Abstract：
People with multiple sclerosis (PwMS) who report dizziness often have gaze instability due to vestibulo-ocular reflex (VOR) deficiencies and compensatory saccade (CS) abnormalities. Herein, we aimed to describe and compare the gaze stabilization mechanisms for yaw and pitch head movements in PwMS. Thirty-seven PwMS (27 female, mean ± SD age = 53.4 ± 12.4 years old, median [IQR] Expanded Disability Status Scale Score = 3.5, [1.0]. We analyzed video head impulse test results for VOR gain, CS frequency, CS latency, gaze position error (GPE) at impulse end, and GPE at 400 ms after impulse start. Discrepancies were found for median [IQR] VOR gain in yaw (0.92 [0.14]) versus pitch-up (0.71 [0.44], p < 0.001) and pitch-down (0.81 [0.44], p = 0.014]), CS latency in yaw (258.13 [76.8]) ms versus pitch-up (208.78 [65.97]) ms, p = 0.001] and pitch-down (132.17 [97.56] ms, p = 0.006), GPE at impulse end in yaw (1.15 [1.85] degs versus pitch-up (2.71 [3.9] degs, p < 0.001), and GPE at 400 ms in yaw (-0.25 [0.98] degs) versus pitch-up (1.53 [1.07] degs, p < 0.001) and pitch-down (1.12 [1.82] degs, p = 0.001). Compared with yaw (0.91 [0.75]), CS frequency was similar for pitch-up (1.03 [0.93], p = 0.999) but lower for pitch-down (0.65 [0.64], p = 0.023). GPE at 400 ms was similar for yaw and pitch-down (1.88 [2.76] degs, p = 0.400). We postulate that MS may have preferentially damaged the vertical VOR and saccade pathways in this cohort.
摘要：
报告头晕的多发性硬化症（PwMS）患者通常由于前庭眼反射（VOR）缺陷和代偿性扫视（CS）异常而导致视线不稳定。在这里，我们旨在描述和比较PwMS中偏航和俯仰头部运动的视线稳定机制。37名PwMS（27名女性，平均±SD年龄=53.4±12.4岁，中位数[IQR]扩展残疾状态量表评分=3.5，[1.0]。我们分析了VOR增益的视频头脉冲测试结果，CS频率,CS延迟，脉冲端凝视位置误差(GPE)，和GPE在脉冲启动后400ms。在偏航(0.92[0.14])与俯仰(0.71[0.44],p<0.001)和俯仰下降(0.81[0.44]，p=0.014]),偏航中的CS延迟（258.13[76.8]）ms与俯仰上升（208.78[65.97]）ms，p=0.001]和变桨(132.17[97.56]ms，p=0.006),偏航冲击端GPE(1.15[1.85]度与俯仰(2.71[3.9]度,p<0.001)，和GPE在400ms偏航(-0.25[0.98]度)与俯仰(1.53[1.07]度,p<0.001)和俯仰下降(1.12[1.82]度，p=0.001)。与偏航(0.91[0.75])相比,音调上升的CS频率相似(1.03[0.93]，p=0.999），但对于变低（0.65[0.64]，p=0.023)。400ms时的GPE类似于偏航和俯仰(1.88[2.76]度,p=0.400)。我们推测，MS可能优先损害了该队列中的垂直VOR和扫视途径。
