Vestibulo-oculomotor reflex function is altered in people with Parkinson’s Disease: a cross-sectional study using the video Head Impulse Test
Autori
Diego Piatti (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Laura Casagrande Conti (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Leonardo Manzari (MSA ENT Academy Center, 03043 Cassino, Italy)
Domenico De Angelis (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Ugo Nocentini (Santa Lucia Foundation, Scientific Institute for Research and Health Care, 00179 Rome, Italy)
Marco Tramontano (Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy; Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy)
Nicola Ferri (Department of Biomedical and Neuromotor Sciences, University of Bologna, 40138 Bologna, Italy)
Background and aims
Parkinson’s Disease (PD) is a neurodegenerative, progressive disorder known for motor and non-motor symptoms (1). Vestibular dysfunction in PD may exacerbate postural instability and gait disturbances. The vestibular system, via the vestibulo-ocular reflex (VOR), is crucial for maintaining dynamic gaze stability, and its role in PD is raising interest among researchers (2). However, the prevalence of vestibular dysfunctions remains unclear how prevalent vestibular dysfunctions are isn’t fully clear. This study aims to objectively investigate the VOR function in people with PD using the video Head Impulse Test.
Methods
This is a cross-sectional study conducted in a neurorehabilitation hospital. People with PD were included if they had no dementia and the ability to walk without physical assistance. The video Head Impulse Test was used to assess the VOR function in the six semicircular canals. Both the Head Impulse Paradigm (HIMP) and the Suppression Head Impulse Paradigm (SHIMP) paradigms were considered.
Results
Thirty-five people with PD (mean age: 69.9±8.4; 11 females) with moderate motor symptoms (UPDRS-part III: 27.7 ± 6.8) were included. Using normative cut-offs, 69% of the participants had at least one dysfunctional canal (60% hypo-gain, 9% hyper-gain). The prevalence reached 83% when both the HIMP and SHIMP paradigms were considered.
Conclusion
There is a high prevalence of vestibular dysfunction in people with PD. The instrumental assessment of VOR gains could reveal undiagnosed vestibular dysfunctions and, in the future, lead to more specific rehabilitation management of people with PD.
REFERENCES
- Kalia LV, Lang AE. Parkinson’s disease. Lancet Lond Engl. 2015;386(9996):896-912. doi:10.1016/S0140-6736(14)61393-3
- Smith PF. Vestibular Functions and Parkinson’s Disease. Front Neurol. 2018;9:1085. doi:10.3389/fneur.2018.01085