Abstract

Clinicians sometimes encounter patients with Parkinson's disease complaining of dizziness in real clinical settings. We sought to identify the relationship between self-perceived dizziness and motor or non-motor symptoms, especially in Parkinsonian patients in the early stages. Eight-six patients with less than five years of Parkinson's disease duration were recruited. We used the dizziness handicap inventory to access self-reported dizziness in patients with early Parkinson's disease. Parkinsonian motor symptoms such as postural instability and gait difficulty and non-motor features for global cognitive function, depressive mood, anxiety state, fatigue state, and autonomic dysfunction were measured using representative scales. Linear regression analysis demonstrated that the dizziness handicap inventory score was significantly related to postural instability and gait difficulty, anxiety, gastrointestinal, and cardiovascular domain of dysautonomia. In addition, the dizziness handicap inventory score was positively correlated with scores for postural instability and gait difficulty, anxiety, gastrointestinal, and cardiovascular dysautonomia. We found that self-reported dizziness was highly linked to postural instability and gait difficulty, anxiety, gastrointestinal and cardiovascular dysfunctions in patients with early Parkinson's disease. Further follow-up studies on the association between dizziness and the pathophysiology of Parkinson's disease are needed.

Highlights

  • Dizziness could manifest as different types of vertigo, faintness, or light-headedness

  • For the evaluation of various non-motor symptoms (NMSs), we have evaluated the Korean version of the Montreal Cognitive Assessment (MoCA-K) for global cognitive status [15], the Korean version of the Beck Depression Inventory (BDI) for depression [16], the Korean version of the Beck Anxiety Inventory (BAI) for anxiety state [17], the Parkinson’s Disease Fatigue Scale (PFS) for fatigue symptom [18, 19], and the Korean version of the Scale for Outcomes in Parkinson’s Disease-Autonomic (SCOPA-AUT) for autonomic dysfunction [20]

  • We found that a complaint of dizziness in patients with early Parkinson’s disease (PD) was significantly associated with some factors of motor and non-motor symptoms

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Summary

Introduction

Dizziness could manifest as different types of vertigo, faintness, or light-headedness. A recent study showed that dizziness in patients with early Parkinson’s disease (PD) might be of various types, orthostatic dizziness (about 40.5%) was the most common type of dizziness [1]. Between 46% and 68% of patients with PD complain of subjective dizziness [1–4]. Some have supposed that dizziness might be caused by orthostatic hypotension [5, 6], whereas others have asserted that dizziness itself is not indicative of orthostatic hypotension in patients with PD [1, 4]. Patients with preclinical or de novo PD could occasionally present with dizziness [4, 7]. Potentially suggesting that dizziness is connected with the pathophysiology of the disease. The clinical implications of patients with PD complaining about dizziness have remained little known until now

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