Skip to main content
SpringerLink
Log in

Vestibular Dysfunction

  • Chapter
  • First Online:
Parkinson’s Disease and Nonmotor Dysfunction

Part of the book series: Current Clinical Neurology ((CCNEU))

  • 2622 Accesses

Abstract

Vestibular dysfunction unquestionably occurs in a significant percentage of individuals with Parkinson’s disease (PD). Potentially, vestibular-derived instability may develop as part of the disease process, per se, but more likely it is the consequence of decline in vestibular function due to aging, comorbid disorders, and/or the act of falling. Failure to identify dysfunction in this critical sensory system may contribute to further morbidity from falling, produce misleading findings on clinical examination, and potentially lead to mis-scoring on standardized tests of parkinsonian function, such as the Unified Parkinson’s Disease Rating Scale (UPDRS).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Diener HC, Dichgans J. On the role of vestibular, visual, and somatosensory information for dynamic postural control in humans. Prog Brain Res. 1988;76:253–62.

    Article  PubMed  CAS  Google Scholar 

  2. Tascioglu AB. Brief review of vestibular system anatomy and its higher order projections. Neuroanatomy. 2005;4:24–7.

    Google Scholar 

  3. Liedgren SR, Schwarz DW. Vestibular evoked potentials in thalamus and basal ganglia of the squirrel monkey (Saimiri sciureus). Acta Otolaryngol. 1976;81:73–82.

    Article  PubMed  CAS  Google Scholar 

  4. Shiroyama T, Kayahara T, Yasui Y, Nomura J, Nakano K. Projections of the vestibular nuclei to the thalamus in the rat: a Phaseolus vulgaris leucoagglutinin study. J Comp Neurol. 1999;407:318–32.

    Article  PubMed  CAS  Google Scholar 

  5. Bottini G, Sterzi R, Paulesu E, Vallar G, Cappa SF, Erminio F, et al. Identification of the central vestibular projections in man: a positron-emission tomography activation study. Exp Brain Res. 1994;99:164–9.

    Article  PubMed  CAS  Google Scholar 

  6. Brandt T, Dieterich M, Danek A. Vestibular cortex lesions affect the perception of verticality. Ann Neurol. 1994;35:403–12.

    Article  PubMed  CAS  Google Scholar 

  7. Mesulam MM. A cortical network for directed attention in unilateral neglect. Ann Neurol. 1981;10:309–25.

    Article  PubMed  CAS  Google Scholar 

  8. Heilman KM, Bowers D, Valenstein E, Watson RT. Hemispace and hemispatial neglect. In: Jeannerod M, editor. Neurophysiology and neuropsychologic aspects of spatial neglect. Amsterdam: Elsevier; 1987. p. 116–50.

    Google Scholar 

  9. Grüsser OJ, Pause M, Schreiter U. Vestibular neurons in the parieto-insular cortex of monkeys (Macaca fascicularis): visual and neck receptor responses. J Physiol. 1990;430:559–83.

    PubMed  Google Scholar 

  10. Brandt T, Dieterich M. The vestibular cortex: its locations, functions, and disorders. Ann NY Acad Sci. 1999;871:293–312.

    Article  PubMed  CAS  Google Scholar 

  11. Bottini G, Karnath HO, Vallar G, Sterzi R, Frith CD, Frackowiak RS, et al. Cerebral representations for egocentric space: functional-anatomical evidence from caloric vestibular stimulation and neck vibration. Brain. 2001;124:1182–96.

    Article  PubMed  CAS  Google Scholar 

  12. Bucher SF, Dieterich M, Wiesmann M, Weiss A, Zink R, Yousry TA, et al. Cerebral functional magnetic resonance imaging of vestibular, auditory, and nociceptive areas during galvanic stimulation. Ann Neurol. 1998;44:120–5.

