{"id":16623,"date":"2025-10-10T16:03:53","date_gmt":"2025-10-10T14:03:53","guid":{"rendered":"https:\/\/ivrt.de\/?p=16623"},"modified":"2026-04-28T17:37:13","modified_gmt":"2026-04-28T15:37:13","slug":"perso-vestibueler-agda-duyarlilasma-fonksiyonel-noerogoeruentuelemesi","status":"publish","type":"post","link":"https:\/\/ivrt.de\/tr\/studien-evidenz\/funktionelle-bildgebung-bei-pppd-sensibilisierung-im-multisensorischen-vestibulaeren-netzwerk\/","title":{"rendered":"PPPD'de Fonksiyonel G\u00f6r\u00fcnt\u00fcleme: Multisensoriyel Vestib\u00fcler A\u011fda Duyarl\u0131la\u015fma"},"content":{"rendered":"<p><strong>Uzman personel i\u00e7in:<\/strong><\/p>\n\n\n\n<p>Der <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/kalici-postural-perseptueel-bas-doenmesi-pppd\/\" data-type=\"post\" data-id=\"5343\">kal\u0131c\u0131 postural-perseptif ba\u015f d\u00f6nmesi<\/a> PPPD genellikle periferik-vestib\u00fcler bir bozuklu\u011fun ard\u0131ndan ortaya \u00e7\u0131kar; ancak denge fonksiyonu \u00e7oktan normale d\u00f6nm\u00fc\u015f olsa bile devam eder. Standart tetkikler genellikle normal \u00e7\u0131kmas\u0131na ra\u011fmen hastalar kal\u0131c\u0131 dengesizlik, hareketle tetiklenen ba\u015f d\u00f6nmesi ve g\u00f6rsel olarak tetiklenen semptomlar bildirmektedir. Merkezi i\u015fleme mekanizmalar\u0131n\u0131n rol\u00fc \u015fimdiye kadar belirsizdi.<\/p>\n\n\n\n<p>\ud83d\udd17 Storm R ve ark., 2025. <em>Galvanik vestib\u00fcler stim\u00fclasyon s\u0131ras\u0131nda kal\u0131c\u0131 postural-persept\u00fcel ba\u015f d\u00f6nmesinde (PPPD) i\u015flevsel beyin aktivitesi, multisens\u00f6r vestib\u00fcler kortikal a\u011fda duyarl\u0131la\u015fmay\u0131 ortaya koymaktad\u0131r.<\/em> Scientific Reports<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40717118\/\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>PubMed'deki Orijinal \u00c7al\u0131\u015fma<\/strong><\/a><\/p>\n\n\n\n<p><strong>\u00c7al\u0131\u015fma tasar\u0131m\u0131:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Kat\u0131l\u0131mc\u0131lar<strong>:<\/strong> 28 PPPD hastas\u0131, ya\u015f ve cinsiyet a\u00e7\u0131s\u0131ndan e\u015fle\u015ftirilmi\u015f 28 sa\u011fl\u0131kl\u0131 kontrol<\/li>\n\n\n\n<li>Y\u00f6ntem<strong>:<\/strong> Galvanik vestib\u00fcler stim\u00fclasyon (GVS) s\u0131ras\u0131nda fonksiyonel manyetik rezonans g\u00f6r\u00fcnt\u00fcleme (fMRG)<\/li>\n\n\n\n<li>Tetkik parametreleri<strong>:<\/strong>\n<ul class=\"wp-block-list\">\n<li>Hareket alg\u0131lama e\u015fi\u011fi (egomotion)<\/li>\n\n\n\n<li>Subjektif ba\u015f d\u00f6nmesi alg\u0131s\u0131n\u0131n \u015fiddeti<\/li>\n\n\n\n<li>PPPD kaynakl\u0131 k\u0131s\u0131tlamalara y\u00f6nelik anketler (\u00f6rn. Dizziness Handicap Inventory)<\/li>\n\n\n\n<li>g\u00f6rsel hareket i\u015fleme (hareket uyumu g\u00f6revi)<\/li>\n\n\n\n<li>postural kontrol (posturografik testler)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>Temel Bulgular<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>PPPD hastalar\u0131, \u00e7ok zay\u0131f vestib\u00fcler uyaranlara bile belirgin bir ba\u015f d\u00f6nmesi alg\u0131s\u0131yla tepki vermektedir.