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Hearing impairment in Parkinson's disease: Expanding the nonmotor phenotype
Authors:Roberto Allocca MD  Gabriella Santangelo PhD  Pasquale Riccardi PhD  Roberto Erro MD  Marianna Amboni MD  PhD  Maria Teresa Pellecchia MD  PhD  Autilia Cozzolino MD  Katia Longo MD  Marina Picillo MD  Marcello Moccia MD  Valeria Agosti PhD  G. Sorrentino MD  PhD  Michele Cavaliere MD  Elio Marciano MD  Paolo Barone MD  PhD
Affiliation:1. Audiology and Vestibology Unit, Department of Neuroscience, University of Naples Federico II, Naples, Italy;2. IDC, Hermitage Capodimonte, Naples, Italy;3. Department of Psychology, Second University of Naples, Caserta, Italy;4. Department of Neurological Sciences, University of Naples Federico II, Naples, Italy;5. University of Naples “Parthenope,” Naples, Italy;6. Neurodegenerative Diseases Center, University of Salerno, Salerno, Italy;7. Department of Otolaryngology, University of Naples Federico II, Naples, Italy
Abstract:
The objective of this study was to evaluate hearing impairment in patients affected by Parkinson's disease compared with hearing scores observed in normal age‐ and sex‐matched controls. One hundred eighteen consecutive patients with a clinical diagnosis of Parkinson's disease were screened. Severity of motor symptoms and staging were measured with the Unified Parkinson's Disease Rating Scale (section III) and the Hoehn and Yahr scale. Audiometric evaluation consisted of a comprehensive audiologic case history and questionnaire, visual otoscopic examination, acoustic immittance measures (tympanogram and acoustic reflexes), pure tone audiometry, and measurement of brain stem auditory‐evoked potentials. Healthy age‐ and sex‐matched subjects were selected as the control group. One hundred six of 118 patients were enrolled. Pure tone audiometry revealed age‐dependent high‐frequency hearing loss in patients with Parkinson's disease compared with both normative values and values for healthy age‐ and sex‐matched controls (75/106 [71%], χ2 = 5.959, P = .02; 92/106 [86.8%] vs 60/106 [56.6%], χ2 = 23.804, P < .001, respectively). Pure tone audiometry scores correlated with Hoehn and Yahr scale scores (P < .05). Brain stem auditory‐evoked potentials were normal in all patients. Our patients with Parkinson's disease showed age‐dependent peripheral, unilateral, or bilateral hearing impairment. Whether these auditory deficits are intrinsic to Parkinson's disease or secondary to a more complex impaired processing of sensorial inputs occurring over the course of illness remains to be determined. Because α‐synuclein is located predominately in the efferent neuronal system within the inner ear, it could affect susceptibility to noise‐induced hearing loss or presbycusis. It is feasible that the natural aging process combined with neurodegenerative changes intrinsic to Parkinson's disease might interfere with cochlear transduction mechanisms, thus anticipating presbycusis. © 2012 Movement Disorder Society
Keywords:Parkinson's disease  hearing impairment  pure tone audiometry
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