Eye deviation during rotation in darkness in trait anxiety: an early expression of perceptual avoidance?

Background: Patients with dizziness and patients with panic disorder and agoraphobia share a common symptomatology. Numerous studies have investigated a potential link between anxiety and the vestibular system, but few of them have addressed the specific topic of spatial representation. Methods: Passive whole-body rotations in the horizontal plane were imposed on two groups of subjects who differed in their level of trait anxiety. Subjects were seated on a mobile robot in darkness. After each passive rotation, subjects were asked to reproduce the stimulus by driving the robot with a joystick and to perform a rotation of the same magnitude. Eye movements were recorded and analyzed. Results: No difference in either perception (accuracy in the reproduction task) or in VOR gain was found between the two groups of subjects. Mean eye deviation, caused by fast phases of the nystagmus, differed in the two groups. It was typically in the anticompensatory direction in the non-anxious group, and in the compensatory direction the anxious group. Such compensatory movement may be explained by an egocentric orientation strategy, that may in turn indicate a lack of interest toward the visual surroundings. Conclusions: An egocentric strategy for self-orientation exhibited at a level below the threshold of awareness could reveal the existence of a physiological mode of processing leading to agoraphobic avoidance.