<\/li>\n\n\n\n<li>Kontrol grubuna k\u0131yasla \u015fu b\u00f6lgelerde anlaml\u0131 derecede artm\u0131\u015f aktivite g\u00f6r\u00fcld\u00fc:\n<ul class=\"wp-block-list\">\n<li>supramarginal girusa<\/li>\n\n\n\n<li>posterior insulan\u0131n (operkulum 3)<\/li>\n\n\n\n<li>beyin sap\u0131 vermisi<\/li>\n<\/ul>\n<\/li>\n\n\n\n<li>PPPD hastalar\u0131nda alg\u0131lanan ba\u015f d\u00f6nmesi \u015fiddeti daha fazlayd\u0131 \u2013 ancak beyin aktivitesi ile do\u011frudan ili\u015fkili de\u011fildi<\/li>\n\n\n\n<li>Insula'daki aktivasyon d\u00fczeyi, i\u015flevsel k\u0131s\u0131tlamalar\u0131n ve postural instabilitenin derecesi ile korelasyon g\u00f6sterdi.<\/li>\n<\/ul>\n\n\n\n<p><strong><strong>Klinik \u00f6nem<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00c7al\u0131\u015fma, PPPD'de multisensoriyel vestib\u00fcler a\u011f\u0131n duyarl\u0131la\u015fmas\u0131n\u0131 kan\u0131tlamaktad\u0131r.<\/li>\n\n\n\n<li>\u00d6n planda periferik bir lezyon de\u011fil, merkezi bir a\u015f\u0131r\u0131 uyar\u0131labilirlik yer almaktad\u0131r<\/li>\n\n\n\n<li>Patofizyolojik mekanizmalar duyusal-n\u00f6ral bir amplifikasyona benzer<\/li>\n\n\n\n<li>Normal uyaranlar\u0131n bile (\u00f6rne\u011fin hareket, g\u00f6rsel izlenimler) a\u015f\u0131r\u0131 g\u00fc\u00e7l\u00fc semptomlar\u0131 neden tetikledi\u011fini a\u00e7\u0131klar<\/li>\n<\/ul>\n\n\n\n<p><strong>Pratik \u0130\u00e7in Sonu\u00e7<\/strong><\/p>\n\n\n\n<p>Bu veriler \u015funu do\u011frulamaktad\u0131r: PPPD merkezi bir n\u00f6rofizyolojik sendromdur; bir kuruntu veya birincil psikojenik bozukluk de\u011fildir.<\/p>\n\n\n\n<p><br>Bu, tedavi i\u00e7in \u015fu anlama gelir:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Hasta e\u011fitimi esast\u0131r; bilgilendirme anlay\u0131\u015f sa\u011flar<\/li>\n\n\n\n<li><a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/vestibueler-rehabilitasyon-tedavisi-ve-denge-egitimi\/\" data-type=\"post\" data-id=\"8932\">Hedefli al\u0131\u015fma<\/a> (g\u00f6rsel-vestib\u00fcler maruz kalma, denge e\u011fitimi) a\u015f\u0131r\u0131 duyarl\u0131l\u0131\u011f\u0131 azaltabilir<\/li>\n\n\n\n<li>SSRI gibi ila\u00e7lar tamamlay\u0131c\u0131 olarak faydal\u0131 olabilir - ancak birincil tedavi de\u011fildir<\/li>\n<\/ul>\n\n\n\n<p><strong>\ud83d\udc49 Kapsaml\u0131 bir ileri e\u011fitime ilgi duyuyorsunuz: <a href=\"https:\/\/ivrt.de\/tr\/hasta-egitimi\/vestibueler-rehabilitasyon-tedavisi-ve-denge-egitimi\/\" data-type=\"post\" data-id=\"8932\">vestib\u00fcler rehabilitasyon tedavisi<\/a> ve PPPD'nin g\u00fcvenli bir \u015fekilde nas\u0131l te\u015fhis edildi\u011fi ve kan\u0131ta dayal\u0131 olarak nas\u0131l tedavi edildi\u011fi?