Vestibular  dysfunction in patients with idiopathic 
parkinson's disease.

J Korean Neurol Assoc > Volume 16(2); 1998 > Article

Journal of the Korean Neurological Association 1998;16(2): 172-179.

파킨슨씨질환에서의 전정기능 이상

이 형, 김태완, 김지언, 임정근, 이상도, 박영춘, 이성룡*

계명의대 의과대학 신경과학교실 약리학교실*

Vestibular dysfunction in patients with idiopathic parkinson's disease.

Hyung Lee, M.D., Tae Wan Kim, M.D., Ji Eun Kim, M.D., Jeong Geun Lim, M.D., Sang Doe Yi, M.D., Young Choon Park, M.D., Seong Ryong Lee, M.D.

Department of Neurology, department of pharmacology* Keimyung University, school of Medicine.

Abstract

Background & Objectives : Qualitative oculomotor abnormalities have been reported in parkinsonian patients for many years, but conflicting results have been obtained. This study was performed to evaluate the correlation between the severity of the disease and the abnormalities of the ocular movements in idiopathic parkinson's disease. Methods : We gave the vestibular function tests in patients with idiopathic parkinson's disease and normal controls. Eye movement recordings were made with automated electronystagmography and rotation test was performed. A total of 46 patients (mean age : 61.2±6.7) and 24 controls (mean age : 60.5±4.3) were studied. The severity of the disease was divided into two groups by modified Hoehn & Yahr staging ; H-Y stage 1 and 2 as a mild group and stage 3 and 4 as a severe group. Results : Saccadic latency and accuracy, pursuitic gain and velocity, vestibulo-ocular reflex (VOR) suppression by vision were significantly altered in patients, whereas mean velocity of optokinetic nystagmus (OKN) and VOR gain in darkness were normal. Alteration of saccadic latency and accuracy, pursuitic gain and velocity, VOR suppression by vision were profound in the severe group compared with a mild group and controls, but the above parameters did not differ between a mild group and controls. In a hemiparkinson's group, saccadic latency and accuracy, pursuitic gain, OKN mean velocity and gain was not different between the both sides. Conclusion : The results indicate that severe Parkinson's disease damages nigrostriatal or other specific pathways which were involved in the regulation of the saccadic, pursuitic and pursuitic-mediated visual fixation system. In a hemiparkinson's group asymmetric damage of dopaminergic innervation which was involved in the regulation of ocular movements was not found. Key words : vestibular function tests, Parkinson's disease, oculomotor abnormalities.