Posturographic Evaluation of Dizziness Complaining Patients under Suspicion to Develop Parkinson's Disease
Hyun Cho
DOI: 10.4236/nm.2011.21004   PDF    HTML     5,149 Downloads   9,135 Views  


Although the typical clinical signs of Parkinson disease (PD) are tremor, rigidity, bradykinesia, and postural instability, PD is preceded by a preclinical phase during which neuronal degeneration develops without typical symptoms. More general nonspecific symptoms including dizziness have also been described to predate the typical PD signs for several years. All subjects were selected among patients in the Willis Hospital (Pusan, South of Korea), with complaints of diz-ziness from September 2009 to September 2010 and the baseline neurological screening and clinical ENT examination, to which the results were within the normal range. At baseline, 113 participants underwent neurological screening and provided information on dizziness. Of those participants, 103 were enrolled including 63 subjects in the control group. We used posturography. It allows quantitative assessment of vestibular-spinal component of body balance. The parame-ter of average speed of pressure center displacement to the lateral plan (VMX) and antero-posterior plan (VMY), which presented statistically significant differences between the groups except VMX with closed eyes. (p = 0.008 and p = 0.012, with closed eyes). With open eyes, only VMY showed significant difference between the groups (p = 0.010). In this study, the patients with dizziness and subjective complaints related to typical clinical signs of PD complaints presented higher instability in the orthostatic position than the control group of patients with dizziness and without such complaint. It could suggest that dizziness may be one symptom of preclinical PD and progress to overt postural instability. It is believed that a stepwise approach with a simple and inexpensive initial screening test of preclinical PD is required.

