title: Hearing impairment in Parkinson's disease: expanding the nonmotor phenotype.
abstract: The objective of this study was to evaluate hearing impairment in patients affected by Parkinson's disease compared with hearing scores observed in normal age- and sex-matched controls. One hundred eighteen consecutive patients with a clinical diagnosis of Parkinson's disease were screened. Severity of motor symptoms and staging were measured with the Unified Parkinson's Disease Rating Scale (section III) and the Hoehn and Yahr scale. Audiometric evaluation consisted of a comprehensive audiologic case history and questionnaire, visual otoscopic examination, acoustic immittance measures (tympanogram and acoustic reflexes), pure tone audiometry, and measurement of brain stem auditory-evoked potentials. Healthy age- and sex-matched subjects were selected as the control group. One hundred six of 118 patients were enrolled. Pure tone audiometry revealed age-dependent high-frequency hearing loss in patients with Parkinson's disease compared with both normative values and values for healthy age- and sex-matched controls (75/106 [71%], χ(2) = 5.959, P = .02; 92/106 [86.8%] vs 60/106 [56.6%], χ(2) = 23.804, P < .001, respectively). Pure tone audiometry scores correlated with Hoehn and Yahr scale scores (P < .05). Brain stem auditory-evoked potentials were normal in all patients. Our patients with Parkinson's disease showed age-dependent peripheral, unilateral, or bilateral hearing impairment. Whether these auditory deficits are intrinsic to Parkinson's disease or secondary to a more complex impaired processing of sensorial inputs occurring over the course of illness remains to be determined. Because α-synuclein is located predominately in the efferent neuronal system within the inner ear, it could affect susceptibility to noise-induced hearing loss or presbycusis. It is feasible that the natural aging process combined with neurodegenerative changes intrinsic to Parkinson's disease might interfere with cochlear transduction mechanisms, thus anticipating presbycusis.
authors.affiliation: University of Naples Parthenope, Naples, Italy.
authors.forename: Carmine
authors.initials: C
authors.lastname: Vitale
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Marcelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Allocca
authors.forename: Gabriella
authors.initials: G
authors.lastname: Santangelo
authors.forename: Pasquale
authors.initials: P
authors.lastname: Riccardi
authors.forename: Roberto
authors.initials: R
authors.lastname: Erro
authors.forename: Marianna
authors.initials: M
authors.lastname: Amboni
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Pellecchia
authors.forename: Autilia
authors.initials: A
authors.lastname: Cozzolino
authors.forename: Katia
authors.initials: K
authors.lastname: Longo
authors.forename: Marina
authors.initials: M
authors.lastname: Picillo
authors.forename: Marcello
authors.initials: M
authors.lastname: Moccia
authors.forename: Valeria
authors.initials: V
authors.lastname: Agosti
authors.forename: G
authors.initials: G
authors.lastname: Sorrentino
authors.forename: Michele
authors.initials: M
authors.lastname: Cavaliere
authors.forename: Elio
authors.initials: E
authors.lastname: Marciano
authors.forename: Paolo
authors.initials: P
authors.lastname: Barone
mesh_terms: D000161:Acoustic Stimulation; D000162:Acoustics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001299:Audiometry; D016022:Case-Control Studies; D004569:Electroencephalography; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D007839:Functional Laterality; D034381:Hearing Loss / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D012720:Severity of Illness Index