Dizziness in patients with early stages of Parkinson's disease: Prevalence, clinical characteristics and implications

Kwon, Kyum‐Yil; Park, Suyeon; Lee, Mina; Ju, Hyunjin; Im, Kayeong; Joo, Byung‐Euk; Lee, Kyung Bok; Roh, Hakjae; Ahn, Moo-Young

doi:10.1111/ggi.13894

Cited by 5 publications

(11 citation statements)

References 32 publications

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“…Dizziness is a common complaint in Parkinson’s disease (PD) patients, and its prevalence ranges 48–68% 1 . This dizziness is mainly due to orthostatic hypotension (OH), but a high proportion of dizzy PD patients without OH are seen in the clinical setting.…”

Section: Introductionmentioning

confidence: 99%

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Dizziness in Parkinson’s disease patients is associated with vestibular function

Park

Kang

2021

Sci Rep

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Dizziness is common in Parkinson’s disease (PD) patients. It is known that orthostatic hypotension (OH) is the main cause of such dizziness, but even without OH, quite a few PD patients complain of dizziness in the clinic. It can be regarded as non-specific because most of these patients have no neurological abnormalities. We hypothesized that this type of dizziness would be associated with vestibular function, although included patients did not have clinically confirmed vestibulopathy. We studied 84 patients without OH among 121 PD patients. Their clinical features and function were compared between patients with and without dizziness. Hoehn and Yahr stage (H&Y stage), the Unified Parkinson's Disease Rating Scale (UPDRS) part III, the Korean version of the Mini-Mental State Examination (K-MMSE), education years, disease duration, total levodopa equivalent daily dose (LEDD), the presence of dizziness, the dizziness severity, and orthostatic hypotension were tested. Vestibular evoked myogenic potentials (VEMPs) were used to characterize vestibular function. Ocular (oVEMPs) and cervical (cVEMPs) were recorded. oVEMPs in the right side showed significantly reduced potentials (p = 0.016) in PD patients with dizziness, but cVEMPs did not (all ps > 0.2). Bilateral absent oVEMP responses were more common in PD patients with dizziness (p = 0.022), but the frequencies of bilateral absent cVEMP responses were not different between the dizzy and non-dizzy groups (p = 0.898). Dizziness in PD patients without orthostatic hypotension may be associated with vestibular hypofunction. Our results provide evidence that can aid clinicians when making a treatment plan for patients with dizziness. i.e., strategies to enhance reduced vestibular function may be helpful, but this suggestion remains to be evaluated.

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Section: Introductionmentioning

confidence: 99%

“…One study reported that non-specific dizziness was seen in 29.7% of patients in the early stage of PD. It is the second most common type of dizziness after orthostatic hypotension 1 . Dizziness has also been reported to be a prodromal symptom of PD.…”

Section: Introductionmentioning

confidence: 99%

Dizziness in Parkinson’s disease patients is associated with vestibular function

Park

Kang

2021

Sci Rep

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“…Dizziness could manifest as different types of vertigo, faintness, or light-headedness. Moreover, a recent study showed that dizziness in patients with early Parkinson's disease (PD) might be of various types, although orthostatic dizziness (about 40.5%) was the most common type of dizziness [4].…”

Section: Introductionmentioning

confidence: 99%

“…Between 46% and 68% of patients with PD complain of subjective dizziness [1][2][3][4]. Some have supposed that dizziness might be caused by orthostatic hypotension [5,6], whereas others have asserted that dizziness itself is not indicative of orthostatic hypotension in patients with PD [1,4]. Also, patients with preclinical or de novo PD could occasionally present with dizziness [4,7].…”

Section: Introductionmentioning

confidence: 99%

“…Some have supposed that dizziness might be caused by orthostatic hypotension [5,6], whereas others have asserted that dizziness itself is not indicative of orthostatic hypotension in patients with PD [1,4]. Also, patients with preclinical or de novo PD could occasionally present with dizziness [4,7]. potentially suggesting that dizziness is connected with the pathophysiology of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Impact of subjective dizziness on motor and non-motor symptoms in patients with early stages of Parkinson's disease

Kwon¹,

Park²,

Lee³

et al. 2022

J. Integr. Neurosci.

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Clinicians sometimes encounter patients with Parkinson's disease complaining of dizziness in real clinical settings. We sought to identify the relationship between self-perceived dizziness and motor or non-motor symptoms, especially in Parkinsonian patients in the early stages. Eight-six patients with less than five years of Parkinson's disease duration were recruited. We used the dizziness handicap inventory to access self-reported dizziness in patients with early Parkinson's disease. Parkinsonian motor symptoms such as postural instability and gait difficulty and non-motor features for global cognitive function, depressive mood, anxiety state, fatigue state, and autonomic dysfunction were measured using representative scales. Linear regression analysis demonstrated that the dizziness handicap inventory score was significantly related to postural instability and gait difficulty, anxiety, gastrointestinal, and cardiovascular domain of dysautonomia. In addition, the dizziness handicap inventory score was positively correlated with scores for postural instability and gait difficulty, anxiety, gastrointestinal, and cardiovascular dysautonomia. We found that self-reported dizziness was highly linked to postural instability and gait difficulty, anxiety, gastrointestinal and cardiovascular dysfunctions in patients with early Parkinson's disease. Further follow-up studies on the association between dizziness and the pathophysiology of Parkinson's disease are needed.

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Benefits of dance for Parkinson’s: The music, the moves, and the company

2022

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Dance classes designed for people with Parkinson’s are very popular and associated not only with increasing individuals’ motor control abilities but also their mood; not least by providing a social network and the enjoyment of the music. However, quantitative evidence of the benefits is inconsistent and often lacks in power. For a better understanding of the contradictory findings between participants’ felt experiences and existing quantitative findings in response to dance classes, we employed a mixed method approach that focussed on the effects of music. Participant experience of the dance class was explored by means of semi-structured interviews and gait changes were measured in a within-subjects design through the Timed Up and Go (TUG) test before and after class, with and without music. We chose the TUG test for its ecological validity, as it is a simple test that resembles movements done in class. We hypothesised that the music and the dance class would have a facilitating effect on the TUG performance. In line with existing research, we found that before class, the gait of 26 participants was significantly improved when accompanied by a soundtrack. However, after class, music did not have a significantly facilitating effect, yet gait without music significantly improved after class compared to before. We suggest that whilst the music acts as an external stimulator for movement before the dance class, after the dance class, participants have an internalised music or rhythm that supports their motor control. Thus, externally played music is of less relevance. The importance of music was further emphasised in the qualitative data alongside social themes. A better understanding of how music and dance affects Parkinson’s symptoms and what aspects make individuals ‘feel better’ will help in the design of future interventions.

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Dizziness in patients with early stages of Parkinson's disease: Prevalence, clinical characteristics and implications

Cited by 5 publications

References 32 publications

Dizziness in Parkinson’s disease patients is associated with vestibular function

Dizziness in Parkinson’s disease patients is associated with vestibular function

Impact of subjective dizziness on motor and non-motor symptoms in patients with early stages of Parkinson's disease

Benefits of dance for Parkinson’s: The music, the moves, and the company

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