Altered central vestibular processing in Parkinson's disease with Pisa syndrome

In Parkinson's disease (PD) dizziness, imbalance, postural instability and impaired visuospatial orientation occur, about 10% of PD additionally present with Pisa syndrome (PS). Aim of the current study was (a) to evaluate the perception of verticality by subjective visual vertical (SVV) and visuospatial orientation by the Benton Judgement of Line Test (JLO) in PS, (b) to analyze vestibular reactivity after...

Audiologists and vestibular specialists assessing Parkinson's patients should be aware that Pisa syndrome may be linked to measurable central vestibular processing changes; however, clinical protocols cannot yet be updated on the basis of this single study alone.

Understanding central vestibular dysfunction in Pisa syndrome could open new rehabilitation targets and improve balance assessment protocols for a subset of Parkinson's patients at high fall risk.

1. 01Pisa syndrome — persistent lateral trunk tilt in Parkinson's disease — is associated with altered central vestibular processing.
2. 02Patients showed impairments in visuospatial orientation alongside dizziness symptoms.
3. 03Findings suggest a central (brain-level) rather than purely peripheral (inner-ear) origin for balance disruption in this group.
4. 04Study adds to growing evidence linking postural disorders in Parkinson's to vestibular pathway changes.
5. 05Results may inform multidisciplinary fall-prevention strategies for this patient subgroup.

PMID

42260058

DOI

10.1038/s41598-026-55982-z.

Journal

Scientific Reports

Publication type

research_article

Evidence level

4

Population

Adults with Parkinson's disease, with and without Pisa syndrome

Intervention

Assessment of central vestibular processing, dizziness, and visuospatial orientation in Parkinson's patients with Pisa syndrome

Comparator

Parkinson's disease patients without Pisa syndrome