Send to

Choose Destination
Eur J Neurosci. 2020 Jan 16. doi: 10.1111/ejn.14680. [Epub ahead of print]

Pathophysiological dissociation of the interaction between time pressure and trait anxiety during spatial orientation judgments.

Author information

Division of Brain Sciences, Academic Department of Neuro-otology, Imperial College London, Charing Cross Hospital, London, UK.
inAmind Laboratory, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK.
King's College Hospital, London, UK.
Leiden University Ringgold Standard Institution - Medicine, Leiden, The Netherlands.
Department of Neuro-otology, Royal National Throat Nose and Ear Hospital, University College London, London, UK.
Department of Clinical and Motor Neurosciences, Centre for Vestibular Neurosciences, London, UK.


Spatial orientation is achieved by integrating visual, vestibular and proprioceptive cues. Individuals that rely strongly upon visual cues to facilitate spatial orientation are termed visually dependent. Heightened visual reliance commonly occurs in patients following vestibular dysfunction and can influence clinical outcome. Additionally, psychological factors, including anxiety, are associated with poorer clinical outcome following vestibular dysfunction. Given that visual dependency measures are affected by psychological and contextual influences, such as time pressure, we investigated the interaction between time pressure and anxiety upon visual dependency in healthy controls and vestibular migraine patients. Visual dependency was assessed using a "Rod and Disk" task at baseline and under time pressure (3 s to complete the task). Non-situational (trait) and situational (state) anxiety levels were quantified using the Spielberg State-Trait Anxiety Inventory. We calculated the change in visual dependency (VD) [∆VD = VDtime pressure  - VDbaseline ] and correlated it with participants' trait anxiety scores. We observed a significant negative correlation between trait anxiety and the change in VD (R2  = .393, p < .001) in healthy controls and a positive correlation in dizzy patients (R2  = .317, p < .001). That is, healthy individuals that were more anxious became less visually dependent under time pressure (i.e., more accurate), whereas less anxious individuals became more visually dependent. The reverse was observed in vestibular migraine patients. Our results illustrate that anxiety can differentially modulate task performance during spatial orientation judgements under time pressure in healthy individuals and dizzy patients. These findings have potential implications for individualised patient rehabilitation therapies.


anxiety; decision-making; spatial orientation; time pressure; vestibular migraine


Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center