帕金森病中的外周听力、脑干听觉反应和P300电位：一项为期一年随访的横断面研究

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中文摘要

背景： 听觉功能障碍和认知损害日益被认为是帕金森病（PD）的非运动特征，但整合外周听力、脑干听觉反应和皮层听觉-认知处理的纵向数据有限。本研究比较了帕金森病患者与健康对照者在基线和一年时的纯音测听、脑干听觉诱发反应和听觉P300电位。
方法： 这项为期一年随访的横断面研究评估了50例帕金森病患者和28名完成两次评估的健康对照者的纯音测听、脑干诱发反应测听（BERA）和听觉P300事件相关电位。同时评估了临床和神经心理学指标。
结果： 帕金森病患者在基线和一年时的蒙特利尔认知评估（MoCA）评分均低于对照者，两次评估时焦虑评分均较高，一年时抑郁评分较高。运动严重程度保持稳定，而左旋多巴等效日剂量增加。基线时外周听力损害在帕金森病中更为常见。部分BERA潜伏期，尤其是左耳IV波潜伏期，显示出名义上的组间差异，但没有任何BERA参数在错误发现率校正后仍然显著。基线Cz-P300波幅在帕金森病中较高，并且在调整年龄、性别、教育程度和听力状态后仍与帕金森病状态独立相关。在仅纳入帕金森病患者的模型中，Cz-P300参数与MoCA评分无独立关联。
结论： 外周听力损害在帕金森病中更为常见，而只有基线Cz-P300波幅在多重检验校正和多变量调整后仍然显著。这些发现提示，听觉电生理指标可能捕捉到帕金森病中感觉-认知功能障碍的某些方面，但其临床意义仍需进一步阐明。

英文摘要

BACKGROUND: Auditory dysfunction and cognitive impairment are increasingly recognized as non-motor features of Parkinson's disease (PD), but longitudinal data integrating peripheral hearing, brainstem auditory responses, and cortical auditory-cognitive processing are limited. This study compared pure-tone audiometry, brainstem auditory evoked responses, and auditory P300 potentials between patients with PD and healthy controls at baseline and one year.
METHODS: This cross-sectional study with one-year follow-up evaluated pure-tone audiometry, Brainstem Evoked Response Audiometry (BERA), and auditory P300 event-related potentials in 50 patients with PD and 28 healthy controls who completed both assessments. Clinical and neuropsychological measures were assessed.
RESULTS: Patients with PD had lower Montreal Cognitive Assessment (MoCA) scores than controls at baseline and one year, higher anxiety scores at both assessments, and higher depression scores at one year. Motor severity remained stable, whereas levodopa equivalent daily dose increased. Peripheral hearing impairment at baseline was more frequent in PD. Selected BERA latencies, particularly left-ear wave IV latency, showed nominal between-group differences, but no BERA parameter survived false discovery rate correction. Baseline Cz-P300 amplitude was higher in PD and remained independently associated with PD status after adjustment for age, sex, education, and hearing status. Cz-P300 parameters were not independently associated with MoCA scores in PD-only models.
CONCLUSION: Peripheral hearing impairment was more frequent in PD, whereas only the baseline Cz-P300 amplitude remained significant after correction for multiple testing and multivariable adjustment. These findings suggest that auditory electrophysiological measures may capture aspects of sensory-cognitive dysfunction in PD, although their clinical significance requires further clarification.