    Article  PubMed  CAS  Google Scholar 

  13. Horak FB, Nutt JG, Nashner LM. Postural inflexibility in parkinsonian subjects. J Neurol Sci. 1992;111:46–58.

    Article  PubMed  CAS  Google Scholar 

  14. Pastor MA, Day BL, Marsden CD. Vestibular induced postural responses in Parkinson’s disease. Brain. 1993;116:1191–9.

    Article  Google Scholar 

  15. Nallegowda M, Singh U, Handa G, Khanna M, Wadhwa S, Yadav SL, et al. Role of sensory input and muscle strength in maintenance of balance, gait, and posture in Parkinson’s disease. Am J Phys Med Rehabil. 2004;83:898–908.

    Article  PubMed  Google Scholar 

  16. Rossi M, Soto A, Santos S, Sesar A, Labella T. A prospective study of alterations in balance among patients with Parkinson’s disease. Protocol of postural evaluation. Eur Neurol. 2009;61:171–6.

    Article  PubMed  CAS  Google Scholar 

  17. Alzamil ZM. Sensory interaction testing using platform posturography in Parkinson’s patients. Med Sci Res. 1996;24(4):287–8.

    Google Scholar 

  18. Westerberg BD, Roberson JB, Stach BA, Silverberg GD, Heit G. The effects of posteroventral pallidotomy on balance function in patients with Parkinson’s disease. Stereotact Funct Neurosurg. 2002;79:75–87.

    Article  PubMed  CAS  Google Scholar 

  19. Jagielski J, Kubiczek-Jagielski M, Sobstyl M, Blaszczyk J, Zabek M, Zaleski M. Posturography as objective evaluation of the balance system in Parkinson’s disease patients after neurosurgical treatment. Neurol Neurochir Pol. 2006;40:127–33.

    PubMed  Google Scholar 

  20. Crucian GP, Barrett AM, Schwartz RL, Bowers D, Triggs WJ, Friedman W, et al. Cognitive and vestibulo-proprioceptive components of spatial ability in Parkinson’s disease. Neuropsychologia. 2000;38: 757–67.

    Article  PubMed  CAS  Google Scholar 

  21. Bronstein AM, Yardley L, Moore AP, Cleevers L. Visually and posturally mediated tilt illusion in Parkinson’s disease and in labyrinthine defective subjects. Neurology. 1996;47:651–6.

    Article  PubMed  CAS  Google Scholar 

  22. Proctor F, Riklan M, Cooper IS, Teuber HL. Judgment of visual and postural vertical by Parkinsonian patients. Neurology. 1964;14:287–93.

    Article  PubMed  CAS  Google Scholar 

  23. Bassetto JM, Zeigelboim BS, Jurkiewicz AL, Klagenberg KF. Neurotological findings in patients with Parkinson’s disease. Rev Bras Otorrinolaringol. 2008;74:350–5.

    Article  Google Scholar 

  24. Reichert WH, Doolittle J, McDowell FH. Vestibular dysfunction in Parkinson disease. Neurology. 1982;32:1133–8.

    Article  PubMed  CAS  Google Scholar 

  25. Rascol O, Clanet M, Montastruc JL, Simonetta M, Soulier-Esteve MJ, Doyon B, et al. Abnormal ocular movements in Parkinson’s disease. Evidence for involvement of dopaminergic systems. Brain. 1989;112:1193–214.

    Article  PubMed  Google Scholar 

  26. Shimizu N, Naito M, Yoshida M. Eye-head co-ordination in patients with Parkinsonism and cerebellar ataxia. J Neurol. 1981;44:422–8.

    Google Scholar 

  27. Teravainen H, Calne DB. Studies of parkinsonian movement. II. Initiation of fast voluntary eye movements. Acta Neurolog Scand. 1980;62:149–57.

    Article  CAS  Google Scholar 

  28. White OB, Saint-Cyr JA. Ocular motor deficits in Parkinson’s disease. I. The horizontal vestibulo-ocular reflex and its regulation. Brain. 1983;106:555–70.

