Hearing dysfunction heralds an increase in non-motor burden and a worse quality of life in Parkinson’s disease: new insights from non-motor spectrum

background: sensorial non-motor symptoms (NMSs) in parkinson's disease (PD) still lack appropriate investigation in clinical practice. this study aimed to assess if and to what extent auditory dysfunction is associated with other NMSs in PD and its impact on patient's quality of life (QoL). methods: We selected patients with idiopathic PD, without other concomitant neurological diseases, dementia, or diagnosis of any audiological/vestibular disease. demographic and clinical data were collected. patients underwent otoscopic examination, audiological testing with pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAEs) and completed non-motor symptoms scale (NMSS) and parkinson's disease questionnaires-39 (PDQ-39). ANCOVA and partial correlation analysis have been used for statistical analysis. Results: 60 patients were enrolled and completed PTA and DPOAEs. 32 patients with hearing impairment (HI), assessed by PTA, (hearing threshold ≥ 25 dB) showed similar disease duration, motor impairment, and staging, compared to patients without HI, but higher scores both in NMSS and in PDQ-39, except for cardiovascular (CV), gastrointestinal (GI), urogenital (U) and sexual function (SF) of NMSS. In addition, DPOAEs showed a significant correlation with higher scores both in NMSS and PDQ-39, except for CV, SF, GI, U and perceptual problem subdomains of NMSS. conclusion: this study demonstrated that PD patients with HI have a greater burden of NMS and lower related QoL and functioning. our results highlight the importance to reconsider HI as a NMS, in parallel with the others. HI evaluation, even in asymptomatic patients, may reveal a wider pathology with a worse QoL.