Assessment of audiovestibular function in patients with psoriatic arthritis: a cross-sectional controlled study

Background Psoriatic arthritis (PsA) is a chronic immune mediated inflammatory disease that may extend beyond the musculoskeletal and dermatological systems. Although cochlear and vestibular involvement has been reported in autoimmune rheumatic diseases, the frequency, pattern, and clinical correlates of audiovestibular dysfunction in PsA remain insufficiently characterized. Previous studies have generally focused on limited audiological or vestibular parameters. This study aimed to comprehensively evaluate cochlear and vestibular function in PsA patients using a multimodal audiovestibular test battery and to investigate the relationship between these findings and disease activity indices. Methods A total of 35 PsA patients and 35 healthy controls underwent pure tone audiometry, word recognition score (WRS), speech reception threshold (SRT), tympanometry, acoustic reflexes, video head impulse test (vHIT), cervical vestibular evoked myogenic potentials (cVEMP), videonystagmography (VNG), and bithermal caloric testing. Disease activity in PsA patients was quantified using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Psoriasis Area and Severity Index (PASI), 28 - joint Disease Activity Score (DAS28), and Disease Activity Index for Psoriatic Arthritis (DAPSA28). Results PsA patients had higher hearing thresholds ( p ≤ 0.001), lower WRS ( p ≤ 0.001), and higher (poorer) SRT values ( p = 0.011) than controls. cVEMP P1–N1 peak-to-peak amplitudes were lower bilaterally (right: p = 0.002; left: p = 0.034). P1 latencies and right N1 latency were shorter in the PsA group, whereas left N1 latency was retained as a descriptive variable because of its markedly skewed distribution. vHIT showed lower VOR gains in the right lateral, bilateral anterior, and right posterior canals; left lateral vHIT gain was retained descriptively because of marked skewness. Abnormal caloric unilateral weakness was present in 34.3% of PsA patients and in no controls ( p ≤ 0.001). DAS28 was negatively correlated with right lateral vHIT gain (Spearman’s ρ = −0.36, p = 0.027), and DAPSA28 was negatively correlated with the participant-level bilateral mean cVEMP P1–N1 amplitude (Spearman’s ρ = −0.42, p = 0.018). Disease duration was positively correlated with right and left caloric SPV responses (Spearman’s ρ = 0.41 and ρ = 0.47, respectively; both p ≤ 0.01). PASI was negatively correlated with caloric canal paresis (Spearman’s ρ = −0.41, p = 0.014). Conclusion PsA was associated with subclinical auditory and vestibular abnormalities across complementary tests. Relationships with disease activity were exploratory and require confirmation in longitudinal studies.