Medición del nivel de ansiedad en personas con desórdenes vestibulares mediante escalas de autopercepción versus respuesta autonómica
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Moscoso Castañeda, Diana Paola
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Antecedentes: El sistema vestibular tiene varias conexiones con otros sistemas del organismo, como sucede con el encargado de la regulación de las emociones: el sistema límbico. El vínculo entre estos dos sistemas se ha descrito desde el siglo pasado y de acuerdo con la literatura, las personas con Desórdenes Vestibulares (DV) experimentan niveles de ansiedad mucho más altos que la población general. La medición de dichos niveles se ha realizado en su mayoría mediante escalas de autopercepción y no mediante registros autonómicos que permitan estimar la ansiedad fisiológica. Por esta razón, no hay evidencia de correlaciones entre las variables subjetivas y objetivas en el análisis de la ansiedad. Objetivo: Determinar la correlación entre las escalas de autopercepción del nivel de ansiedad y la respuesta autonómica en personas con DV en estado de reposo y durante la estimulación de realidad virtual, en comparación con sujetos sin alteración vestibular. Método: Este estudio observacional analítico incluyó 26 personas con DV con su respectivo grupo control emparejado por sexo y edad. Los estímulos empleados para el registro autonómico y de las escalas de ansiedad fueron dos videos 360° de realidad virtual. Resultados: Las personas con DV mostraron una activación simpática significativamente mayor tanto en reposo como durante la exposición a realidad virtual en comparación con el grupo control. El coeficiente de Spearman evidenció en el grupo de estudio, una correlación negativa entre los indicadores de actividad simpática y las escalas de autopercepción, así como una correlación positiva entre las variables de actividad parasimpática y el inventario de ansiedad. En el grupo control no se encontraron correlaciones significativas. Conclusión: La opuesta correlación entre las variables analizadas sugiere que la respuesta autonómica no fue consistente con la interpretación subjetiva de ansiedad en la población con DV, aun cuando son evidentes los altos marcadores de ansiedad fisiológica determinados a través de la activación simpática.
Abstract: Background: The vestibular system has several connections with other systems of the organism, as happens with the one in charge of regulating emotions: the limbic system. The link between these two systems has been described since the last century and according to the literature, people with Vestibular Disorders (VD) experience levels of anxiety higher than the general population. The measuring of these levels has been done mostly through scales of self-perception and not through autonomic registers that allow to estimate physiological anxiety. For this reason, there is no evidence of correlations between subjective and objective variables in the analysis of anxiety. Objective: To determinate the correlation between the scales of self-perception of the anxiety level and the autonomic response in people with VD at rest and during stimulation with virtual reality compared to people without vestibular disfunction. Method: This observational analytic study included 26 people with vestibular disorder with their respective control group matched by age and sex. Two 360° virtual reality videos were used as a stimulus for autonomic and anxiety scales register. Results: People with VD showed a significantly greater sympathetic activation both at rest and during exhibition to virtual reality compared to control group. The Spearman coefficient evidenced in the study group, a negative correlation between indicators of sympathetic activity and scales of self-perception as well as a positive correlation between variables of parasympathetic activity and inventory anxiety. In the group control no significant correlations was found. Conclusion: The opposite correlation between variables analyzed suggest that response autonomic is not consistent with the subjective interpretation of anxiety in population with VD even when the high indicators of physiological anxiety determinate through sympathetic activation are evident.
Abstract: Background: The vestibular system has several connections with other systems of the organism, as happens with the one in charge of regulating emotions: the limbic system. The link between these two systems has been described since the last century and according to the literature, people with Vestibular Disorders (VD) experience levels of anxiety higher than the general population. The measuring of these levels has been done mostly through scales of self-perception and not through autonomic registers that allow to estimate physiological anxiety. For this reason, there is no evidence of correlations between subjective and objective variables in the analysis of anxiety. Objective: To determinate the correlation between the scales of self-perception of the anxiety level and the autonomic response in people with VD at rest and during stimulation with virtual reality compared to people without vestibular disfunction. Method: This observational analytic study included 26 people with vestibular disorder with their respective control group matched by age and sex. Two 360° virtual reality videos were used as a stimulus for autonomic and anxiety scales register. Results: People with VD showed a significantly greater sympathetic activation both at rest and during exhibition to virtual reality compared to control group. The Spearman coefficient evidenced in the study group, a negative correlation between indicators of sympathetic activity and scales of self-perception as well as a positive correlation between variables of parasympathetic activity and inventory anxiety. In the group control no significant correlations was found. Conclusion: The opposite correlation between variables analyzed suggest that response autonomic is not consistent with the subjective interpretation of anxiety in population with VD even when the high indicators of physiological anxiety determinate through sympathetic activation are evident.