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H. Cho, "Posturographic Evaluation of Dizziness Complaining Patients under Suspicion to Develop Parkinson's Disease," Neuroscience and Medicine, Vol. 2 No. 1, 2011, pp. 28-33. doi: 10.4236/nm.2011.21004.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] S. T. DeKosky, K. Marek, “Looking Backward to Move Forward: Early Detection of Neurodegenerative Disorders,” Science, Vol. 302, No.5646, 2003, pp. 830-834. doi:10.1126/science.1090349
[2] E. C. Wolters, C. Francot, P. Bergmans, A. Winogrodzka, J. Booij, H. W. Berendse, H. W. Berendse, J. C. Stoof, “Preclinical (premotor) Parkinson’s Disease,” Journal of Neurology, Vol. 247, No. 2, 2000, pp. 103-109.
[3] M. M. Ponsen, D. Stoffers, J. Booij, B. L. van Eck-Smit, E. Wolters and H. W. Berendse, “Idiopathic Hyposmia as a Preclinical Sign of Parkinson’s Disease,” Annals of Neurology, Vol. 56, No. 2, 2004, pp. 173-181. doi:10.1002/ana.20160
[4] G. Glosser, C. Clark, B. Freundlich, L. Kliner-Krenzel, P. Flaherty and M. Stern, “A Controlled Investigation of Current and Premorbid Personality: Characteristics of Parkinson’s Disease Patients”, Movement Disorders, Vol. 10, No. 2, 1995, pp. 201-206.
[5] G. W. Paulson and N. Dadmehr, “Is there a Premorbid Personality Typical for Parkinson’s Disease?” Neurology, Vol. 41, No. 5, 1991, pp. 73-76.
[6] A. F. Leentjens, M. Van den Akker, J. F. Metsemakers, R. Lousberg and F. R. Verhey, “Higher Incidence of Depression Preceding the Onset of Parkinson’s Disease: A Register Study,” Movement Disorders, Vol. 18, No. 4, 2003, pp. 414-418. doi:10.1002/mds.10387
[7] E. G. Gonera, M. van Hof, H. J. Berger, C. van Weel and M. W. Horstink, “Symptoms and Duration of the Prodromal Phase in Parkinson’s Disease,” Movement Disorders, Vol. 12, No.6,1997, pp. 871-876. doi:10.1002/mds.870120607
[8] S. L. Whitney. “Treatment of Elderly Patients with Vestibular Dysfunction”. In: S.J. Herdman, 2nd ed., Vestibular Rehabilitation, S?o Paulo: Manole, 2002, pp. 505-528.
[9] P.-M. Gagey. “Non-vestibular Dizziness and Static Posturography”, Acta Oto-Rhino-Laryngologica Belgica, Vol. 45, 1991, 335-339.
[10] N. C. Zhong and J. Jin. “New Posture Equilibrometer for the Diagnosis of Vestibular Disease,” European Archives of Oto-Rhino-Laryngology, Vol. 248, No. 3, 1991, pp. 135-138. doi:10.1007/BF00178922
[11] R. M. Kantner, A. M. Rubin, C. W. Armstrong and V. Cummings, “Stabilometry in Balance Assessment of Dizzy and Normal Subjects,” American Journal of Otolaryngology, Vol. 12, No. 4, 1991, pp. 196-204. doi:10.1016/0196-0709(91)90120-5
[12] J.G. Douglas, O. Eugene, G. Sid. “Diagnostic Criteria for Parkinson Disease”, Archives of Neurology , Vol. 56, No. 1,1999, pp. 33-39. doi:10.1001/archneur.56.1.33
[13] S. Fahn and R. L. Elton, “UPDRS Development Committee. Unified Parkinson’s DiseaseRating Scale,” In: S. Fahn, C.D. Marsden and D.B. Calne, Eds., Recent Developments in Parkinson’s Disease, Vol. 2, London, England: MacMillan, 1987, pp. 153-163.
[14] B. H. Wood, J. A. Bilclough, A. Bowron and R. W. Walker, “Incidence and Prediction of Falls in Parkinson's Disease: A Prospective Multidisciplinary Study,” Journal of Neurology, Neurosurgery, and Psychiatry, Vol. 72, No. 6, 2002, pp. 721-725. doi:10.1136/jnnp.72.6.721
[15] M. E. Norré and G. Forrez, “Posture Testing (Posturography) in the Diagnosis of Peripheral Vestibular Pathology,” Archives of Otolaryngology, Vol. 243, No. 3, 1986, pp. 186-189.
[16] F. F. Ganan?a, A. S. O. Castro, F. C. Branco and J. Natour, “Interference from the Patient's Quality of Life of Patients with Chronic Peripheral Vestibular Area,” Revista Brasileira de Oto-Rino-Laringologia, Vol. 70, No.1, 2004, pp. 94-101.
[17] M. I. Geerlings, C. Jonker, L. M. Bouter, H. J. Ader and B. Schmand, “Association between Memory Complaints and Incident Alzheimer’s Disease in Elderly People with Normal Baseline Cognition,” The American Journal of Psychiatry, Vol. 156, No. 4,1999, pp. 531-537.
[18] A. F. Jorm, K. H. Masaki, D. G. Davis, J. Hardman, J. Nelson, W. R. Markesbery, H. Petrovitch, G. W. Ross and L. R. White, “Memory Complaints in Nondemented Men Predict Future Pathologic Diagnosis of Alzheimer Disease,” Neurology, Vol. 63, No.10, 2004, pp. 1960-1961.
[19] C. Jonker, M. I. Geerlings and B. Schmand, “Are Memory Complaints Predictive for Dementia? A Review of Clinical and Population-Based Studies,” International Journal of Geriatric Psychiatry, Vol. 15, No. 1, 2000, pp. 983-991. doi:10.1002/1099-1166(200011)15:11<983::AID-GPS238>3.0.CO;2-5
[20] J. C. de Groot, F. E. de Leeuw, M. Oudkerk, A. Hofman, J. Jolles and M. M. Breteler, “Cerebral White Matter Lesions and Subjective Cognitive Dysfunction: The Rotterdam Scan Study,” Neurology, Vol. 56, No.11,2001, pp. 1539-1545.
[21] S. T. DeKosky and K. Marek, “Looking Backward to Move Forward: Early Detection of Neurodegenerative Disorders,” Science, Vol. 302, No. 5646, 2003, pp. 830-834. doi:10.1126/science.1090349
[22] M. M. Ponsen, D. Stoffers, J. Booij, B. L. van Eck-Smit, E. Wolters and H. W. Berendse, “Idiopathic Hyposmia as a Preclinical Sign of Parkinson’s Disease,” Annals of Neurology, Vol. 56, No.2, 2004, pp. 173-181. doi:10.1002/ana.20160
[23] A. W. Michell, S. J. Lewis, T. Foltynie and R. A. Barker. “Biomarkers and Parkinson’s Disease,” Brain, Vol. 127, No. 8, 2004, pp. 1693-1705.
[24] M. A. Sanz, R. B. Guzman, C. C. Cerverón and J. M. Baydal, “Analysis of the Visuo-Vestibular Interaction and Visual Influence Postural Control,” Acta Otorrinolaringológica Espa?ola, Vol. 55, 2004, pp. 9-16.

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