{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:31:44Z","timestamp":1789623104426,"version":"build-2803163510"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T00:00:00Z","timestamp":1720137600000},"content-version":"vor","delay-in-days":4,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Subjective unsteadiness or dizziness, usually without increase in body sway, is common in older people. The absence of mechanistic understanding of such symptoms renders clinical management difficult. Here, we explore the mechanisms behind such idiopathic dizziness (ID), focusing on postural control abnormalities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Thirty patients with ID and 30 age-matched controls stood on a moving platform. Platform oscillations were randomly delivered at different velocities (from 0 to 0.2\u00a0m\/s). Markers of postural control, including objective sway (trunk sway path, recorded via a sensor attached to vertebrae C7), stepping responses, subjective instability and anxiety ratings were obtained. MRI scans were available for correlations with levels of cerebral small vessel disease in 28 patients and 24 controls.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We observed a significant relationship between objective and subjective instability in all groups. The slope of this fit was significantly steeper for patients than controls, indicating greater perceived instability for the same body sway. Stepwise linear regression showed that the slopes of this objective\u2013subjective instability relationship were best explained by concerns about falling (Falls Efficacy Scale-International), clinical physical functioning (Short Physical Performance Battery) and, to some degree, by neuroimaging markers of cerebral small vessel disease. In addition, patients had a reduced stepping threshold, suggesting an overly cautious postural response.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The distorted perception of instability and subtle impairments in balance control, including abnormal and overly cautious stepping responses, underlies the emergence of ID. It appears to relate to changes in postural performance, psychological functioning and disruption of postural brain networks associated with cerebral small vessel disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afae137","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T01:09:01Z","timestamp":1720141741000},"source":"Crossref","is-referenced-by-count":14,"title":["Towards an explanation for \u2018unexplained\u2019 dizziness in older people"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-9920","authenticated-orcid":false,"given":"Patricia","family":"Castro","sequence":"first","affiliation":[{"name":"Department of Brain Sciences, Imperial College London, Charing Cross Hospital , London, UK"},{"name":"Facultad de Medicina Cl\u00ednica Alemana, Universidad del Desarrollo, Escuela de Fonoaudiolog\u00eda , Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Ibitoye","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Imperial College London, Charing Cross Hospital , London, UK"},{"name":"Department of Clinical and Movement Neurosciences, University College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toby","family":"Ellmers","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Imperial College London, Charing Cross Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Kaski","sequence":"additional","affiliation":[{"name":"Department of Clinical and Movement Neurosciences, University College London , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qadeer","family":"Arshad","sequence":"additional","affiliation":[{"name":"inAmind Laboratory , Department of Neuroscience, Psychology and Behaviour, , Leicester, UK"},{"name":"University of Leicester , Department of Neuroscience, Psychology and Behaviour, , Leicester, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo M","family":"Bronstein","sequence":"additional","affiliation":[{"name":"Department of Brain Sciences, Imperial College London, Charing Cross Hospital , London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,7,4]]},"reference":[{"key":"2024070501085206400_ref1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/ageing\/23.2.117","article-title":"The prevalence and characteristics of dizziness in an elderly community","volume":"23","author":"Colledge","year":"1994","journal-title":"Age Ageing"},{"key":"2024070501085206400_ref2","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1093\/ageing\/16.6.393","article-title":"Postural disturbances in a 75-year-old population: I. 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