摘要
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.
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.
