Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional vestibular disorder characterized by exacerbation of symptoms by standing, movements, and/or visual stimulation. The Niigata PPPD Questionnaire (NPQ) is an effective screening tool for identifying PPPD, typically with a score of 27 or higher. However, NPQ scores of 27 or more can also occur in diseases other than PPPD.
We examined the prevalence of NPQ scores of 27 or higher among patients with vestibular symptoms lasting for more than 3 months and explored the diagnoses and clinical features of cases with elevated NPQ scores that were not diagnosed as PPPD.
A retrospective study was conducted from January 2019 to March 2023 on 1,296 patients who presented to Nagoya City University Hospital’s Otorhinolaryngology Department with vestibular symptoms. Of these, 696 patients met the criteria of being ≥18 years and suffering from vestibular symptoms for more than 3 months. Of the 696 patients, 558 completed the NPQ, Dizziness Handicap Inventory (DHI), and Hospital Anxiety and Depression Scale (HADS) questionnaires at their initial visit.
More than half of the non-PPPD cases had NPQ scores of 27 or higher. Among the patients with elevated NPQ scores, in patients with PPPD, a correlation was noted between the NPQ scores and the severity of the vestibular symptoms, whereas correlations with scores on the depression and anxiety scales were less pronounced. In contrast, in patients with conditions such as Meniere’s disease, benign paroxysmal positional vertigo (BPPV), and vestibular migraine, while the NPQ scores were not correlated with the severity of the vestibular symptoms, the severity of the symptoms correlated closely with the scores on the depression and anxiety scales.
