Correlation of Abnormal Cervical Proprioception with Visual-Vestibular Interaction Dysfunction in Cervicogenic Dizziness

Abstract

Objective: To investigate the correlation between abnormal cervical proprioceptive input (joint position sense, JPS) and visual-vestibular interaction dysfunction in patients with cervicogenic dizziness (CV), providing objective evidence for the “sensory integration dysfunction” pathomechanism. Methods: A retrospective case-control study was conducted. Thirty-seven CV patients and 37 healthy controls were included. Objective data including cervical JPS error, key parameters of computerized dynamic posturography (CDP) sensory organization test (SOT) (primarily vestibular ratio and sensory integration ratio), and subjective visual vertical (SVV) deviation were collected and analyzed. Pearson or Spearman correlation analysis was used to examine the relationship between mean cervical JPS error and visual-vestibular function metrics. Results: Compared with the healthy control group, the CV group showed significantly greater cervical JPS error, as well as significantly abnormal vestibular ratio, sensory integration ratio in CDP-SOT, and SVV deviation (all P<0.001). Within the CV group, the mean cervical JPS error was significantly negatively correlated with the vestibular ratio (r=-0.658) and sensory integration ratio (r=-0.624), and positively correlated with the SVV deviation angle (r=0.573, all P<0.001). Multiple linear regression indicated that cervical JPS error was an independent factor predicting dizziness handicap inventory (DHI) scores (β=0.338, P=0.008). Conclusion: Patients with cervicogenic dizziness exhibit distinct abnormalities in cervical proprioceptive input, which are significantly correlated with impaired visual-vestibular central integration and spatial perception. This provides objective quantitative support for the sensory integration dysfunction mechanism in CV and suggests that clinical assessment and rehabilitation should focus on the restoration of sensorimotor integration function.