Journal of Neural Transmission

, Volume 126, Issue 2, pp 123–129 | Cite as

Cerebral perfusion abnormalities in patients with persistent postural-perceptual dizziness (PPPD): a SPECT study

  • Seunghee Na
  • Jooyeon Jamie Im
  • Hyeonseok Jeong
  • Eek-Sung Lee
  • Tae-Kyeong Lee
  • Yong-An ChungEmail author
  • In-Uk SongEmail author
Neurology and Preclinical Neurological Studies - Original Article


Persistent postural-perceptual dizziness (PPPD) is a recently defined syndrome with chronic dizziness interrupting daily life. Although the high levels of anxiety and functional changes in postural control strategy and multi-sensory information processing and integration may be underlying the pathophysiology, its neural mechanisms are poorly understood. The aim of this study was to examine the regional cerebral blood flow (rCBF) in patients with PPPD using single photon emission computed tomography (SPECT). A total of 25 patients with PPPD and 25 healthy controls participated in the study. All participants underwent brain SPECT and the patients completed the Dizziness Handicap Inventory. SPECT images were compared between the groups, and the correlation of rCBF and disease severity/duration was assessed in patients. Compared with controls, PPPD patients showed a significantly decreased rCBF in the insula and frontal lobe, mainly in the left posterior insula, bilateral superior frontal gyrus, right inferior frontal gyrus, right precentral gyrus, and left medial orbital gyrus. Additionally, PPPD patients showed a significant rCBF increase in the bilateral cerebellum compared with controls. The results of our study suggest that the altered rCBF in the insular, frontal, and cerebellar cortices might be reflecting the process of maladaptation and the compensatory responses for the changes in PPPD.


Persistent postural-perceptual dizziness Single photon emission computed tomography Brain perfusion Regional cerebral blood flow 



This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

Nothing to report.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Seunghee Na
    • 1
  • Jooyeon Jamie Im
    • 2
  • Hyeonseok Jeong
    • 2
  • Eek-Sung Lee
    • 3
  • Tae-Kyeong Lee
    • 3
  • Yong-An Chung
    • 2
    Email author
  • In-Uk Song
    • 1
    Email author
  1. 1.Department of NeurologyCollege of Medicine, The Catholic University of KoreaSeoulSouth Korea
  2. 2.Department of RadiologyCollege of Medicine, The Catholic University of KoreaSeoulSouth Korea
  3. 3.Department of NeurologySoonchunhyang University College of MedicineBucheonSouth Korea

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