{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:55:44Z","timestamp":1773712544782,"version":"3.50.1"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T00:00:00Z","timestamp":1650499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Persistent postural\u2013perceptual dizziness (PPPD) is a chronic functional vestibular disorder that can be precipitated by acquired brain injuries. Poststroke depression (PSD) is the most common psychiatric sequela of stroke, affecting 33% of stroke survivors. Pathophysiologic mechanisms of PPPD and PSD are not fully understood.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case Report<\/jats:title><jats:p>A 40-year-old woman developed new, debilitating chronic dizziness exacerbated by her own motion and exposure to visual motion stimuli plus prolonged depressive symptoms, both beginning within days after a localized right insular stroke. A collaborative evaluation by specialists in neurology, otorhinolaryngology, optometry, and psychiatry concluded that the insular stroke caused simultaneous onset of PPPD and PSD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Prior case reports described short-lived vertigo following insular strokes, but no long-term vestibular symptoms without ongoing nystagmus or gait ataxia. In this case, chronic dizziness and motion sensitivity continued in the absence of focal neurologic deficits, invoking the possibility that changes in functioning of brain networks subserving spatial orientation persisted despite otherwise adequate recovery from the stroke, a mechanism previously proposed for PPPD. This case also reinforced prior work implicating pathways through the insula in PSD. Co-occurrence of PPPD and PSD offers insights into simultaneous functions of the insula in multiple networks in human brain.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.841072","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T13:53:14Z","timestamp":1650549194000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Right Insular Stroke Causing Simultaneous Onset of a Functional Vestibular Disorder and Psychiatric Disorder\u2014Persistent Postural\u2013Perceptual Dizziness and Post\u2013stroke Depression"],"prefix":"10.3389","volume":"13","author":[{"given":"David C.","family":"Fipps","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey P.","family":"Staab","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas D.","family":"Allen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3233\/VES-170622","article-title":"Diagnostic criteria for persistent postural-perceptual dizziness (PPPD): Consensus document of the committee for the Classification of Vestibular Disorders of the B\u00e1r\u00e1ny Society","volume":"27","author":"Staab","year":"2017","journal-title":"J Vestib Res."},{"key":"B2","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1055\/s-0039-3402736","article-title":"Persistent Postural-Perceptual Dizziness","volume":"40","author":"Staab","year":"2020","journal-title":"Semin Neurol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1161\/STROKEAHA.117.016979","article-title":"Diagnosing Stroke in Acute Dizziness and Vertigo: Pitfalls and Pearls","volume":"49","author":"Saber Tehrani","year":"2018","journal-title":"Stroke."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1680","DOI":"10.1212\/WNL.0000000000001501","article-title":"Why acute unilateral vestibular cortex lesions mostly manifest without vertigo","volume":"84","author":"Dieterich","year":"2015","journal-title":"Neurology."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1852","DOI":"10.1007\/s00415-019-09342-9","article-title":"Vestibular symptoms in acute hemispheric strokes","volume":"266","author":"Eguchi","year":"2019","journal-title":"J Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1007\/s13139-020-00675-2","volume":"55","author":"Im","year":"2021","journal-title":"Nucl Med Mol Imaging."},{"key":"B7","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1007\/s00415-020-10150-9","article-title":"Primary or secondary chronic functional dizziness: does it make a difference? 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