{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T21:09:00Z","timestamp":1782508140314,"version":"3.54.5"},"reference-count":28,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,1]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parkinson\u2019s disease (PD) is a neurodegenerative, progressive disorder known for motor and non-motor symptoms. The vestibular system, via the vestibulo-ocular reflex (VOR), is crucial for maintaining dynamic gaze stability, and its role in PD is raising interest among researchers. Indeed, vestibular dysfunction in PD may exacerbate postural instability and gait disturbances; however, the prevalence of vestibular dysfunctions remains unclear. This study aims to objectively investigate the VOR function in people with PD using the video head impulse test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a cross-sectional study conducted in a neurorehabilitation hospital. People with PD were included if they had no cognitive impairment and the ability to walk without physical assistance. The video head impulse test was used to assess the VOR function across all six semicircular canals, using both the Head Impulse Paradigm (HIMP) and the Suppression Head Impulse Paradigm (SHIMP) paradigms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>35 people with PD (mean age: 69.9\u00b18.4; 11 females) with moderate motor symptoms (MDS-UPDRS-part III: 27.7\u00b16.8) were included. Using normative cut-offs, 69% of the participants had at least one dysfunctional canal (60% hypo-gain, 9% hyper-gain). The prevalence reached 83% when both the HIMP and SHIMP paradigms were considered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a high prevalence of vestibular dysfunction in people with PD. The instrumental assessment of VOR gains could reveal undiagnosed vestibular dysfunctions and, in the future, lead to more specific rehabilitation management of people with PD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099765","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T18:25:19Z","timestamp":1754418319000},"page":"e099765","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Assessment of vestibulo-ocular reflex function in people with Parkinson\u2019s disease: a cross-sectional study in a rehabilitation setting using the video head impulse test"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8563-9967","authenticated-orcid":false,"given":"Nicola","family":"Ferri","sequence":"first","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Casagrande Conti","sequence":"additional","affiliation":[{"name":"IRCCS Santa Lucia Foundation, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo","family":"Manzari","sequence":"additional","affiliation":[{"name":"MSA ENT Academy Center, Cassino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Piatti","sequence":"additional","affiliation":[{"name":"IRCCS Santa Lucia Foundation, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"De Angelis","sequence":"additional","affiliation":[{"name":"IRCCS Santa Lucia Foundation, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Nocentini","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Rome, Lazio, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6034-0638","authenticated-orcid":false,"given":"Marco","family":"Tramontano","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy"},{"name":"Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,8,5]]},"reference":[{"key":"2025123106451495000_15.8.e099765.1","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1016\/S0140-6736(14)61393-3","article-title":"Parkinson\u2019s disease","volume":"386","author":"Kalia","year":"2015","journal-title":"The Lancet"},{"key":"2025123106451495000_15.8.e099765.2","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/00034894211067838","article-title":"Assessment of the Clinical Use of Vestibular Evoked Myogenic Potentials and the Video Head Impulse Test in the Diagnosis of Early-Stage Parkinson\u2019s Disease","volume":"132","author":"Berkiten","year":"2023","journal-title":"Ann Otol Rhinol Laryngol"},{"key":"2025123106451495000_15.8.e099765.3","doi-asserted-by":"publisher","DOI":"10.1002\/mds.29189"},{"key":"2025123106451495000_15.8.e099765.4","doi-asserted-by":"crossref","DOI":"10.3390\/brainsci12070956","article-title":"Assessment of Vestibular-Evoked Myogenic Potentials in Parkinson\u2019s Disease: A Systematic Review and Meta-Analysis","volume":"12","author":"Cui","year":"2022","journal-title":"Brain Sci"},{"key":"2025123106451495000_15.8.e099765.5","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2024.1398764","article-title":"Vestibular dysfunction in Parkinson\u2019s disease: a neglected topic","volume":"15","author":"Gui","year":"2024","journal-title":"Front Neurol"},{"key":"2025123106451495000_15.8.e099765.6","doi-asserted-by":"crossref","first-page":"3527","DOI":"10.1007\/s00415-024-12311-6","article-title":"Vestibular-evoked myogenic potential abnormalities in Parkinson\u2019s disease with freezing of gait","volume":"271","author":"Jiang","year":"2024","journal-title":"J Neurol"},{"key":"2025123106451495000_15.8.e099765.7","doi-asserted-by":"crossref","DOI":"10.3389\/fneur.2018.01085","article-title":"Vestibular Functions and Parkinson\u2019s Disease","volume":"9","author":"Smith","year":"2018","journal-title":"Front Neurol"},{"key":"2025123106451495000_15.8.e099765.8","doi-asserted-by":"crossref","first-page":"7139","DOI":"10.1038\/s41598-021-86533-3","article-title":"Head movement kinematics are altered during gaze stability exercises in vestibular schwannoma