Asymptomatic Hearing Impairment Frequently Occurs in Early-Onset Parkinson’s Disease

Shetty, Kuldeep; Krishnan, Syam; Thulaseedharan, Jissa Vinoda; Mohan, Manju; Kishore, Asha

doi:10.14802/jmd.18048

Cited by 20 publications

(32 citation statements)

References 35 publications

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“…The difference in audiometric thresholds between patients with Parkinson's disease and controls, by means of PTA testing, is in agreement with previous clinical results ( Vitale et al , 2012 , 2016 ; Shetty et al , 2019 , Scarpa et al , 2020 ). Our results extend previous observations by tackling a large cohort of patients.…”

Section: Discussionsupporting

confidence: 92%

“…In the field of hearing research, alterations in patients with Parkinson's disease were observed in different frequency ranges, although the association with disease features has not been fully defined ( Gawel et al , 1981 ; Fradis et al , 1988 ; Vitale et al , 2012 ; Pisani et al , 2015 ; Folmer et al , 2017 ; Shetty et al , 2019 ). Recent studies have also demonstrated impairment in central auditory processing ( Folmer et al , 2017 ) and reduction of distortion-product otoacoustic emission (DPOAE) levels ( Pisani et al , 2015 ), which reflect cochlear outer hair cell function.…”

Section: Introductionmentioning

confidence: 99%

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Lateralization of cochlear dysfunction as a specific biomarker of Parkinson’s disease

Sisto

Viziano

Stefani

et al. 2020

Brain Communications

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In the last decade, animal studies highlighted the sensitivity of hearing function to lack of specific cochlear dopamine receptors, while several studies on humans reported association between hearing loss and Parkinson’s disease, partially recovered after levodopa administration in de novo patients. Taken together, these observations suggest investigating the possible use of cochlear function outcome variables, particularly, otoacoustic emissions, as sensitive biomarkers of Parkinson’s disease. Any lateralization of hearing dysfunction correlated with Parkinson’s disease lateralization would 1) further confirm their association, and 2) provide a disease-specific differential outcome variable. Differential indicators are particularly useful for diagnostic purposes, because their effectiveness is not limited by physiological inter-subject fluctuations of the outcome variable. Recent advances in the acquisition and analysis techniques of otoacoustic emissions suggest using them for evaluating differential cochlear damage in the two ears. In this study, we quantitatively evaluated hearing function in a population of subjects with Parkinson’s disease, to investigate the occurrence of hearing loss, and, particularly, whether hearing dysfunction shows lateralization correlated to motor symptoms. Pure tone audiometry and distortion product otoacoustic emissions were used as outcome variables in eighty patients (mean age 65 ± 9 years) and forty-one controls (mean age 64 ± 10 years). An advanced customized acquisition and analysis system was developed and used for otoacoustic testing, which guarantees response stability independent of probe insertion depth, and has the sensitivity necessary to accurately assess the low levels of otoacoustic response typical of elderly subjects. To our knowledge, this is the first study introducing the distinction between ipsilateral and contralateral ear, with respect to the body side more affected by Parkinson’s disease motor symptoms. Significant asymmetry was found in the auditory function, as both otoacoustic responses and audiometric hearing levels were worse in the ipsilateral ear. Significantly worse hearing function was also observed in patients with Parkinson’s disease compared to controls, confirming previous studies. Several pathophysiological mechanisms may be hypothesized to explain asymmetric cochlear damage in Parkinson's disease, including the impairment of dopamine release and the involvement of extra-dopaminergic circuits, with the cholinergic pathway as a likely candidate. The observed asymmetry in the audiological response of patients with Parkinson’s disease suggests that lateralization of hearing dysfunction could represent a specific non-motor signature of the disease. The possible diagnostic use of cochlear dysfunction asymmetry as a specific biomarker of Parkinson’s disease deserves further investigation, needing a more precise quantitative assessment, which would require a larger sample size.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Lateralization of cochlear dysfunction as a specific biomarker of Parkinson’s disease

Sisto

Viziano

Stefani

et al. 2020

Brain Communications

View full text Add to dashboard Cite

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“…These studies did not find significant differences between patients with PD and HCs regarding pure-tone hearing thresholds. On the other hand, higher pure-tone hearing thresholds in patients with PD have been reported by other research groups in the middle to high frequency range (1.5-8 kHz) (21)(22)(23)(24)(25)(26)(27)(28). The differences between study results may be influenced by the approach chosen to analyze the data (e.g., categorical vs. continuous data-analysis, consideration of confounding variables, correction for multiple comparisons).…”

