神经损伤与功能重建2026，Vol.21Issue(6)：328-333,6.DOI:10.16780/j.cnki.sjssgncj.20260770
帕金森病患者多维度前庭功能异常的分期特征及其与平衡功能的关系
Staging Characteristics of Multidimensional Vestibular Dysfunction and Its Relationship with Balance Function in Patients with Parkinson's Disease
摘要
Abstract
Objective:To analyze the distribution patterns of multidimensional vestibular dysfunction across different Hoehn-Yahr(H-Y)stages in patients with Parkinson's disease(PD),and to explore its associations with motor symptoms,balance function,and peripheral inflammatory cytokines.Methods:A total of 78 patients with idiopathic PD admitted to the Department of Neurology,the First Hospital of Hebei Medical University,from June 2022 to June 2024 were retrospectively enrolled.According to the H-Y stage,the patients were divided into an early-stage group(H-Y stages 1.0-2.5,n=45)and a middle-to-advanced-stage group(H-Y stages 3.0-4.0,n=33).General clinical data,disease duration,levodopa equivalent daily dose(LED),Unified Parkinson's Disease Rating Scale part Ⅲ(UPDRS-Ⅲ)score,Tinetti gait score,Activities-specific Balance Confidence Scale(ABC)score,and Berg Balance Scale score were collected.Vestibular function tests included caloric testing,smooth pursuit,saccade testing,optokinetic nystagmus,gaze-evoked nystagmus,cervical vestibular-evoked myogenic potential(cVEMP),and ocular vestibular-evoked myogenic potential(oVEMP).Peripheral blood inflammatory cytokines were also measured.Results:In the 78 patients with PD,cVEMP abnormalities were observed in 40 patients(51.3％),oVEMP abnormalities in 40 patients(51.3％),and any VEMP abnormality in 53 patients(67.9％).Compared with the early-stage group,the middle-to-advanced-stage group had a longer disease duration,higher LED and UPDRS-Ⅲ scores,and lower Tinetti gait,ABC,and Berg Balance Scale scores(all P＜0.05).The rates of cVEMP,oVEMP,and optokinetic nystagmus abnormalities were higher in the middle-to-advanced-stage group than in the early-stage group(all P＜0.05).Spearman correlation analysis showed that H-Y stage was positively correlated with disease duration,LED,UPDRS-Ⅲ score,cVEMP abnormality,oVEMP abnormality,any VEMP abnormality,and optokinetic nystagmus abnormality,and negatively correlated with Tinetti gait,ABC,and Berg Balance Scale scores.Patients with cVEMP abnormalities had lower ABC scores and higher interleukin-5(IL-5)levels,whereas patients with oVEMP abnormalities had more advanced H-Y stages and higher IL-5 levels.Conclusion:The abnormalities of cVEMP,oVEMP,and optokinetic nystagmus in PD patients may exhibit features correlated with Hoehn-Yahr(H-Y)staging,suggesting that dysfunction in the otolith-brainstem reflex pathway and visual-vestibular oculomotor integration is more pronounced in patients at higher disease stages.cVEMP abnormalities may be associated with reduced balance confidence,whereas oVEMP abnormalities are more likely to reflect the involvement of the vestibulo-ocular pathway associated with greater disease severity.The association between IL-5 and VEMP abnormalities remains an exploratory finding and requires further validation.关键词
帕金森病/前庭功能/前庭诱发肌源性电位/视动眼震/Hoehn-Yahr分期/平衡障碍Key words
Parkinson's disease/vestibular function/vestibular-evoked myogenic potential/optokinetic nystagmus/Hoehn-Yahr stage/balance impairment分类
医药卫生引用本文复制引用
米阳倩,王阳,郭红蕾,郝永慈,刘少娜,焉双梅,李冬,顾平,张赛..帕金森病患者多维度前庭功能异常的分期特征及其与平衡功能的关系[J].神经损伤与功能重建,2026,21(6):328-333,6.基金项目
河北省重点研发计划项目(多维度前庭技术在帕金森病姿势平衡障碍评估中的作用,No.22377750D) （多维度前庭技术在帕金森病姿势平衡障碍评估中的作用,No.22377750D）
