Parkinson hastalarında işitme fonksiyonlarının odyolojik ve elektrofizyolojik yöntemlerle ölçülmesi, non-motor semptomlar ve klinik progresyon ile ilişkisinin değerlendirilmesi
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Date
2022
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Namık Kemal Üniversitesi
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info:eu-repo/semantics/openAccess
Abstract
Parkinson hastalığı bazal gangliyonlar ve beynin birçok bölgesindeki dopaminerjik nöronların kaybı sonucu ortaya çıkan kronik nörodejeneratif bir süreçtir. Parkinson hastalarının yaklaşık %90'ında gözlenen non-motor semptomların, hastalıktan uzun yıllar önce başladığı, hastalığın ilerlemesiyle birlikte sıklık ve şiddetinin artış gösterdiği bilinmektedir. Bu semptomlar arasında yer alan kognitif bozukluk Parkinson hastalığına sıklıkla eşlik etmekte ve tespitinde P300 testinden yararlanılabilmektedir. İşitme kaybı ise non-motor semptomlar arasında yer almamakla birlikte yaş ilerledikçe sıklığı ve şiddeti artan bir bulgudur. Klinik pratikte işitme fonksiyonu işitsel uyarılmış beyin sapı yanıtı (BERA) ile değerlendirilebilmektedir. Bu çalışmada, Parkinson hastalarının işitme fonksiyonlarının, işitsel uyarılmış beyin sapı yanıtı ve P300 değerlerinin hastaların klinik bulguları, NMS'leri ve nöropsikolojik tabloları ile ilişkisini ve tüm bu verilerin 1 yıl içerisindeki değişimini değerlendirmeyi amaçladık. Çalışmamız prospektif bir olgu kontrol çalışmasıdır. Çalışmamıza, Nöroloji polikliğinimizde takip edilen ileri işitme kaybı ve ek nöropsikiyatrik hastalığı olmayan 50 Parkinson hastası ve 28 sağlıklı kontrol dahil edildi. Hastalara Birleşik Parkinson Hastalığı Değerlendirme Ölçeği III. kısmı, Hoehn&Yahr ölçeği, Beck Depresyon Ölçeği, Beck Anksiyete Ölçeği, Montreal Bilişsel Değerlendirme Ölçeği, Non-Motor Semptom Fluktuasyon Günlüğü, P300 ve BERA testleri başlangıçta ve 1 yıl sonunda uygulandı. Parkinson hastalarında işitme kaybı hem başlangıç hem 1 yıl sonunda anlamlı derecede yüksekti. Birinci yıl sonunda Parkinson hastalarının Cz-P300 latansında anlamlı derecede uzama tespit edildi. Parkinson hastalarının sol kulak BERA-IV. dalga boyu hem başlangıç hem 1 yıl sonunda anlamlı derecede daha uzundu. Parkinson hastalarında non-motor semptom sayısı ile sol kulak BERA-V. dalga boyu arasında pozitif yönde bir korelasyon izlendi. Sonuç olarak; Parkinson hastalarında non-motor semptomların takibinde BERA-V. dalga boyunun kullanılabileceği tespit edildi. Şiddetli motor semptomları olan ve kognitif fonksiyonlar başta olmak üzere non-motor semptomları bozuk olan ileri evre hastaların izleminde P300 ve BERA testinin kullanılabileceği ancak 1 yıldan daha uzun aralıklı takip süresi gerektiği sonucuna varıldı. Anahtar kelimeler: Parkinson hastalığı, non-motor semptom, işitme kaybı, P300, BERA
Parkinson's disease is a chronic neurodegenerative process that results from the loss of dopaminergic neurons in the basal ganglia and many regions of the brain. It is known that nonmotor symptoms observed in approximately 90% of Parkinson's patients begin many years before the disease, and their frequency and severity increase with the progression of the disease. Cognitive impairment, which is among these symptoms, often accompanies Parkinson's disease and the P300 test can be used for its detection. Hearing loss, on the other hand, is not among the non-motor symptoms, but it is a finding that increases in frequency and severity with age. In clinical practice, hearing function can be evaluated by auditory evoked brainstem response (BERA). In this study, we aimed to evaluate the relationship between the hearing functions, auditory evoked brainstem response and P300 values of patients with Parkinson's disease and the clinical findings, NMS and neuropsychological tables of the patients, and the change in all these data within 1 year. Our study is a prospective