills, academic skills, reading, and their correspondents in Portuguese in the following databases: PubMed, Scielo, LILACS and PsycINFO. Observational studies that examined the relationship between dizziness and academic achievement in childhood, published between 2007 and 2017, were included. Articles that did not allow access to the full text, and studies based on samples with motor, hearing, and cognitive disorders were excluded. Results: we initially found 315 articles and three met the established inclusion and exclusion criteria. These were scored according to the Newcastle-Ottawa Modified Scale with scores between 2 and 3 and as IIb according to the American Speech-Language Hearing Association levels of evidence and quality indicators. Conclusion: the results of this integrative review showed a low level of scientific evidence on the relationship between dizziness and academic achievement in childhood. It is important to emphasize the importance of improving study design to better understand their relationship, to allow provision of the best preventive, assessment, and intervention methods.
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Misiewicz Z, Hiekkalinna T, Paunio T, Varilo T, Terwilliger JD, Partonen T, Hovatta I. A genome-wide screen for acrophobia susceptibility loci in a Finnish isolate. Sci Rep 2016; 6:39345. [PMID: 27996024 PMCID: PMC5171840 DOI: 10.1038/srep39345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 11/16/2016] [Indexed: 12/02/2022] Open
Abstract
Acrophobia, an abnormal fear of heights, is a specific phobia characterized as apprehension cued by the occurrence or anticipation of elevated spaces. It is considered a complex trait with onset influenced by both genetic and environmental factors. Identification of genetic risk variants would provide novel insight into the genetic basis of the fear of heights phenotype and contribute to the molecular-level understanding of its aetiology. Genetic isolates may facilitate identification of susceptibility alleles due to reduced genetic heterogeneity. We took advantage of an internal genetic isolate in Finland in which a distinct acrophobia phenotype appears to be segregating in pedigrees originally ascertained for schizophrenia. We conducted parametric, nonparametric, joint linkage and linkage disequilibrium analyses using a microsatellite marker panel, genotyped in families to search for chromosomal regions correlated with acrophobia. Our results implicated a few regions with suggestive evidence for linkage on chromosomes 4q28 (LOD = 2.17), 8q24 (LOD = 2.09) and 13q21-q22 (LOD = 2.22). We observed no risk haplotypes shared between different families. These results suggest that genetic predisposition to acrophobia in this genetic isolate is unlikely to be mediated by a small number of shared high-risk alleles, but rather has a complex genetic architecture.
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Affiliation(s)
- Zuzanna Misiewicz
- Department of Biosciences, University of Helsinki, Helsinki, Finland
| | - Tero Hiekkalinna
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Tiina Paunio
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Development of Work and Work Organizations, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teppo Varilo
- Department of Medical Genetics, University of Helsinki, Helsinki, Finland
| | - Joseph D Terwilliger
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, Department of Genetics and Development, and Gertrude H. Sergievsky Center, Columbia University, New York NY, USA.,Division of Medical Genetics, New York State Psychiatric Institute, New York NY, USA
| | - Timo Partonen
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Iiris Hovatta
- Department of Biosciences, University of Helsinki, Helsinki, Finland.,Department of Health, National Institute for Health and Welfare, Helsinki, Finland
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Kotova OV, Zamergrad MV. Dizziness and anxiety disorders in the elderly. TERAPEVT ARKH 2016. [DOI: 10.17116/terarkh2016889131-134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Perhaps each dizzy patient feels anxiety. Varying emotional disorders are particularly common in elderly patients with dizziness. The causes of the frequent concurrence of dizziness and mental disorders (anxiety and depression) are diverse. Amongst these there are two chief conditions: 1) vestibular vertigo may cause anxiety to a greater extent than many other symptoms; 2) anxiety and depression are themselves frequently manifested by the sensations resembling vestibular ones that patients are inclined to call dizziness. On the contrary, anxiety may appear in some cases as the sensations resembling dizziness. Besides the latter, the patient may present a lot of complaints, which serves as a manifestation of psychoautonomic syndrome (the basis for which is anxiety and depression). At the same time, the term «phobic postural instability» is proposed to describe psychogenic disorders, in which dizziness becomes virtually the only chief complaint. The treatment of dizziness and anxiety disorders in the elderly encompasses a few areas: vestibular rehabilitation, drug therapy, and psychotherapy. The paper describes the possibilities of using anvifen as a pathogenetically sound treatment in patients with anxiety disorders, as anvifen is a GABA-ergic medication.
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