Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Otolaryngology-Head and Neck Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Neurol. 2024 Jun;271(6):3527-3536. doi: 10.1007/s00415-024-12311-6. Epub 2024 Mar 27.
Vestibular dysfunction is closely associated with the pathophysiology of Parkinson's disease (PD) accompanied by freezing of gait (FOG); however, evidence supporting this clinical association is lacking. Vestibular-evoked myogenic potentials (VEMPs) have been widely acknowledged as a crucial electrophysiological parameter in the clinical evaluation of vestibular function.
The present study investigated the possible correlation of FOG occurrence with VEMP observations in patients diagnosed with PD.
Altogether, 95 idiopathic PD patients were recruited into the present cross-sectional study. All patients underwent motor and non-motor assessments using serial scales. In addition, the electrophysiological vestibular evaluation was conducted, which included cervical (cVEMP) and ocular VEMP (oVEMP) assessments. Furthermore, the correlations of bilateral c/oVEMP absence with clinical phenotypes, especially FOG, among the PD patients were analyzed.
Among the 95 patients with PD, 44 (46.3%) had bilateral oVEMP absence and 23 (24.2%) had bilateral cVEMP absence, respectively. The proportions of patients with bilateral oVEMP absence (77.8% vs 30.9%, p = 0.004) and bilateral cVEMP absence (44.4% vs 19.5%, p = 0.035) were higher in the patient group exhibiting FOG than in the group without FOG. Following the adjustment of confounding variables, bilateral oVEMP absence (OR = 8.544, p = 0.007), rather than bilateral cVEMP absence, was shown to independently predict FOG occurrence in patients with PD.
The close correlation between bilateral oVEMP absence and FOG in PD patients sheds new light on the possible role of central vestibular/upper brainstem dysfunction in FOG development in patients with PD.
前庭功能障碍与伴有冻结步态（FOG）的帕金森病（PD）的病理生理学密切相关；然而，支持这种临床关联的证据不足。前庭诱发肌源性电位（VEMPs）已被广泛认为是评估前庭功能的重要电生理参数。
本研究旨在探讨 PD 患者 FOG 发生与 VEMP 观察结果之间的可能相关性。
共纳入 95 例特发性 PD 患者进行横断面研究。所有患者均接受了使用一系列量表进行的运动和非运动评估。此外，还进行了电生理前庭评估，包括颈椎（cVEMP）和眼动 VEMP（oVEMP）评估。此外，分析了 PD 患者双侧 c/oVEMP 缺失与临床表型（尤其是 FOG）之间的相关性。
在 95 例 PD 患者中，分别有 44 例（46.3%）存在双侧 oVEMP 缺失，23 例（24.2%）存在双侧 cVEMP 缺失。存在 FOG 的患者组中双侧 oVEMP 缺失的比例（77.8%比 30.9%，p=0.004）和双侧 cVEMP 缺失的比例（44.4%比 19.5%，p=0.035）均高于无 FOG 的患者组。在调整混杂变量后，双侧 oVEMP 缺失（OR=8.544，p=0.007）而非双侧 cVEMP 缺失，与 PD 患者 FOG 的发生独立相关。
PD 患者双侧 oVEMP 缺失与 FOG 之间的密切相关性提示中枢前庭/上脑干功能障碍可能在 PD 患者 FOG 发展中起作用。