    Article  PubMed  Google Scholar 

  29. Sherrif C, Campbell-Novaro S, Specht J, Maitland CG. Examination of patients with Parkinsonism utilizing low contrast sensitivity and optical coherence tomography. North American Neuro-Ophthalmology Society, Tuscon, AZ, 8–12 March 2010.

    Google Scholar 

  30. Drachman DA, Hart CW. An approach to the dizzy patient. Neurology. 1972;22:323–34.

    Article  PubMed  CAS  Google Scholar 

  31. Polensek SH, Tusa RJ, Sterk CE. The challenges of managing vestibular disorders: a qualitative study of clinicians’ experiences associated with low referral rates for vestibular rehabilitation. Int J Clin Pract. 2009;63:1604–12.

    Article  PubMed  CAS  Google Scholar 

  32. Tusa RJ. Benign paroxysmal positional vertigo. Curr Neurol Neurosci Rep. 2001;1:478–85.

    Article  PubMed  CAS  Google Scholar 

  33. Halmalgyi GM, Curthoys IS. A clinical sign of canal paresis. Arch Neurol. 1988;45:737–9.

    Article  Google Scholar 

  34. Fife TD, Tusa RJ, Furman JM, Zee DS, Frohman E, Baloh RW, et al. Assessment: Vestibular testing techniques in adults and children. Report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology. 2000;55:1431–41.

    Article  PubMed  CAS  Google Scholar 

  35. Tusa RJ. Beside assessment of the dizzy patient. Neurol Clin. 2005;23:655–73.

    Article  PubMed  Google Scholar 

  36. Maitland CG, Skidd P, Booker T, Holomb K. Examination of vestibulospinal function identifies the canal affected in benign paroxysmal positional vertigo. Orlando, FL: North America Neuro-ophthalmology Society; 2008.

    Google Scholar 

  37. Istl YE, Hyden D, Schwarz DW. Quantification and localization of the vestibular loss on unilateral labyrinthectomized patients using a precise rotatory test. Acta Otolaryngol. 1983;96:437–45.

    Article  PubMed  CAS  Google Scholar 

  38. Bent LR, McFadyen BJ, Merkley VF, Kennedy PM, Inglis JT. Magnitude effects of galvanic vestibular stimulation on the trajectory of human gain. Neurosci Lett. 2000;279:157–60.

    Article  PubMed  CAS  Google Scholar 

  39. Colebatch JG, Halmagyi GM, Skuse NF. Myogenic potentials generated by a click-evoked vestibulocollic reflex. J Neurol Neurosurg Psychiatry. 1994;57: 190–7.

    Article  PubMed  CAS  Google Scholar 

  40. Sloane PD, Coeytaux RR, Beck RS, Dallara J. Dizziness: state of the science. Ann Intern Med. 2001;134:823–32.

    PubMed  CAS  Google Scholar 

  41. Kroenke K, Hoffman RM, Einstadter D. How common are various causes of dizziness? A critical review. South Med J. 2000;93:160–7.

    PubMed  CAS  Google Scholar 

  42. Maarsingh OR, Dros J, Schellevis FG, van Weert HC, Dindels PJ, Horst HE. Dizziness reported by elderly patients in family practice: prevalence, incidence, and clinical characteristics. BMC Fam Pract. 2010;11:1–9.

    Article  Google Scholar 

  43. Nedzelski JM, Barber HO, Mellmoyl L. Diagnosis in a dizziness unit. J Otolaryngol. 1986;15:101–4.

    PubMed  CAS  Google Scholar 

  44. Lawson J, Fitzgerald J, Birchall J, Aldren CP, Kenny RA. Diagnosis of geriatric patients with severe dizziness. J Am Geriatr Soc. 1999;47:12–7.

