Suffering from anxiety alongside vertigo and dizziness could be an indication of a benign brain tumour, alarming new research has suggested.
A vestibular schwannoma (VS) is a type of non-cancerous (benign) brain tumour, also known as an acoustic neuroma.
This type of tumour usually grows slowly over many years and affects the nerve responsible for hearing and balance, which can cause problems such as hearing loss, tinnitus and dizziness.
Even benign brain tumours, which unlike cancerous ones don’t spread to other parts of the body, can still be deadly as they grow within the sensitive tissue of the organ.
Among patients with VS, vertigo—which makes it feel like you or everything else around you is spinning so much so as to affect your balance—and dizziness have long been reported as the main predictors of overall quality of life and functional impairment—but until now, experts did not know why.
But now experts have found that a history of anxiety makes patients more susceptible to dizziness and other brain tumour-related symptoms.
In the current study, published in the journal JAMA Otolaryngology—Head & Neck Surgery, researchers from Washington University analysed data from 109 adults who were diagnosed with an untreated, unilateral brain tumour between June 2004 and January 2025.
Participants—who were diagnosed through the use of MRI scans at Barnes-Jewish Hospital in St Louis, Missouri—completed a questionnaire which rated the physical, functional and emotional aspects of their dizziness.
An acoustic neuroma may not cause any obvious symptoms at first but those that gradually develop tend to include hearing loss, tinnitus and vertigo
Known as the Dizziness Handicap Inventory, the self-assessment questionnaire consists of 25 questions, each with three possible answers coded as: no (value=0), sometimes (2), and yes (4)—with 100 indicating the most severe disability with regards to dizziness.
Participants were also asked to rate their anxiety using the Generalised Anxiety Disorder-7 scale, with high scores indication more severe anxiety.
The researchers also took into consideration formal diagnoses of generalised anxiety disorder and whether patients had any mention of anxiety in their medical records.
The researchers found that those who had a history of anxiety had a dizziness score that was nearly 14 points higher than those with no such history, suggesting that anxiety exacerbates brain tumour-related symptoms.
Tyler Wilson, an expert in neurotology and study lead author, said: ‘Psychological distress has been found to have an effect on vertigo in patients with disease and conditions affecting the vestibular system.
‘Although these studies have identified the association between vertigo and anxiety disorders, to our knowledge, no study to date has examined the role of anxiety in VS.
‘This gap provides the opportunity for other VS interventions such as mindfulness, based stress reduction.’
Whilst the average DHI score was around 27—suggesting that dizziness had a significant impact on the majority of patients’ lives—the researchers found this was much more severe for patients with a history of anxiety.
Experts say during the last 50 years an increasing number of benign brain tumours have been diagnosed, thought to be due at least in part to increasing use of MRIs
Generalised anxiety disorder (GAD) is a common mental health condition where you often feel very anxious about lots of different things
For every additional point in severity of anxiety measured, DHI scores increased by 2.6 points.
Interestingly, patients with hearing loss symptoms said that dizziness had less of an impact on their daily lives than those whose hearing had remained intact.
Whilst researchers noted that the size of a tumour did not seem to have an effect on dizziness, the NHS warns that large tumours can be serious as they can cause a life-threatening build-up of fluid in the brain.
The researchers concluded: ‘Dizziness is often unreported by referring physicians and should be assessed when suspecting a diagnosis of VS.’
Other common symptoms of VS include persistent headaches, temporary blurred or double vision, numbness, pain or weakness on one side of the face, problems with coordination and voice changes or difficulty swallowing.
Treatment options for brain tumours vary depending of factors like where the tumour is located, when it was found and how big it is.
Simply monitoring the tumour is often considered the first treatment option, with surgery only recommended if scans show the tumour is growing.
Brain surgery involves cutting out the tumour through an incision in the skull. This may be followed by stereotactic radiosurgery to stop any remaining traces from getting bigger.
Over 12,000 patients in Britain are diagnosed with a brain tumour each year, with about half of these cases being cancerous.
VS tend to affect adults aged 30 to 60 and usually have no obvious cause, although according to the NHS a small number of cases are the result of a genetic condition called neurofibromatosis type 2 (NF2).
Around one in 20 patients who have their tumour removed will relapse meaning many have to have routine MRI scans after treatment and even then symptoms such as hearing loss and tinnitus can persist.