<\/strong><\/p>\n\n\n\n<p>G\u00fcncel e\u011fitim tekliflerini \u015furada bulabilirsiniz: <strong><a href=\"https:\/\/ivrt.de\/tr\/saglik-personeli-icin\/hizmet-ici-egitim-arama\/\" data-type=\"link\" data-id=\"https:\/\/ivrt.de\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\">IVRT E\u011fitim Arama<\/a>.<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>Hastalar i\u00e7in \u2013 basit\u00e7e a\u00e7\u0131kland\u0131<\/strong><\/p>\n\n\n\n<p><strong><strong><strong>PPPD'de beyin neden ba\u015f d\u00f6nmesine a\u015f\u0131r\u0131 duyarl\u0131 tepki verir<\/strong><\/strong><\/strong><\/p>\n\n\n\n<p>Das <a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/kalici-postural-perseptueel-bas-doenmesi-pppd\/\" data-type=\"post\" data-id=\"5343\">Kal\u0131c\u0131 post\u00fcral-alg\u0131sal ba\u015f d\u00f6nmesi sendromu<\/a> (PPPD), orijinal neden (\u00f6rne\u011fin denge organ\u0131n\u0131n iltihaplanmas\u0131) \u00e7oktan ortadan kalkm\u0131\u015f olmas\u0131na ra\u011fmen ba\u015f d\u00f6nmesinin devam etti\u011fi bir rahats\u0131zl\u0131kt\u0131r.<\/p>\n\n\n\n<p>Pek \u00e7ok ma\u011fdur kendini g\u00fcvensiz hisseder, hareketleri rahats\u0131z edici derecede g\u00fc\u00e7l\u00fc olarak alg\u0131lar veya y\u00fcr\u00fcyen merdivenler, ekran ba\u015f\u0131nda \u00e7al\u0131\u015fma veya kalabal\u0131klar gibi g\u00f6rsel uyaranlara kar\u015f\u0131 hassasiyet g\u00f6sterir.<br><br>\ud83d\udcc4 Storm R ve ark., 2025. <em>Galvanik vestib\u00fcler stim\u00fclasyon s\u0131ras\u0131nda kal\u0131c\u0131 postural-persept\u00fcel ba\u015f d\u00f6nmesinde (PPPD) i\u015flevsel beyin aktivitesi, multisens\u00f6r vestib\u00fcler kortikal a\u011fda duyarl\u0131la\u015fmay\u0131 ortaya koymaktad\u0131r.<\/em> Scientific Reports.<\/p>\n\n\n\n<p><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40717118\/\" data-type=\"link\" data-id=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\" target=\"_blank\" rel=\"noreferrer noopener\">Orijinal \u00e7al\u0131\u015fmaya<\/a><\/p>\n\n\n\n<p><strong>Yeni \u00e7al\u0131\u015fma ne g\u00f6steriyor?<\/strong><\/p>\n\n\n\n<p>Bilim insanlar\u0131, PPPD hastalar\u0131nda ve sa\u011fl\u0131kl\u0131 bireylerde beynin denge sisteminin hafif uyaranlar\u0131na nas\u0131l tepki verdi\u011fini inceledi:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>\u00c7ok zay\u0131f uyaranlar bile PPPD hastalar\u0131nda ba\u015f d\u00f6nmesine neden oldu<\/li>\n\n\n\n<li>Beyinde, \u00f6rne\u011fin insula korteksi (beden alg\u0131s\u0131 i\u00e7in) ve beyincik (denge i\u00e7in) gibi belirli b\u00f6lgeler a\u015f\u0131r\u0131 aktifti.<\/li>\n\n\n\n<li>Ba\u015f d\u00f6nmesi g\u00fcnl\u00fck ya\u015fam\u0131 ne kadar \u00e7ok etkilerse, bu beyin b\u00f6lgeleri o kadar g\u00fc\u00e7l\u00fc bir \u015fekilde aktive oluyordu<\/li>\n<\/ul>\n\n\n\n<p><strong><strong>Bu ne anlama geliyor?<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ba\u015f d\u00f6nmen hayal \u00fcr\u00fcn\u00fc de\u011fil \u2013 beyinde \u00f6l\u00e7\u00fclebilir<\/li>\n\n\n\n<li>PPPD, beynin uyaranlara kar\u015f\u0131 a\u015f\u0131r\u0131 duyarl\u0131 oldu\u011fu anlam\u0131na gelir.