Auditory dysfunction in Parkinson’s disease

In addition to typical motor symptoms, Parkinson's disease (PD) is characterized by several non-motor symptoms that significantly impair the patient's quality of life. However, auditory dysfunction, like other sensory impairments across various modalities, is either not assessed at all or is interpreted outside the context of PD. The currently available data demonstrate the multifactorial nature of changes in the auditory analyzer, combining the natural processes of aging, neurotransmitter disorders, and degeneration of neural structures and pathways associated with the pathophysiology of PD. Abnormalities are detected at both the peripheral level and in the auditory nuclei of the brain stem and cortical regions of the brain. The paper presents the clinical manifestations of auditory dysfunction and its pathophysiological mechanisms in PD, as well as the features of diagnostic approaches to their detection. Particular attention is paid to neuroimaging changes in the brain in patients with auditory disorders. Functional MRI, MRI morphometry, and tractography methods can detect changes in brain regions involved in the perception and processing of auditory information. Neuroimaging data explaining how auditory dysfunction is associated with cognitive impairment, including dementia, are also presented. In conclusion, the importance of not only conducting a comprehensive assessment of auditory function in patients with PD, but also developing guidelines for its improvement, is emphasized.