Persistent postural-perceptual dizziness (PPPD) is a common chronic functional neuro-otological disorder characterized by persistent non-spinning dizziness, unsteadiness, and heightened sensitivity to upright posture, motion, and visually complex environments....
✦ The floor
Discussion
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Clinicians managing PPPD patients should be aware of co-existing attentional dysfunction as a mechanistic feature — not merely a symptom — which may support the rationale for cognitive-focused therapies (e.g., CBT, mindfulness) in treatment planning.
Understanding that attentional dysfunction is mechanistically embedded in PPPD — rather than a secondary complaint — could reshape how vestibular and neuro-otology teams assess and treat this common but often mismanaged condition.
- 01PPPD is a chronic functional dizziness disorder; attentional problems are a significant but under-recognised feature.
- 02Narrative review synthesises mechanistic evidence linking altered attention networks to PPPD symptoms.
- 03Proposed mechanisms include maladaptive threat-monitoring and attentional resource competition with postural control.
- 04Findings support incorporating cognitive and attentional therapies into PPPD rehabilitation.
- 05Published in Frontiers in Neurology (doi: 10.3389/fneur.2026.1938453).
Attentional dysfunction is a mechanistic feature of PPPD, not merely a secondary symptom.
studypartially supportedMaladaptive threat-monitoring and attentional-postural resource competition contribute to PPPD symptomatology.
opinionpartially supported- PMID
- 42780841
- DOI
- 10.3389/fneur.2026.1938453.
- Journal
- Frontiers in Neurology
- Publication type
- review
- Evidence level
- 5
- Population
- Patients with persistent postural-perceptual dizziness (PPPD)
- Intervention
- Review of mechanistic evidence for attentional dysfunction in PPPD
Primary outcomes
Mechanistic pathways linking attentional dysfunction to PPPD symptoms