Section: Audiological Measurements Peripheral Auditory Testsmentioning

confidence: 90%

“…Each wave, labeled using Roman numerals, reflects the synchronous firing of different auditory cell populations. As such, waves I and II are derived from the distal and proximal regions of the (25,27,79,80). On the other hand, multiple other studies have reported prolonged latencies for the centrally generated waves III to V in patients with PD compared to age-matched HCs (21,24,28,(81)(82)(83)(84).…”

Section: Electrophysiological Measurements Short Latency Auditory Evomentioning

confidence: 98%

“…As increasing evidence suggests that PD initially affects the brainstem and follows a predominant upwards course ( 75 ), considerable attention has been devoted to measures of brainstem functioning in PD, such as the ABR. On the one hand, various studies have reported normal latency measures in patients with PD compared HCs ( 25 , 27 , 79 , 80 ). On the other hand, multiple other studies have reported prolonged latencies for the centrally generated waves III to V in patients with PD compared to age-matched HCs ( 21 , 24 , 28 , 81 – 84 ).…”

Section: Electrophysiological Measurementsmentioning

confidence: 99%

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Future Perspectives on the Relevance of Auditory Markers in Prodromal Parkinson's Disease

et al. 2020

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Research on auditory processing in Parkinson's disease (PD) has recently made substantial progress. At present, evidence has been found for altered auditory processing in the clinical stage of PD. The auditory alterations in PD have been demonstrated with low-cost and non-invasive assessments that are already used in routine clinical practice. Since auditory alterations have been reported early in disease progression, it would be highly relevant to investigate whether auditory markers could be provided in the prodromal stage of PD. In addition, auditory alterations in early stage PD might be modulated by dopaminergic medication. Therefore, the aim of this review is (1) to summarize the literature on auditory processing in PD with a specific focus on the early disease stages, (2) to give future perspectives on which audiological and electrophysiological measurements could be useful in the prodromal stage of PD and (3) to assess the effect of dopaminergic medication on potential auditory markers in the prodromal stage of PD.

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Identifying Parkinson Risk Markers in Primary Care—Old Associations and New Insights

2022

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Timely identification of individuals at risk for neurodegenerative diseases such as Parkinson disease (PD) is increasingly important as more neuroprotective agents are investigated. Improving early diagnosis may facilitate access to clinical trials now and prepare for the future availability of diseasemodifying treatments. Early diagnoses may also facilitate pharmacologic and nonpharmacologic therapies with the potential to improve quality of life. 1 In addition, an early diagnosis is important for families and caregivers to understand the symptoms their loved ones may be experiencing and prepare for the future. 2 The primary care setting is commonly where symptoms heralding the onset of PD are first discussed. However, little is known regarding the prediagnostic manifestations of PD that are seen in primary care clinics, particularly in underserved populations. In this issue of JAMA Neurology, Simonet and colleagues 3 present data about comorbidities and subjective concerns voiced at primary care clinics up to 10 years before the diagnoses of PD by individuals representing a diverse population in East London, UK, with socioeconomic deprivation. Investigators extracted clinical information from electronic health care records from East London primary care offices from 1990 to 2018 and compared concerns between individuals who subsequently developed PD and those who did not, looking back 2 years, 2 to 5 years, and 5 to 10 years before the date of the PD diagnosis. As may be expected, the study identified prediagnostic concerns including constipation, erectile dysfunction, depression, anxiety, fatigue, insomnia, dizziness, cognitive impairment, shoulder pain, and tremor in the PD group. In addition, epilepsy was associated with subsequent PD across all assessed time frames and hearing loss was associated with subsequent PD when identified less than 2 years or 2 to 5 years prior to PD diagnosis.Simonet and colleagues 3 specifically aimed to investigate numerous risk factors associated with subsequent PD diagnoses in East London. The term risk factor typically indicates something that increases the chance of developing a disease. Simonet and colleagues 3 describe what the PD prodromal criteria identify as risk markers-disease indicators that can be symptoms, signs, or biomarkers. 4 The current study identifies many of the risk markers and prodromal markers included in the research criteria for prodromal PD 4,5 : never smoking, type 2 diabetes, parkinsonism, constipation, hypotension/ dizziness, erectile dysfunction, depression, anxiety, and global cognitive deficits. Some study findings are suggestive of overt but undiagnosed PD, such as shoulder pain (potentially associated with decreased arm swing), tremor, rigidity, and imbal-

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Asymptomatic Hearing Impairment Frequently Occurs in Early-Onset Parkinson’s Disease

Cited by 20 publications

References 35 publications

Lateralization of cochlear dysfunction as a specific biomarker of Parkinson’s disease

Lateralization of cochlear dysfunction as a specific biomarker of Parkinson’s disease

Future Perspectives on the Relevance of Auditory Markers in Prodromal Parkinson's Disease

Identifying Parkinson Risk Markers in Primary Care—Old Associations and New Insights

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