<\/li>\n\n\n\n<li>\u0130yi haber: Beyin yine buna al\u0131\u015fabilir<\/li>\n<\/ul>\n\n\n\n<p><strong><strong>PPPD'ye ne iyi gelir?<\/strong><\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/ivrt.de\/tr\/bas-doenmesi-hastaliklari\/vestibueler-rehabilitasyon-tedavisi-ve-denge-egitimi\/\" data-type=\"post\" data-id=\"8932\">Hedefe y\u00f6nelik egzersizler ve denge e\u011fitimi<\/a><\/li>\n\n\n\n<li>G\u00f6rsel uyaranlarla antrenman (\u00f6rn. sanal ger\u00e7eklik, hareketli desenler)<\/li>\n\n\n\n<li>Ba\u015f d\u00f6nmesi korkusuna kar\u015f\u0131 bilgilendirme ve stratejiler<\/li>\n<\/ul>\n\n\n\n<p>Hedef: Beyniniz kademeli olarak daha az hassas hale geliyor \u2013 g\u00fcvenli\u011finizi geri kazan\u0131yorsunuz.<\/p>\n\n\n\n<p>\ud83c\udfaf <strong>\u00d6zel olarak e\u011fitilmi\u015f IVRT\u00ae ba\u015f d\u00f6nmesi ve vestib\u00fcler terapistlerimiz<\/strong> PPPD tedavisinde \u00f6zel olarak e\u011fitilmi\u015ftir: <strong><a href=\"https:\/\/ivrt.de\/tr\/etkilenenler-icin\/terapist-arama\/\" data-type=\"page\" data-id=\"101\" target=\"_blank\" rel=\"noreferrer noopener\">IVRT Terapist Arama<\/a><\/strong><\/p>\n\n\n\n<p><a id=\"_msocom_1\"><\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>F\u00fcr Fachpersonal: Der persistierende postural-perzeptive Schwindel (PPPD) tritt h\u00e4ufig nach einer peripher-vestibul\u00e4ren St\u00f6rung auf \u2013 bleibt aber auch dann bestehen, wenn sich die Gleichgewichtsfunktion l\u00e4ngst normalisiert hat. Betroffene berichten \u00fcber anhaltende Unsicherheit, Schwindel bei Bewegung und visuell ausgel\u00f6ste Symptome \u2013 obwohl Standarduntersuchungen oft unauff\u00e4llig sind. Die Rolle zentraler Verarbeitungsmechanismen war bisher unklar. \ud83d\udd17 Storm R [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":17996,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_jf_save_progress":"","iawp_total_views":759,"footnotes":""},"categories":[215],"tags":[],"class_list":["post-16623","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-studien-evidenz"],"_links":{"self":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts\/16623","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/comments?post=16623"}],"version-history":[{"count":2,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts\/16623\/revisions"}],"predecessor-version":[{"id":16628,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/posts\/16623\/revisions\/16628"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/media\/17996"}],"wp:attachment":[{"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/media?parent=16623"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/categories?post=16623"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ivrt.de\/tr\/wp-json\/wp\/v2\/tags?post=16623"}],"curies":[{"name":"Naber","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}