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KMID : 1036520230130010004
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Clinical Neuro-Ophthalmology
2023 Volume.13 No. 1 p.4 ~ p.8
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The Vestibulo-ocular Reflex in Parkinson’s Disease
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Lee Sun-Uk
Cho Yong-Keun
Yu-Jun Zhang
Lee Joo-Hyeong
Park Euy-Hyun
Lee Chan-Nyoung
Park Kun-Woo
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Abstract
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Parkinson’s disease (PD) is a chronic neurodegenerative disorder characterized by bradykinesia, rigidity, tremor, and postural instability. Because postural instability is one of the cardinal symptoms, vestibular dysfunction could be implicated. We investigated the patency of vestibulo-ocular reflex (VOR) using video head-impulse tests in PD patients. We prospectively recruited 133 patients (71 women, mean age ± standard deviation = 68 ± 10 years) with de-novo PD, who had a neurotologic evaluation from December 2019 to March 2023 at a tertiary medical center in South Korea. The results of video-HITs were compared with 42 healthy participants (32 women, 42± 15 years). Video-HITs were normal in most patients, except 32 patients (24%) showing decreased VOR gain, at least for either side. Abnormal VOR gain was mostly observed for the left horizontal (HC, n= 16), followed by right HC (n= 9), left posterior (PC, n= 8), right PC (n= 4), and right anterior canal (AC, n= 3). The VOR gain for the HC had a negative correlation with age (r= -0.174, P= 0.046), whereas no association was found with the disease duration (r= -0.105, P= 0.228) or UPDRS-III (r= -0.063, P= 0.483). Multiple linear regression showed that VOR gain for the HC had a negative association with age (standardized β= -0.198, P= 0.025). Our observation indicates that vestibular dysfunction is negligible, if any, and the clinical significance is limited in patients with PD. In addition, VOR impairment is not associated with alpha-synucleinopathy in patients with PD.
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KEYWORD
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Parkinson’s disease, Vertigo, Head-impulse test, Vestibulo-ocular reflex
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