Parkinson’s disease: disturbed vestibular function and levodopa

• Published in: Journal of the neurological sciences Vol. 353; no. 1-2; pp. 49 - 58
• Main Authors: Lithgow, Brian J., Shoushtarian, Mehrnaz
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 15.06.2015
• Subjects: Aged; Biomarker; Case-Control Studies; Electrodiagnosis - instrumentation; Electrodiagnosis - methods; Electrovestibulography; Female; Humans; Levodopa; Levodopa - therapeutic use; Male; Mental Status Schedule; Middle Aged; Neurology; Parkinson Disease - drug therapy; Parkinson Disease - physiopathology; Parkinson’s disease; Postural Balance - drug effects; Postural control; Symptomatology; Vestibule, Labyrinth - drug effects; Vestibule, Labyrinth - physiopathology; Symptomatology; Biomarker; Levodopa; Postural control; Electrovestibulography; Parkinson’s disease
• ISSN: 0022-510X; 1878-5883; 1878-5883
• DOI: 10.1016/j.jns.2015.03.050

Evidence indicates Levodopa effects central postural control. As electrophysiological postural control biomarkers, sensory oto-acoustic features were extracted from Electrovestibulography (EVestG) data to identify 20 healthy age and gender matched individuals as Controls from 20 PD subjects before (PDlowmed) and 18 after (PDmed) morning doses of Levodopa. EVestG data was collected using a single tilt stimulus applied in the pitch plane. The extracted features were based on the measured firing pattern, interval histogram and the shape of the average field potential response. An unbiased cross validated classification accuracy of 88%, 88% and 79% was achieved using combinations of 2 features for separating PDlowmed from control, control from PD (combined PDlowmed and PDmed), and PDlowmed from PDmed groups respectively. One feature showed significant correlations (p<0.05) with the Modified Hoehn and Yahr PD staging scale. The results indicate disturbed vestibular function is observed in both the PDmed and PDlowmed conditions, and these are separable. The implication is that Levodopa may also affect peripheral as well as central postural control. •Electrovestibulography recordings can detect changes in vestibular response.•The vestibular response is different for Control versus PD patients on Levodopa.•The vestibular response is different for PD patients after Levodopa medication.•Evidence indicates Levodopa effects central and peripheral postural control.