Editorial: Mechanisms of functional dizziness: a window for understanding space-motion cognition
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By
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Hayo Andres Breinbauer
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Sofia Waissbluth
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Paul Hinckley Delano
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Diego Kaski
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June 3, 2026
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Clinical Scorecard: Exploring the Mechanisms Behind Functional Dizziness to Enhance Understanding of Space-Motion Cognition
At a Glance
| Category | Detail |
|---|
| Condition | |
| Key Mechanisms | |
| Target Population | Patients with Functional Dizziness, including Persistent Postural-Perceptual Dizziness (PPPD) and Mal de Débarquement Syndrome (MdDS). |
| Care Setting | |
Key Highlights
- FD is characterized by cognitive dysfunction rather than structural damage.
- Allocentric mapping and predictive coding errors are central to PPPD-related cognitive dysfunction.
- Vestibular rehabilitation therapy (VRT) is associated with improved quality of life in PPPD patients.
- Anxiety and depression are independent predictors of poorer outcomes in VRT.
Guideline-Based Recommendations
Diagnosis
- Utilize Bárány Society criteria for diagnosing PPPD.
Management
- Implement vestibular rehabilitation therapy tailored to FD.
Monitoring & Follow-up
- Assess quality of life and dizziness-related handicap using standardized scales.
Risks
- Assess the impact of anxiety and depression on treatment outcomes.
Patient & Prescribing Data
VRT should encourage outward attention to the environment.
Clinical Best Practices
- Incorporate cognitive and affective components in the management of FD.
- Use a combination of supervised and home-based VRT exercises.
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