Significant Posturography Findings in Patients with Psychogenic Dizziness

Abstract

Posturography is useful for investigating global balance performance (Kushiro & Goto, 2011). We found that anxiety affects postural perturbation in the anteroposterior axis, possibly indicating that anxiety affects the interactions between visual inputs and vestibular as well as somatosensory inputs in the maintenance of postural balance in patients complaining of dizziness (Goto et al. 2011a). Dizziness is a common somatic complaint that can be caused by several factors including peripheral or central vestibular dysfunction. Anxiety and depression are closely related to somatic complaints, including dizziness. Patients suffering from vestibular disorders are prone to anxiety (Eagger et al., 1992), which is known to affect postural stability. Patients can present with dizziness even in the absence of any signs of organic or functional dysfunction; such patients are usually diagnosed with psychogenic dizziness. The aim of our study was to identify abnormal findings in patients with psychogenic dizziness. Healthy subjects with high anxiety are reported to have larger sway in the anteroposterior axis (Wada et al., 2001). This characteristic disappears when the eyes are closed (Ohno et al. 2004). It is believed that anxiety affects the postural sway of the anteroposterior axis and the interactions of visual inputs with vestibular and somatosensory inputs are influenced by anxiety in healthy subjects (Wada et al. 2001). Maki and McIlroy (1996) reported that healthy subjects with elevated levels of state anxiety undergoing cognitive tasks such as mental arithmetic tend to lean forward. This observation shows that elevated levels of state anxiety cause the center of gravity to shift forward. We previously reported a clear relationship between anxiety and anteroposterior perturbations (Goto et al. 2011a). There are several types of patients with vestibular disorders due to organic and psychogenic factors and combinations thereof. There may be some specific pattern of posturography depending on the levels of anxiety and vestibular deficits. It would be useful to know if there is a relationship between anxiety and postural sway in patients complaining of dizziness. Therefore, the relationship between the levels of anxiety and postural sway in patients complaining of dizziness was evaluated. In addition, the effect of visual input was investigated. Posturography is a useful tool for investigating the effects of various conditions (Kushiro & Goto, 2011), and we used it to evaluate postural sway. Anxiety levels were assessed by the hospital anxiety and depression scale (HADS).