Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder characterized by persistent dizziness, postural instability, and visual hypersensitivity. Although several non-pharmacological interventions have been proposed, their comparative efficacy remains unclear.
Audiologists and vestibular specialists managing PPPD should review the ranked treatment outcomes from this network meta-analysis to inform which non-pharmacological interventions — such as vestibular rehabilitation, CBT, or mindfulness — are most likely to address balance, anxiety, and depression in their patients.
PPPD is one of the most common chronic vestibular disorders, and this is among the first network meta-analyses to simultaneously rank non-drug treatments across three clinically important outcomes, offering a rare comparative framework where head-to-head trials are lacking.
- 01Systematic review and network meta-analysis comparing non-pharmacological PPPD treatments.
- 02Outcomes assessed: balance, anxiety, and depression — capturing the multidimensional burden of PPPD.
- 03Network meta-analysis allows indirect comparisons across interventions not directly tested against each other.
- 04Published in Journal of Neurology (DOI: 10.1007/s00415-026-13891-1).
- 05Findings may guide clinical preference for specific therapies over others in PPPD management.
Non-pharmacological interventions differ in comparative efficacy for balance, anxiety, and depression outcomes in PPPD.
studypartially supported- PMID
- 42240653
- DOI
- 10.1007/s00415-026-13891-1.
- Journal
- Journal of Neurology
- Publication type
- meta_analysis
- Evidence level
- 1a
- Population
- Patients with persistent postural-perceptual dizziness (PPPD)
- Intervention
- Non-pharmacological interventions (e.g., vestibular rehabilitation, CBT, mindfulness)
- Comparator
- Multiple active comparators via network meta-analysis
Primary outcomes
Balance outcomes; Anxiety outcomes; Depression outcomes