Chronic dizziness: neuro-sensitization and psycho-sensitization

This review aims to investigate the potential mechanisms driving the transition from acute vestibular events to chronic dizziness, focusing on the roles of neural sensitization and psychological sensitization in symptom persistence. The evolution of vestibular dizziness is analyzed from the perspectives of vestibular compensation, sensory reweighting, and the fear-avoidance model....

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✦ The floor

Discussion

Signed responses from readers of the wire.

✦ Clinical Takeaway ✦

Audiologists and vestibular clinicians treating patients with persistent dizziness should consider both neural sensitization and psychological factors (e.g., anxiety, catastrophizing) as targets for multidisciplinary management, not vestibular rehab alone.

✦ Why It Matters ✦

Recognizing the dual neural and psychological pathways to chronic dizziness supports a biopsychosocial treatment model and may improve outcomes for patients with persistent vestibular symptoms.

✦ Key Points ✦

01Reviews mechanisms by which acute vestibular events can transition to chronic dizziness.
02Identifies both neural sensitization (brain becoming overly reactive) and psycho-sensitization (anxiety, fear) as key drivers.
03Chronic dizziness is not solely a peripheral vestibular problem—central and psychological mechanisms are implicated.
04Supports multidisciplinary management including vestibular rehab and psychological intervention.
05Relevant to conditions such as PPPD (persistent postural-perceptual dizziness).

✦ Claims & Evidence ✦

ClaimEvidenceSupport

Neural sensitization mechanisms contribute to the transition from acute vestibular events to chronic dizziness.

studypartially supported

Psychological sensitization (e.g., anxiety, maladaptive coping) independently perpetuates chronic dizziness beyond the original vestibular insult.

opinionpartially supported

✦ Research metadata ✦

PMID: 42852120
DOI: 10.3389/fnint.2026.1929481.
Journal: Frontiers in Integrative Neuroscience
Publication type: review
Evidence level: 5
Population: Patients with acute and chronic vestibular disorders
Intervention: Review of neural and psychological sensitization mechanisms

Primary outcomes

Mechanisms of neural sensitization in chronic dizziness; Role of psychological sensitization in dizziness chronification

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