Timing matters: Otological symptoms and Parkinson's disease |
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| Affiliation: | 1. Institute of Neurogenomics, Helmholtz Zentrum München, Munich, Germany;2. Department of Neurology, P.J. Safarik University, Kosice, Slovak Republic;3. Department of Neurology, University Hospital of L. Pasteur, Kosice, Slovak Republic;4. Department of Neurology, Zvolen Hospital, Slovakia;5. Department of Neurology, Medical University Innsbruck, Innsbruck, Austria;6. Second Department of Neurology, Faculty of Medicine, Comenius University, University Hospital Bratislava, Bratislava, Slovakia;7. Technical University of Munich, Munich, Germany; School of Medicine, Institute of Human Genetics;8. Department of Neurology, Charles University, 1st Faculty of Medicine and General University Hospital in Prague, Prague, Czech Republic;9. Department of Neuropediatrics and Muscle Disorders, University Medical Center, Faculty of Medicine, University of Freiburg, Germany;10. Ludwig Maximilian University of Munich, Munich, Germany;11. Hospital for Neuropediatrics and Neurological Rehabilitation, Centre of Epilepsy for Children and Adolescents, Schoen Klinik Vogtareuth, Vogtareuth, Germany;12. MGZ - Medical Genetics Center Munich, Munich, Germany;13. Department of Pediatrics, Technical University of Munich School of Medicine, Munich, Germany;14. Inborn Errors of Metabolism, Pediatric Intensive Care Unit, University Hospital of Nantes, Nantes, France;15. Lehrstuhl für Neurogenetik, Technische Universität München, Munich, Germany;p. Munich Cluster for Systems Neurology, SyNergy, Munich, Germany |
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| Abstract: | IntroductionOtological symptoms contribute to the disability of established Parkinson's disease (PD). We sought to evaluate whether prodromal onset may affect PD progression.MethodsA retrospective cohort design was used to compare time to advanced disease, defined as a Hoehn & Yahr stage ≥3 in consecutive PD patients with history of auditory and/or vestibular symptoms appearing before versus after PD onset. Time from PD onset to H&Y ≥ 3 was determined using Cox proportional hazards, with adjusted results summarized as hazards ratio (HR).ResultsAfter adjusting for age at PD onset, there was a lower risk of progression to advanced disease in patients with prodromal otological symptoms compared to those with otological symptoms after PD onset (HR = 0.34; 95%CI: 0.15–0.75, p = 0.008). This association remained significant after adjusting for age at PD onset and MDS-UPDRS III (HR = 0.25; 95% CI: 0.10–0.63, p = 0.003) and propensity score-adjusted analysis (HR = 0.46; 95% CI: 0.24–0.91, p = 0.025).ConclusionProdromal otological symptoms might be associated with a reduced risk of motor progression in PD. |
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| Keywords: | Parkinson's disease Vertigo Hearing loss Meniere's disease Otology |
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