    PubMed  CAS  Google Scholar 

  45. Colledge NR, Barr-Hamilton RM, Lewis SJ, Sellar RJ, Wilson JA. Evaluation of investigations to diagnose the cause of dizziness in elderly people: a community based controlled study. BMJ. 1996;313: 788–92.

    Article  PubMed  CAS  Google Scholar 

  46. Brown KE, Whitney SL, Wrisley DM, Furman JM. Physical therapy outcomes for patients with bilateral vestibular loss. Laryngoscope. 2001;111:1812–7.

    Article  PubMed  CAS  Google Scholar 

  47. Samelson EJ, Zhang Y, Kiel DP, Hannan MT, Felson DT. Effect of birth cohort on risk of hip fracture; age-specific incident rates in the Framingham Study. Am J Public Health. 2002;92:858–62.

    Article  PubMed  Google Scholar 

  48. Vellas BJ, Wayne SJ, Garry BJ, Baumgartner RN. A two-year longitudinal study of falls in 482 community-dwelling elderly adults. J Gerontol A Biol Sci Med Sci. 1998;53:M264–74.

    Article  PubMed  CAS  Google Scholar 

  49. Murray KJ, Hill K, Phillips B, Waterston J. A pilot study of falls risk and vestibular dysfunction in older fallers presenting to hospital emergency departments. Disabil Rehabil. 2005;27:499–506.

    Article  PubMed  Google Scholar 

  50. Lord SR, Ward JA, Williams P, Anstey KJ. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42:1110–7.

    PubMed  CAS  Google Scholar 

  51. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson’s disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatry. 2002;72:721–5.

    Article  PubMed  CAS  Google Scholar 

  52. Bloem BR, Grimbergen YA, Cramer M, Willemsen M, Zinderman AH. Prospective assessment of falls in Parkinson’s disease. J Neurol. 2001;248:950–8.

    Article  PubMed  CAS  Google Scholar 

  53. Wielinski CL, Erickson-Davis C, Wichmann R, Walde-Douglas M, Parashos SA. Falls and injuries resulting from falls among patients with Parkinson’s disease and other parkinsonian syndromes. Mov Disord. 2005;20:410–5.

    Article  PubMed  Google Scholar 

  54. Wenning GK, Ebersbach G, Verny M, Chaudhuri KR, Jellinger K, McKee A, et al. Progression of falls in postmortem-confirmed parkinsonian disorders. Mov Disord. 1999;14:947–50.

    Article  PubMed  CAS  Google Scholar 

  55. Latt MD, Lord SR, Morris JG, Fung VS. Clinical and physiological assessments for elucidating falls risk in Parkinson’s disease. Mov Disord. 2009;24:1280–9.

    Article  PubMed  Google Scholar 

  56. Bronte-Stewart H, Minn AY, Rodrigues K, Buckley EL, Nashner LM. Postural instability in idiopathic Parkinson’s disease: the role of medications in unilateral pallidotomy. Brain. 2002;125:2100–14.

    Article  PubMed  Google Scholar 

  57. Epley JM. The canalithic repositioning procedure: for treatment of benign paroxysmal positional vertigo. Otolaryngol Head Neck Surg. 1992;107:399–404.

    PubMed  CAS  Google Scholar 

  58. Krebs DE, Gill-Body KM, Riley PO, Parker SW. Double-blind, placebo-controlled trial of rehabilitation for bilateral vestibular hypofunction: preliminary report. Otolaryngol Head Neck Surg. 1993;109: 735–41.

    PubMed  CAS  Google Scholar 

  59. Horak FB, Jones-Rycewicz C, Black FO, Shumway-Cook A. Effects of vestibular rehabilitation on dizziness and imbalance. Otolaryngol Head Neck Surg. 1992;106:175–80.

    PubMed  CAS  Google Scholar 

  60. Strupp M, Arbusow V, Maag KP, Gall C, Brandt T. Vestibular exercises improve central vestibulospinal compensation after vestibular neuritis. Neurology. 1998;51:838–44.

