Shetty Kuldeep, Krishnan Syam, Thulaseedharan Jissa Vinoda, Mohan Manju, Kishore Asha
Comprehensive Care Centre for Movement Disorders, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India.
J Mov Disord. 2019 May;12(2):84-90. doi: 10.14802/jmd.18048. Epub 2019 Apr 5.
Recent reports of hearing impairment in Parkinson's disease (PD) have suggested that auditory dysfunction could be a non-motor manifestation of PD. These reports were based on observations of elderly patients for whom presbycusis may, to some extent, have contributed to hearing dysfunction. Therefore, we aimed to explore the auditory functions in younger patients with PD.
We conducted a case-control study in a relatively younger (< 55 years of age at study time) population of PD patients and healthy volunteers to test whether auditory dysfunction is a significant non-motor dysfunction in PD. Pure tone audiometry (PTA) and brainstem evoked response audiometry (BERA) were performed in all participants.
None of the patients or controls reported hearing deficits. Fifty-one patients with PD and 50 healthy volunteers who were age- and gender-matched to the patients participated. PTA-detected hearing impairment was found in 64.7% of patients and 28% of controls (p < 0.001) for both low-mid and/or high frequencies. Hearing impairment was more frequent in the younger subgroups of patients than age-matched controls, while the frequency of hearing impairment was similar in older groups of subjects. BERA was not different between patients and controls.
Asymptomatic auditory dysfunction is a common non-motor manifestation of early-onset PD and more frequent in younger patients, indicating that it may be independent of aging. The mechanism underlying this dysfunction appears to be peripheral, although a central dysfunction cannot be ruled out based on the findings of this study.
帕金森病(PD)近期有关听力障碍的报告表明,听觉功能障碍可能是PD的一种非运动性表现。这些报告基于对老年患者的观察,而在这些患者中,老年性耳聋可能在一定程度上导致了听力功能障碍。因此,我们旨在探究较年轻的PD患者的听觉功能。
我们在相对年轻(研究时年龄<55岁)的PD患者和健康志愿者群体中进行了一项病例对照研究,以测试听觉功能障碍是否是PD中一种显著的非运动功能障碍。所有参与者均接受了纯音听力测定(PTA)和脑干听觉诱发电位测定(BERA)。
患者和对照组均未报告有听力缺陷。51例PD患者和50名与患者年龄和性别匹配的健康志愿者参与了研究。对于低频-中频和/或高频,PTA检测到的听力障碍在64.7%的患者和28%的对照组中存在(p<0.001)。患者较年轻亚组中的听力障碍比年龄匹配的对照组更常见,而在年龄较大的受试者组中,听力障碍的发生率相似。患者和对照组之间的BERA没有差异。
无症状性听觉功能障碍是早发性PD常见的非运动性表现,在较年轻患者中更常见,表明它可能与衰老无关。尽管根据本研究结果不能排除中枢功能障碍,但这种功能障碍的潜在机制似乎是外周性的。