Reframing the lived experience of persistent dizziness: insights from active inference.
5 affiliations
- 1Two Trees Physical Therapy, Ventura, CA, United States.
- 2Royal College of Surgeons in Ireland, Dublin, Ireland.
- 3Health Sciences University Centre for PAIn Research, Bournemouth, United Kingdom.
- 4Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, United Kingdom.
- 5Escola Superior de Saúde Atlântica, Barcarena, Portugal.
Abstract
We present an active inference account of persistent dizziness predicated on models of enactivism and ecological psychology; including first-hand accounts of the patient's lived experience. Mechanistically, we consider persistent dizziness to reflect an initial failure of sensory attenuation of vestibular and other sensory prediction errors. This failure becomes self-maintaining if the patient infers-or learns-that unattenuated prediction errors cannot be resolved through action. The ensuing formulation provides an integrative account of the pathophysiology of dizziness and how it underwrites-and is maintained by-affective inference and an altered sense of agency that shapes the experience of the person with dizziness. We foreground the holistic person-centered approach on offer from a clinical perspective, and consider complementary levels of therapeutic intervention under this theoretical framework.
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BibTeX
@article{broberg2026reframing,
title = {{Reframing the lived experience of persistent dizziness: insights from active inference.}},
author = {Marc A Broberg and Mick Thacker and Karl J Friston and Jorge E Esteves},
journal = {Frontiers in psychology},
year = {2026},
month = oct,
doi = {10.3389/fpsyg.2026.1867836},
url = {https://europepmc.org/article/MED/42953163},
note = {CC BY},
}
RIS
TY - JOUR
TI - Reframing the lived experience of persistent dizziness: insights from active inference.
AU - Marc A Broberg
AU - Mick Thacker
AU - Karl J Friston
AU - Jorge E Esteves
PY - 2026
DA - 2026/10/14
JO - Frontiers in psychology
DO - 10.3389/fpsyg.2026.1867836
UR - https://europepmc.org/article/MED/42953163
AB - We present an active inference account of persistent dizziness predicated on models of enactivism and ecological psychology; including first-hand accounts of the patient's lived experience. Mechanistically, we consider persistent dizziness to reflect an initial failure of sensory attenuation of vestibular and other sensory prediction errors. This failure becomes self-maintaining if the patient infers-or learns-that unattenuated prediction errors cannot be resolved through action. The ensuing formulation provides an integrative account of the pathophysiology of dizziness and how it underwrites-and is maintained by-affective inference and an altered sense of agency that shapes the experience of the person with dizziness. We foreground the holistic person-centered approach on offer from a clinical perspective, and consider complementary levels of therapeutic intervention under this theoretical framework.
SN - 1664-1078
ER -