Cognitive deficits in patients with peripheral vestibular dysfunction.

Autor: Obermann M; Department of Neurology, Dizziness and Vertigo Center Essen, University Hospital Essen, Essen, Germany.; Department of Neurology, Weser-Egge Hospital Höxter, Höxter, Germany., Gebauer A; Department of Neurology, Dizziness and Vertigo Center Essen, University Hospital Essen, Essen, Germany., Arweiler-Harbeck D; Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany., Lang S; Department of Otorhinolaryngology, University Hospital Essen, Essen, Germany., Seilheimer B; Medical Affairs & Research, Heel, Baden-Baden, Germany., Kleinschnitz C; Department of Neurology, Dizziness and Vertigo Center Essen, University Hospital Essen, Essen, Germany., Diener HC; Department of Neuroepidemiology, Institute for Medical Informatics, Biometry, and Epidemiology, University of Duisburg-Essen, Essen-Werden, Germany., Holle D; Department of Neurology, Dizziness and Vertigo Center Essen, University Hospital Essen, Essen, Germany., Naegel S; Department of Neurology, Dizziness and Vertigo Center Essen, University Hospital Essen, Essen, Germany.; Department of Neurology, Martin Luther University Halle-Wittenberg, Halle/Saale, Germany.
Jazyk: angličtina
Zdroj: European journal of neurology [Eur J Neurol] 2023 Jun 04. Date of Electronic Publication: 2023 Jun 04.
DOI: 10.1111/ene.15907
Abstrakt: Background and Purpose: Previous studies demonstrated cognitive deficits in patients with peripheral vestibulopathy (PVP) with dysfunction of spatial navigation and orientation, but also documented cognitive decline in nonspatial abilities. This study evaluates cognitive deficits in patients with unilateral vestibulopathy (UVP) as well as bilateral vestibulopathy (BVP) in multiple cognitive domains using common screening tests to reliably detect these deficits in clinical practice.
Methods: This prospective study compared patients with UVP and BVP to age- and sex-matched healthy controls (HC). Tests included the Alzheimer's Disease Assessment Scale (ADAS), Mini-Mental Status Examination (MMSE), Trail Making Test Part A and B, Clock Drawing Task, Executive Interview-25 (EXIT25), Dementia Detection (DemTect), and the Judgment of Line Orientation (JLO). The Montgomery-Åsberg Depression Rating Scale was used to control for depression. Videonystagmography objectively reconfirmed PVP. The Vertigo Symptoms Scale and the Dizziness Handicap Inventory were used to assess for symptom severity and restrictions of activities of daily living.
Results: Eighty-one patients (65 UVP, 16 BVP) were compared to 55 HC. Patients showed impairment in ADAS, MMSE, DemTect, EXIT25, and JLO. No differences between UVP and BVP were detected. The relative risk (RR) estimates of developing cognitive deficits following PVP were increased. The RR for the ADAS was higher in BVP (RR = 4.91, 95% confidence interval [CI] = 1.87-12.9, p = 0.001) than in UVP (RR = 3.75, 95% CI = 1.65-8.51, p = 0.002), but was similar for the MMSE and DemTect between groups.
Conclusions: Patients with PVP showed deficits in multiple cognitive domains including nonspatial cognitive abilities. Vestibulopathy could be a risk factor for the development of cognitive impairment.
(© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
Databáze: MEDLINE
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