Yoo Dae Myoung, Kang Ho Suk, Kim Ji Hee, Kim Joo-Hee, Choi Hyo Geun, Han Kyeong Min, Kim Nan Young, Bang Woo Jin, Kwon Mi Jung
Hallym Data Science Laboratory, Hallym University College of Medicine, Anyang 14068, Republic of Korea.
Laboratory of Brain and Cognitive Sciences for Convergence Medicine, Hallym University College of Medicine, Anyang 14068, Republic of Korea.
Healthcare (Basel). 2025 May 14;13(10):1145. doi: 10.3390/healthcare13101145.
: Parkinson's disease (PD) and benign paroxysmal positional vertigo (BPPV) are both prevalent in the geriatric population. While dizziness is a common non-motor symptom in PD, the relationship between PD and incident BPPV remains unclear. Limited data suggest potential shared mechanisms, including mitochondrial dysfunction and oxidative stress, but large-scale epidemiological evidence is lacking. This investigation focused on assessing the incidence of BPPV in patients with PD compared to matched controls using a nationwide cohort. : Data from the Korean National Health Insurance Service-Health Screening Cohort were used to perform a retrospective cohort analysis. We identified 8232 newly diagnosed PD patients and matched them 1:4 with 32,928 controls based on age, sex, income, and residential region. Stratified Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for incident BPPV. Subgroup and Kaplan-Meier analyses were also performed. : Over 220,151 person-years of follow-up revealed a lower incidence of BPPV in the PD group relative to the control group (4.98 vs. 5.95 per 1000 person-years); the corresponding adjusted HR was 0.77 (95% CI: 0.66-0.90; = 0.001), indicating a 23% reduced risk. The inverse association remained consistent across most subgroups, including older adults and rural residents. Kaplan-Meier analysis further illustrated a significant decline in the cumulative incidence of BPPV in PD patients ( = 0.007). PD may contribute to a lower incidence of BPPV, which could be explained by reduced mobility, altered vestibular function, or diagnostic challenges. Clinicians should consider BPPV in PD patients presenting with dizziness.
帕金森病（PD）和良性阵发性位置性眩晕（BPPV）在老年人群中都很常见。虽然头晕是PD常见的非运动症状，但PD与新发BPPV之间的关系仍不清楚。有限的数据表明存在潜在的共同机制，包括线粒体功能障碍和氧化应激，但缺乏大规模的流行病学证据。本研究旨在使用全国性队列评估PD患者与匹配对照组中BPPV的发病率。
来自韩国国民健康保险服务健康筛查队列的数据用于进行回顾性队列分析。我们确定了8232例新诊断的PD患者，并根据年龄、性别、收入和居住地区将他们与32928例对照组按1:4进行匹配。采用分层Cox比例风险模型估计新发BPPV的风险比（HR）和95%置信区间（CI）。还进行了亚组分析和Kaplan-Meier分析。
超过220151人年的随访显示，PD组BPPV的发病率低于对照组（每1000人年分别为4.98例和5.95例）；相应的调整后HR为0.77（95%CI：0.66-0.90；P = 0.001），表明风险降低了23%。在包括老年人和农村居民在内的大多数亚组中，这种反向关联仍然一致。Kaplan-Meier分析进一步表明PD患者中BPPV的累积发病率显著下降（P = 0.007）。PD可能导致BPPV发病率较低，这可以通过活动能力下降、前庭功能改变或诊断挑战来解释。临床医生在诊治出现头晕的PD患者时应考虑BPPV。
