Objective: To investigate findings on ocular motility, fear of falling and functionality in two patients with Parkinson’s Disease (PD) from Brazil.
Background: PD impaires motor control, ocular motility, and balance. Slowed saccades and gaze control issues affect visual stability and spatial orientation, increasing fall risk. Investigating saccades with videonystagmography (VNG) may add more precision on determining risk of falling in PD patients.
Method: This is a cross-sectional exploratory study in which patients with PD were assessed regarding ocular motility through saccadic parameters from videonystagmography (VNG) and analyzed them alongside Falls Efficacy Scale-International (FES-I). Patients were recruited from a Movement Disorders Outpatient Clinic in Brazil and were evaluated by the research team.
Results: Patient A: The participant was a 55-year-old male who had been diagnosed with PD 15 years ago. He was using levodopa, rasagiline and entacapone and was a candidate for DBS implantation. He had a history of frequent falls, with the most recent one documented two weeks prior to assessement. He had a score of 3 on the Modified Hoehn and Yahr scale (H&Y) and 80% at Schwab and England (S&E). VNG revealed hypometric saccades, corroborated by alterations in precision parameter and morphological irregularities in the graph trace. The patient obtained a score of 25 on the FES-I, indicating a high level of concern about falling.
Patient B: A 50-year-old female, diagnosed with PD five years ago, reported an increased frequency of falls over time, the most recent fall occurred shortly after the assessment. VNG showed impaired saccadic movements, confirmed by abnormalities in the parameters of precision, latency and speed. A high concern about falling was evidenced by a FES-I score of 49. This patient had a score of 2 on H&Y, and 80% on S&E, indicating an intermediate stage of disease evolution.
Conclusion: Even though both patients were independent on activities of daily living and had no significant impairment due to falls, they had high fear of falling and videonystagmography findings showing saccadic abnormalities. These findings may be related to a higher risk of falling in the near feature, which may have an impact on patients’ prognosis and decision-making regarding continuous dopaminergic therapeutic strategies, but further investigation is needed to clarify if association exists.
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[4] Yardley L, et al. The Falls Efficacy Scale International (FES-I): A comprehensive version of the Falls Efficacy Scale to assess fear of falling in older people. Age Ageing. 2005;34(6):551-556. doi:10.1093/ageing/afp225
To cite this abstract in AMA style:
I. Monteiro, M. Salmito, K. Aguiar, F. Rolim, M. Rela, A. Ferreira Gomes, F. Carvalho. Falls in Parkinson Disease, Videonystagmography and Fear of Falls – an Exploratory Study. [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/falls-in-parkinson-disease-videonystagmography-and-fear-of-falls-an-exploratory-study/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/falls-in-parkinson-disease-videonystagmography-and-fear-of-falls-an-exploratory-study/