patients","volume":"11","author":"Wang","year":"2021","journal-title":"Sci Rep"},{"key":"2025123106451495000_15.8.e099765.9","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/j.neulet.2017.08.021","article-title":"Vestibulo-ocular reflex abnormality in Parkinson\u2019s disease detected by video head impulse test","volume":"657","author":"Lv","year":"2017","journal-title":"Neurosci Lett"},{"key":"2025123106451495000_15.8.e099765.10","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0061488","article-title":"The video Head Impulse Test (vHIT) detects vertical semicircular canal dysfunction","volume":"8","author":"Macdougall","year":"2013","journal-title":"PLoS One"},{"key":"2025123106451495000_15.8.e099765.11","doi-asserted-by":"crossref","first-page":"261","DOI":"10.3233\/VES-201626","article-title":"Vestibular semicircular canal function as detected by video Head Impulse Test (vHIT) is essentially unchanged in people with Parkinson\u2019s disease compared to healthy controls","volume":"32","author":"Hawkins","year":"2022","journal-title":"J Vestib Res"},{"key":"2025123106451495000_15.8.e099765.12","doi-asserted-by":"crossref","first-page":"5129","DOI":"10.1007\/s00405-024-08721-x","article-title":"Video head impulse test in subacute and chronic stroke survivors: new perspectives for implementation of assessment in rehabilitation","volume":"281","author":"Tramontano","year":"2024","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"2025123106451495000_15.8.e099765.13","doi-asserted-by":"crossref","first-page":"799","DOI":"10.3390\/audiolres14050067","article-title":"Abnormal Vestibulo\u2013Ocular Reflex Function Correlates with Balance and Gait Impairment in People with Multiple Sclerosis","volume":"14","author":"Tramontano","year":"2024","journal-title":"Audiol Res"},{"key":"2025123106451495000_15.8.e099765.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"2025123106451495000_15.8.e099765.15","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21198"},{"key":"2025123106451495000_15.8.e099765.16","doi-asserted-by":"publisher","DOI":"10.1002\/mds.22340"},{"key":"2025123106451495000_15.8.e099765.17","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.17.5.427"},{"key":"2025123106451495000_15.8.e099765.18","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(75)90026-6"},{"key":"2025123106451495000_15.8.e099765.19","first-page":"682","article-title":"Measurement in neurological rehabilitation","volume":"5","author":"Wade","year":"1992","journal-title":"Curr Opin Neurol Neurosurg"},{"key":"2025123106451495000_15.8.e099765.20","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.3390\/healthcare10101926","article-title":"Video Suppression Head Impulses and Head Impulses Paradigms in Patients with Vestibular Neuritis: A Comparative Study","volume":"10","author":"Manzari","year":"2022","journal-title":"Healthcare (Basel)"},{"key":"2025123106451495000_15.8.e099765.21","doi-asserted-by":"crossref","DOI":"10.3389\/fsurg.2021.666390","article-title":"Enhanced Eye Velocity in Head Impulse Testing-A Possible Indicator of Endolymphatic Hydrops","volume":"8","author":"Curthoys","year":"2021","journal-title":"Front Surg"},{"key":"2025123106451495000_15.8.e099765.22","doi-asserted-by":"crossref","first-page":"225","DOI":"10.3233\/VES-200708","article-title":"VOR gain calculation methods in video head impulse recordings","volume":"30","author":"Zamaro","year":"2020","journal-title":"VES"},{"key":"2025123106451495000_15.8.e099765.23","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-024-03649-5","article-title":"Effectiveness of vestibular rehabilitation on postural balance in Parkinson\u2019s disease: a systematic review and meta-analysis of randomized controlled trials","volume":"24","author":"do Amaral","year":"2024","journal-title":"BMC Neurol"},{"key":"2025123106451495000_15.8.e099765.24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32340-0"},{"key":"2025123106451495000_15.8.e099765.25","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-020-10228-4"},{"key":"2025123106451495000_15.8.e099765.26","doi-asserted-by":"crossref","first-page":"22","DOI":"10.3390\/healthcare13010022","article-title":"Knowledge, Barriers, and Future Directions of Vestibular Rehabilitation Practice in Neurorehabilitation: An Italian Survey","volume":"13","author":"Ferri","year":"2025","journal-title":"Healthcare (Basel)"},{"key":"2025123106451495000_15.8.e099765.27","doi-asserted-by":"crossref","first-page":"1853","DOI":"10.1007\/s00221-021-06107-7","article-title":"Suppression head impulse test paradigm (SHIMP) characteristics in people with Parkinson\u2019s disease compared to healthy controls","volume":"239","author":"Hawkins","year":"2021","journal-title":"Exp Brain Res"},{"key":"2025123106451495000_15.8.e099765.28","doi-asserted-by":"crossref","first-page":"3553","DOI":"10.1007\/s00221-021-06219-0","article-title":"Using virtual reality to assess vestibulo-visual interaction in people with Parkinson\u2019s disease compared to healthy controls","volume":"239","author":"Hawkins","year":"2021","journal-title":"Exp Brain Res"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-099765","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T14:45:38Z","timestamp":1767192338000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-099765"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":28,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,5]]},"published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1136\/bmjopen-2025-099765"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-099765","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}