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Static and dynamic otolith reflex function in people with Parkinson’s disease

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Abstract

Purpose

Parkinson’s disease (PD) is a neurodegenerative disorder with possible vestibular system dysfunction. This study reports the transient and sustained functions of the otoliths and their reflex pathways in PD compared to healthy controls (HC) and determines if otolith function relates to previous fall history.

Methods

Forty participants with PD and 40 HC had their otolith function assessed. Transient saccular and utricular-mediated reflexes were assessed by cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs, respectively) elicited by air-conducted stimulus (clicks) and bone-conducted vibration (light tendon hammer taps). Static otolith function was assessed by the Curator Subjective Visual Vertical (SVV) test.

Results

Compared to HC, the PD group had significantly more absent cVEMP responses to both clicks (47.5% vs. 30%, respectively, p = 0.03) and taps (21.8% vs. 5%, respectively, p = 0.002). Only the PD group had bilaterally absent tap cVEMPs, this was related to previous falls history (p < 0. 001). In both groups, click oVEMPs were predominantly absent, and tap oVEMPs were predominantly present. The PD group had smaller tap oVEMP amplitudes (p = 0.03) and recorded more abnormal SVV responses (p = 0.01) and greater error on SVV compared to HC, p < 0.001. SVV had no relationship with VEMP responses (p = 0.14).

Conclusions

PD impacts on cVEMP reflex pathways but not tap oVEMP reflex pathways. Bone-conducted otolith stimuli (taps) are more robust than air-conducted sound stimuli (clicks) for both o and cVEMPs. A lack of association between SVV and VEMP responses suggest that static and dynamic otolith functions are differentially affected in PD.

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Funding

We gratefully acknowledge grant support for HGM from the Garnett Passe and Rodney Williams Memorial Foundation and the student research support for KEH from the Faculty of Science, University of Sydney.

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Authors and Affiliations

  1. Vestibular Research Laboratory, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia

    Kim E. Hawkins & Ian S. Curthoys

  2. Sydney Human Factors Research, School of Psychology, Faculty of Science, University of Sydney, Sydney, Australia

    Elodie Chiarovano & Hamish G. MacDougall

  3. Discipline of Physiotherapy, Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, Australia

    Serene S. Paul

Authors
  1. Kim E. Hawkins
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  2. Elodie Chiarovano
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  3. Serene S. Paul
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  4. Hamish G. MacDougall
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  5. Ian S. Curthoys
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Contributions

KH: conceptualisation, original draft and writing review, investigation, data curation, methodology, and formal analysis. EC: conceptualisation, investigation, writing review and editing, and supervision. SP: conceptualisation, formal analysis, writing review and editing, and supervision. HGM: resources and editing. IC: conceptualisation, writing review and editing, and supervision.

Corresponding author

Correspondence to Kim E. Hawkins.

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The authors declare they have no relevant financial or non-financial interests to disclose.

Ethics approval

All procedures performed in this study were in accordance with the 1964 Helsinki Declaration and its later amendments. Ethical approval was provided by the University of Sydney Human Ethics board (protocol 2017/925). Participants provided written informed consent prior to study enrolment.

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Raw BCV VEMP data supplied.

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Hawkins, K.E., Chiarovano, E., Paul, S.S. et al. Static and dynamic otolith reflex function in people with Parkinson’s disease. Eur Arch Otorhinolaryngol 278, 2057–2065 (2021). https://doi.org/10.1007/s00405-020-06446-1

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  • DOI: https://doi.org/10.1007/s00405-020-06446-1

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