Timing matters: Otological symptoms and Parkinson's disease. (September 2021)

• Record Type: Journal Article
• Authors: Mahajan, Abhimanyu; Marsili, Luca; Dwivedi, Alok K.; Situ-Kcomt, Miguel; Grimberg, Maria B.; Wachter, Nathan; Abdelghany, Elhusseini; Duque, Kevin R.; Espay, Alberto J.
• Is Part Of: Parkinsonism & related disorders. Volume 90(2021)
• Page Start: 23
• Page End: 26
• Publication Date: 2021-09
• Subjects: Parkinson's disease -- Vertigo -- Hearing loss -- Meniere's disease -- Otology; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2021.07.030
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: Otological symptoms contribute to the disability of established Parkinson's disease (PD). We sought to evaluate whether prodromal onset may affect PD progression. Methods: A 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). Results: After 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). Conclusion: Prodromal otological symptoms might be associated with a reduced risk of motor progression in PD. Highlights: We evaluated the effect of otological symptoms on PD progression using a retrospective cohort-design. From 188 consecutive eligible PD patients, 91 had otological symptoms and 97 did not. There was a lower risk of progression in patients whose otological symptoms appeared before compared to after PD onset. This novel observation is of unclear biological significance and further studies are warranted.