Cognitive Stress, Emotional Factors and Balance in Meni re's Disease: An Experimental Study

Abstract

Clinicians have emphasized the role of stress in the causes of vertigo attacks in Menière's disease, an inner ear disorder. The principal aim of the present study was to investigate the immediate effects of cognitive stress, defined as exposure to the Stroop test, and rest, on balance among Menière patients ( n = 10), non-Menière patients ( n = 10) whose complaint was dizziness, and a group free from dizziness ( n = 10). Depression, anxiety and phobic avoidance were rated on established psychological inventories. Further, reported discomfort and subjective instability before and after the stress and rest manipulations, which the participants rated on Visual Analogue Scales (VAS), were investigated. Balance was tested on a stabilometer and the Body Sway Velocity (BSV) was calculated. BSV was measured after exposure to cognitive stress and after a resting session. The total mean BSV was lower after exposure to stress than after the resting session, indicating less sway. As expected, all three groups showed higher mean BSV when tested with their eyes closed. No differences were found among the groups on either balance or questionnaire results. The mean BSV values were not correlated to depression, anxiety or phobic avoidance measured with the psychological inventories, nor to the mean VAS ratings of instability and discomfort in relation to the stress and resting sessions. However, mean VAS ratings of discomfort and instability were significantly correlated to depression, phobic avoidance and anxiety in different patterns in the three groups. The results and implications are discussed.