Brain Dynamics of Persistent Postural-Perceptual Dizziness at Rest Reveal Alterations in Multisensory and Motor Areas

In 17 patients with persistent postural-perceptual dizziness, resting-state fMRI shows altered CAP dynamics from rTPJ, caudate nucleus, and hippocampus, but not OP2, compared with 20 matched healthy controls.

• Why it matters: PPPD involves unsteadiness linked to altered multisensory integration and visual dependence, yet dynamic connectivity at rest and its relationship to clinical and postural measures were unclear.
• What they did: Resting-state fMRI CAPs were computed from seeds rTPJ, caudate nucleus, hippocampus, and OP2, comparing temporal metrics between groups; PLSC then related CAP patterns to mood, vertigo, stress, and visual dependence for gait and postural control.
• The result: Two PLSC latent components emerged: one linked rTPJ, OP2, and hippocampal CAPs to shared visual-network co-deactivation with stress, mood, vertigo, and visual dependence for gait, and another linked caudate and two rTPJ CAPs to postural sway with eyes closed; brain-behavior scores correlated in both groups.