    Article  PubMed  CAS  Google Scholar 

  61. Ashburn A, Fazakarley L, Ballinger C, Pickering R, McLellan LD, Fitton C. A randomized controlled trial of a home-based exercise programme to reduce the risk of falling among people with Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2007;78:678–84.

    Article  PubMed  Google Scholar 

  62. Dibble LE, Hale TF, Marcus RL, Droge J, Gerber JP, Lastayo PC. High-intensity resistance training amplifies muscle hypertrophy and functional gains in persons with Parkinson’s disease. Mov Disord. 2006;21:1444–52.

    Article  PubMed  Google Scholar 

  63. Nieuwboer A, Kwakkel G, Rochester L, Jones D, van Wegen E, Willems AM, et al. Cueing training in the home improves gait-related mobility in Parkinson’s disease. J Neurol Neurosurg Psychiatry. 2007;78:134–40.

    Article  PubMed  CAS  Google Scholar 

  64. Hirsch MA, Toole T, Maitland CG, Rider RA. The effects of balance training and high-intensity resistance training on persons with idiopathic Parkinson’s disease. Arch Phys Med Rehabil. 2003;84:1109–17.

    Article  PubMed  Google Scholar 

  65. Toole T, Hirsch MA, Forkink A, Lehman DA, Maitland CG. The effects of a balance and strength training program on equilibrium in Parkinsonism: a preliminary study. NeuroRehabilitation. 2000;14:165–74.

    PubMed  Google Scholar 

  66. Rossi-Izquierdo M, Soto-Varela A, Santos-Perez S, Sesar-Ignatio A, Labella-Cabellero T. Vestibular rehabilitation with computerized dynamic posturography in patients with Parkinson’s disease: improving ­balance impairment. Disabil Rehabil. 2009;31:1907–16.

    Article  PubMed  Google Scholar 

  67. Pan W, Soma R, Kwak S, Yamamoto Y. Improvement of motor functions by noisy vestibular stimulation in central neurodegenerative disorders. J Neurol. 2008;255:1657–61.

    Article  PubMed  CAS  Google Scholar 

  68. Tamlin B, McDonald K, Correll M, Sharpe MH. The immediate effects of vestibular stimulation on gait in patients with parkinsonism. Neurorehab Neural Repair. 1993;7:35–9.

    Article  Google Scholar 

  69. Munneke M, Nijkrake M, Keus S, Kwakkel G, Berendse H, Roos R. Efficacy of community-based physiotherapy networks for patients with Parkinson’s disease: a cluster-randomised trial. Lancet Neurol. 2010;9:46–54.

    Article  PubMed  Google Scholar 

  70. Deus S, Bloem BR, Hendriks EJ, Bredero-Cohen AB, Munneke M. Evidence-based analysis of physical therapy in Parkinson’s disease with recommendations for practice and research. Mov Disord. 2007;22:451–60.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Florida State University College of Medicine, Neuro-Opthalmology and Balance Disorders Clinic, Tallahassee Memorial Hospital, Tallahassee, FL, USA

    Charles G. Maitland M.D.

Authors
  1. Charles G. Maitland M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charles G. Maitland M.D. .

Editor information

Editors and Affiliations

  1. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA

    Ronald F. Pfeiffer (Professor and Vice Chair) (Professor and Vice Chair)

  2. Parkinson’s Disease and Related Disorders Clinic, SUNY Downstate Medical Center, Brooklyn, NY, USA

    Ivan Bodis-Wollner

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Maitland, C.G. (2013). Vestibular Dysfunction. In: Pfeiffer, R.F., Bodis-Wollner, I. (eds) Parkinson’s Disease and Nonmotor Dysfunction. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-429-6_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-60761-429-6_25

  • Published:

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-60761-428-9

  • Online ISBN: 978-1-60761-429-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation