
Frontiers in Neurology
Spatial navigation entropy suggests allocentric dysfunction in PPPD
Introduction: Persistent postural-perceptual dizziness (PPPD) is a common chronic dizziness disorder with an unclear pathophysiology. It is hypothesized that PPPD may involve functional dysfunction of the construction of inner cognitive maps, leading to disrupted spatial cognition. Methods: Fifty-two participants (19 PPPD patients, 20 vestibular controls without PPPD, and 13 healthy volunteers) completed a virtual Morris Water Maze task in non-immersive and virtual reality modalities. Results: PPPD patients exhibited significantly worse navigation performance than both control groups, with greater impairments in predominantly allocentric tasks, and increased exploratory gaze behavior. Discussion: Findings suggest PPPD involves deficits in allocentric spatial navigation, likely due to predictive coding errors and impaired internal model updating, rather than sensory input dysfunction.



