Evaluation of Autonomic Function Using Short-Term Heart Rate Variability in Patients With Benign Paroxysmal Positional Vertigo: A Prospective Case-Control Study
Evaluation of Autonomic Function Using Short-Term Heart Rate Variability in Patients With Benign Paroxysmal Positional Vertigo: A Prospective Case-Control Study
Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder. Although the pathophysiology of BPPV is mainly attributed to the displacement of otoconia within the semicircular canals, recent studies suggest that psychological stress and anxiety may be associated with the onset or recurrence of the disease. However, the biological mechanisms underlying this relationship remain poorly understood, and objective evaluation of autonomic nervous system function in patients with BPPV is limited.
Heart rate variability (HRV) is a non-invasive method widely used to assess autonomic nervous system activity. Short-term HRV measurements provide information about autonomic balance and vagal tone. In particular, parameters such as the root mean square of successive differences (RMSSD) and the coefficient of variation of RR intervals (COV RR/R) are considered indicators of parasympathetic activity.
The aim of this prospective case-control study is to evaluate vagal tone in patients with BPPV using short-term HRV analysis and to compare the findings with age-, sex-, and body mass index-matched healthy controls. Participants will undergo standardized HRV measurements at rest and during controlled breathing. Perceived stress levels will also be assessed using the Perceived Stress Scale (PSS-10).
The primary outcomes of the study are RMSSD and the coefficient of variation of RR intervals (COV RR/R), obtained from short-term HRV recordings. These parameters will be compared between BPPV patients and healthy controls, and their associations with perceived stress levels will also be explored. The findings of this study may provide insights into the role of autonomic regulation and stress-related mechanisms in the pathophysiology of BPPV.
Inclusion Criteria:
Age 18 years or older
Clinical diagnosis of benign paroxysmal positional vertigo (BPPV) confirmed by positional testing (Dix-Hallpike and/or Roll test) with positional nystagmus
No known history of cardiac disease
Ability and willingness to provide written informed consent
Healthy Control Group
Age 18 years or older
No history of vertigo or known vestibular disorder
Age- and sex-matched to the BPPV group
No known history of cardiac disease
Ability and willingness to provide written informed consent
Exclusion Criteria:
Inability to provide informed consent or impaired mental capacity
Known arrhythmia, heart failure, ischemic heart disease, or other clinically significant cardiac disorder
Use of medications that may directly affect heart rate variability, including beta-blockers, non-dihydropyridine calcium channel blockers, antiarrhythmic drugs, digoxin, systemic corticosteroids, centrally acting sympatholytic agents, or psychotropic medications that may influence autonomic balance
Active infection or systemic inflammatory disease
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