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

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