case-control study. Our study included 50 Parkinson's patients with advanced hearing loss and no additional neuropsychiatric disease, followed in our Neurology outpatient clinic, and 28 healthy controls. Patient Unified Parkinson's Disease Rating Scale III. part, Hoehn & Yahr scale, Beck Depression Scale, Beck Anxiety Scale, Montreal Cognitive Assessment Scale, Non-Motor Symptom Fluctuation Diary, P300 and BERA tests were applied at the beginning and at the end of 1 year. Hearing loss was significantly higher in Parkinson's patients both at the beginning and at the end of 1 year. At the end of the first year, a significant prolongation of Cz-P300 latency was detected in Parkinson's patients. Left ear BERA-IV of Parkinson's patients. wavelength was significantly longer at both baseline and 1 year. Left ear BERA-V with the number of nonmotor symptoms in Parkinson's patients. A positive correlation was observed between wavelength. As a result; BERA-V in the follow-up of non-motor symptoms in Parkinson's patients. wavelength could be used. It was concluded that P300 and BERA test can be used in the follow- up of advanced stage patients with severe motor symptoms and non-motor symptoms, especially cognitive functions, but intermittent follow-up period longer than 1 year is required. Keywords: Parkinson's disease, non-motor symptom, hearing loss, P300, BERA
Parkinson's disease is a chronic neurodegenerative process that results from the loss of dopaminergic neurons in the basal ganglia and many regions of the brain. It is known that nonmotor symptoms observed in approximately 90% of Parkinson's patients begin many years before the disease, and their frequency and severity increase with the progression of the disease. Cognitive impairment, which is among these symptoms, often accompanies Parkinson's disease and the P300 test can be used for its detection. Hearing loss, on the other hand, is not among the non-motor symptoms, but it is a finding that increases in frequency and severity with age. In clinical practice, hearing function can be evaluated by auditory evoked brainstem response (BERA). In this study, we aimed to evaluate the relationship between the hearing functions, auditory evoked brainstem response and P300 values of patients with Parkinson's disease and the clinical findings, NMS and neuropsychological tables of the patients, and the change in all these data within 1 year. Our study is a prospective case-control study. Our study included 50 Parkinson's patients with advanced hearing loss and no additional neuropsychiatric disease, followed in our Neurology outpatient clinic, and 28 healthy controls. Patient Unified Parkinson's Disease Rating Scale III. part, Hoehn & Yahr scale, Beck Depression Scale, Beck Anxiety Scale, Montreal Cognitive Assessment Scale, Non-Motor Symptom Fluctuation Diary, P300 and BERA tests were applied at the beginning and at the end of 1 year. Hearing loss was significantly higher in Parkinson's patients both at the beginning and at the end of 1 year. At the end of the first year, a significant prolongation of Cz-P300 latency was detected in Parkinson's patients. Left ear BERA-IV of Parkinson's patients. wavelength was significantly longer at both baseline and 1 year. Left ear BERA-V with the number of nonmotor symptoms in Parkinson's patients. A positive correlation was observed between wavelength. As a result; BERA-V in the follow-up of non-motor symptoms in Parkinson's patients. wavelength could be used. It was concluded that P300 and BERA test can be used in the follow- up of advanced stage patients with severe motor symptoms and non-motor symptoms, especially cognitive functions, but intermittent follow-up period longer than 1 year is required. Keywords: Parkinson's disease, non-motor symptom, hearing loss, P300, BERA
Description
Tıp Fakültesi, Nöroloji Ana Bilim Dalı
Keywords
Nöroloji, Neurology
