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Background: Sensorial non-motor symptoms (NMSs) in Parkinson's disease (PD) still lack appropriate investigation in clinical practice. This study aimed to assess if and to what extent auditory dysfunction is associated with other NMSs in PD and its impact on patient's quality of life (QoL)., Methods: We selected patients with idiopathic PD, without other concomitant neurological diseases, dementia, or diagnosis of any audiological/vestibular disease. Demographic and clinical data were collected. Patients underwent otoscopic examination, audiological testing with pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAEs) and completed Non-Motor Symptoms Scale (NMSS) and Parkinson's Disease Questionnaires-39 (PDQ-39). ANCOVA and partial correlation analysis have been used for statistical analysis., Results: 60 patients were enrolled and completed PTA and DPOAEs. 32 patients with hearing impairment (HI), assessed by PTA, (hearing threshold ≥ 25 dB) showed similar disease duration, motor impairment, and staging, compared to patients without HI, but higher scores both in NMSS and in PDQ-39, except for cardiovascular (CV), gastrointestinal (GI), urogenital (U) and sexual function (SF) of NMSS. In addition, DPOAEs showed a significant correlation with higher scores both in NMSS and PDQ-39, except for CV, SF, GI, U and perceptual problem subdomains of NMSS., Conclusion: This study demonstrated that PD patients with HI have a greater burden of NMS and lower related QoL and functioning. Our results highlight the importance to reconsider HI as a NMS, in parallel with the others. HI evaluation, even in asymptomatic patients, may reveal a wider pathology with a worse QoL., (© 2024. The Author(s).)

Purpose: Experimental works have indicated the potential of the vestibular system to affect body composition to be mediated by its extensive connections to brainstem nuclei involved in regulating metabolism and feeding behavior. The aim of this study was to evaluate-by means of bioelectrical impedance analysis (BIA)-the body composition in a group of chronic UVH normal-weighted patients when compared with an equally balanced group of healthy participants, serving as a control group (CG)., Methods: Forty-six chronic UVH and 60 CG participants underwent otoneurological (including video Head Impulse Test [vHIT] and static posturography testing [SPT]), BIA measurements and self-report (SRM) and performance measures (PM)., Results: Beyond significant (p < 0.001) changes in SPT variables (surface and length) and SRM/PM (including Dizziness Handicap Inventory, Dynamic Gait Index and Activity Balance Confidence scales), UVH participants demonstrated significant (p < 0.001) higher values of fat mass and visceral fat and lower values of muscle mass (p = 0.004), when compared to CG. Significant correlations were found in UVH participants between otoneurological and BIA measurements., Conclusion: These study findings represent the first clinical in-field attempt at depicting, with the use of BIA parameters, changes in body composition related to chronic UVH. Since such alterations in metabolic parameters could be considered both the consequences and/or the cause of vestibular-related quality of life deficit, BIA parameters could be considered as cheap, easy to use, noninvasive assessments in case of chronic UVH.

Aim: Since cervical joint position error (JPE) and visual dependency (VD) may reflect altered ascending inputs from the neck receptors, the aim of the present study was to test how these parameters may be impacted by those clinical parameters in cervicogenic dizziness (CGD) patients when compared with healthy subjects participants., Materials and Methods: 93 subjects participants fulfilling inclusion criteria for CGD and 98 age- and gender-matched healthy subjects volunteers - undergoing cervical relocation and rod and disc test to evaluate JPE and VD, respectively - were compared to each other. Cervical range of motion (CROM), Dizziness Handicap Inventory (DHI), Neck Disability Index (NDI), Neck pain intensity (NPI), Tampa Scale for Kinesiophobia (TSK-17) and Hospital Anxiety and Depression Scale (HADS) were also collected in both groups., Results: When compared to healthy participants, CGD patients were found to have a higher degree of JPE in right ( p  = 0.008, mean difference, MD: 2.88) and left ( p  = 0.006, MD: 2.55) rotation as well as in extension ( p  = 0.011, MD: 2.31), flexion ( p  = 0.009, MD: 2.35) and mean value ( p  = 0.001, MD: 2.53) and higher degrees of error in CCW at +40° and -40° ( p  = 0.012, MD: 0.85 and p  = 0.016, MD: 0.82, respectively) and CW at +40° and -40° ( p  = 0.018, MD: 0.83 and p  = 0.015 MD: 0.81, respectively). CGD patients also demonstrated a significant reduction in degrees of CROM in active flexion ( p  = 0.011, MD: -34.63), extension ( p  = 0.018, MD: -21.67), left ( p  = 0.012, MD: -28.29) and right ( p  = 0.009, MD: -28.52) rotation, and left ( p  = 0.02, MD: -7.29) and right ( p  = 0.021, MD: -5.05) lateral flexion. Furthermore, these patients demonstrated higher scores in total DHI ( p  = 0.007, MD: 25.17) (and relative DHI-P, DHI-F, DHI-E; p  = 0.009, MD: 11.4; p  = 0.014, MD: 8.73 and p  = 0.018, MD: 5.03, respectively), in TSK-17 ( p  = 0.017, MD: 17.56), and HADS, both in anxiety ( p  = 0.022, MD: 4.62) and depression ( p  = 0.02, MD: 7.31) subscale., Conclusions: A possible common physiopathological background may impact on processes involved in both the JPE and VD behaviour, entangled in a vicious circle with the impaired subjective clinical and quality of life perception.

Objective: Evaluating postural function in patients with otosclerosis by assessing otoneurological function and balance-related quality of life before and 6 weeks after surgical treatment. Correlations between and clinical features were investigated., Methods: Thirty-three patients affected by otosclerosis underwent otoneurological examination, video Head Impulse Test (vHIT), and static posturography before and after stapedotomy. Quality of life and dizziness-related handicap were screened by means of validated questionnaires. Correlation analysis was performed in order to discover possible relations with audiological pre- and postoperative parameters., Results: A significant improvement in posturographic parameters was found. Correlation analysis yielded a negative correlation between preoperative bone conduction auditory threshold and both vHIT scores and postural performance improvement, evaluated by spectral analysis. Moreover, a positive correlation was also found between improvements in posturographic scores and quality-of-life questionnaires., Conclusion: The study results demonstrated an improvement in postural function and self-reported measures in a cohort of patients with otosclerosis 6 weeks after stapedotomy. The inverse correlation with preoperative auditory levels may reflect lesser chance for balance restoration in cases with worse sensorineural function. Possible implications for daily activities and overall quality of life were suggested by improved self-report questionnaire results., Level of Evidence: 4 Laryngoscope, 130:2448-2454, 2020., (© 2019 The American Laryngological, Rhinological and Otological Society, Inc.)

Objective: Considering the altered multisensory signal compensation during senescence, the aim of the present study was to evaluate the integration rearrangements in unilateral vestibular hypofunction (UVH) during age-related cognitive decline., Study Design: Cross-sectional study., Setting: Longitudinal cohort study unit and of University tertiary referral center., Patients: Older UVH individuals ≥ 55 years with Mild Cognitive Impairment (MCI) or Alzheimer Disease (AD) and matched UVH control group with age-appropriate cognitive function., Intervention: Vestibulo-ocular reflex, postural sway examination (respectively performed by means of video head impulse test and static posturography), and dizziness-related and quality of life scores were collected in all three groups of UVH patients cognitively evaluated by means of Mini Mental State Examination and Alzheimer's Disease Assessment Scale (ADAS-cog)., Main Outcome Measures: Vestibulo-ocular reflex gain, length, surface, and spectral values of body oscillation were measured. Dizziness Handicap Inventory, Activities-specific Balance Confidence scale, and Dynamic Gait Index scores were collected., Results: A significant (p < 0.05) increase in surface and length values during both eyes closed and eyes open conditions was found when comparing scores for AD to both MCI and control group patients, respectively. These patients demonstrated significantly (p < 0.05) lower spectral values of body oscillation on posturography platform in both eyes closed and eyes open condition within the low-frequency interval than MCI and AD patients., Conclusion: This is the first study reporting an association between cognitive decline and posturography parameters with possible preventive clinical implications in evaluating the risk for falls in high-risk patients, such as older adults with common neuro-otological disorders.

• Vestibular deficits and cognitive decline share many central pathways. • Degree of cognitive decline may limit vestibular rehabilitation outcomes. • Implementation of head-mounted displays may support vestibular rehabilitation. Due to the gap in the knowledge in the field of vestibular rehabilitation the purpose of this randomized study is to highlight the outcomes of head-mounted display (HMD) implementation in older adults and patients with mild cognitive impairment (MCI), suffering from unilateral vestibular hypofunction (UVH). Vestibulo-ocular reflex (VOR) gain, postural sway examination and dizziness-related and quality of life scores were collected in 12 UVH elderly and 12 UVH subjects suffering from MCI only undergoing vestibular rehabilitation and in 11 UVH elderly and 12 UVH subjects suffering from MCI undergoing a home-based HMD + vestibular rehabilitation protocol. Although the within-subjects analysis found in all groups a significant (p < 0.05) improvement in posturography parameters and dizziness-related and quality of life scores and no changes in VOR gain, implementation of HMD demonstrated a significant (p < 0.05) increase in post-treatment between-group comparisons in the same tests and VOR gain with respect to those older adults and participants with MCI only undergoing vestibular rehabilitation. Positive correlations were discovered between Mini-Mental Score Exam values and pre-/post-treatment differences in (i) power spectra values in the low-frequency interval (r = 0.72) and in (ii) Dynamic Gait Index scores (r = 0.76). This study demonstrates that the implementation of a home-based virtual reality protocol may be a safe option in order to ameliorate VOR, postural control and the quality of life also in the vestibular impaired patients in whom the presence of cognitive decline could hinder the achievement of the goal of rehabilitation. [ABSTRACT FROM AUTHOR]

Purpose: Multiple chemical sensitivity (MCS) also known as idiopathic environmental intolerance/illness (IEI) encompasses a cohort of subjective symptoms characterized by susceptibility to a wide spectrum of environmental compounds, causing symptoms involving various organs and a decrease in quality of life. The aim of this systematic review is to summarize evidence about MCS, with focus on indexed studies analyzing sensory pathway-related disorders.Methods: Medical databases were searched for English language articles related to the topic, published between 1965 and 2017 in academic, peer-reviewed journals. Particular focus was concentrated on articles depicting disturbances involving sensory organs. References of the relevant articles were examined to identify additional significant documents.Results: Fifty-eight studies were eligible for full text review. Of these, 34 studies met the selection criteria and were included in this analysis. Many variables, such as different diagnostic criteria, lack of homogeneous symptom questionnaires and the general incidence of personality traits in control subjects, biased studies as confounding factors. However, moderate evidences show that sensory pathways are somewhat altered, especially with respect to information processing in the limbic system and related cortical areas. Recent studies suggested the presence, in MCS cohorts, of attention bias, sensitization and limbic kindling, as well as recently revealed subclinical organic alterations along sensory pathways.Conclusions: Evidences are consistent with MCS/IEI to be the result of a neural altered processing of sensorial ascending pathways, which combined with peculiar personality traits constitutes the underpinning of a multisensory condition needing multidisciplinary clinical approach. [ABSTRACT FROM AUTHOR]