Reduced betweenness centrality of a sensory-motor vestibular network in subclinical agoraphobia

• Published in: 2019 41st Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) Vol. 2019; pp. 4342 - 4345
• Main Authors: Indovina, I, Conti, A, Lacquaniti, F, Staab, JP, Passamonti, L, Toschi, N
• Format: Conference Proceeding Journal Article
• Language: English
• Published: United States IEEE 01.07.2019
• Subjects: Agoraphobia - psychology; Atmospheric measurements; Dizziness; Fear; Functional magnetic resonance imaging; Humans; Personality; Psychology; Vertigo; Vestibule, Labyrinth - physiopathology; Visualization
• ISSN: 1557-170X; 1558-4615
• DOI: 10.1109/EMBC.2019.8857332

Agoraphobic patients feel dizzy in crowded open spaces and respond to this symptom with excessive fear and avoidance. These clinical features show great similitude with the newly defined syndrome of persistent postural perceptual dizziness (PPPD). Patients with PPPD show decreased activity and connectivity in regions of the vestibular cortex. Due to the great overlap between these two conditions, we hypothesized that individuals with sub-clinical agoraphobia would show reduction in the connectivity features of these regions. We selected a group of healthy individuals from the Human Connectome Project that self-reported agoraphobia episodes, and compared it with a control group. We accurately matched the two groups for psychological measures and personality traits in order to study the neural correlates of vestibular symptoms independently of possible psychiatric vulnerabilities. We found that the agoraphobia group showed reduced betweenness centrality of a network encompassing key regions of the vestibular cortex. Dysfunctions of the vestibular cortex may explain the dizziness symptom for a disorder previously labelled as psychogenic.