帕金森病的临床诊断仍然具有挑战性,多系统萎缩症(MSA)的诊断生物标志物很少。本研究旨在探讨联合眼动试验对帕金森病(PD)和MSA患者的诊断价值。
我们招募了96名PD患者,33例MSA患者(18例MSA-P,15例MSA-C),和40名健康对照者测量了他们的水平眼球运动。记忆引导扫视(MGS)的多步模式,反射扫视的超肌层/超肌层,平稳追击运动(SPM)中的异常扫视,凝视诱发的眼球震颤,定性分析了凝视试验中的方波抽搐。还对SPM的自反扫视参数和增益进行了定量分析。
MGS测试表明,与对照组相比,任何一种诊断的患者多步模式的发生率均显着较高(68.6%,65.2%,和对抗。2.5%,p<.05,在PD中,MSA,与。controls,分别)。反射性扫视测试表明,MSA患者表现出明显较高的异常扫视发生率(63.6%,子宫内膜增生和子宫内膜增生)比PD患者和对照组(33.3%,7.5%,分别,超肌层)(p<.05)。SPM测试表明,PD患者的增益略有下降,其中28.1%出现“扫视侵入”;MSA患者的增益显着下降,其中51.5%出现“追赶扫视”(p<.05)。只有MSA患者表现为凝视诱发的眼球震颤(24.2%),凝视试验中的方波波动(6.1%)(p<.05)。
一组眼球运动测试可能有助于区分PD和MSA。在扫视眼球运动中同时存在子宫内膜增生和子宫内膜增生,伴随“追赶扫视”的平稳追逐运动的收益受损,“凝视诱发的眼球震颤,凝视测试中的方波抽搐,MGS中的多步骤模式可能为MSA的诊断提供线索。
Clinical diagnosis of Parkinsonism is still challenging, and the diagnostic biomarkers of Multiple System Atrophy (MSA) are scarce. This study aimed to investigate the diagnostic value of the combined eye movement tests in patients with Parkinson\'s disease (PD) and those with MSA.
We enrolled 96 PD patients, 33 MSA patients (18 with MSA-P and 15 with MSA-C), and 40 healthy controls who had their horizontal ocular movements measured. The multiple-step pattern of memory-guided saccade (MGS), the hypometria/hypermetria of the reflexive saccade, the abnormal saccade in smooth pursuit movement (SPM), gaze-evoked nystagmus, and square-wave jerks in gaze-holding test were qualitatively analyzed. The reflexive saccadic parameters and gain of SPM were also quantitatively analyzed.
The MGS test showed that patients with either diagnosis had a significantly higher incidence of multiple-step pattern compared with controls (68.6%, 65.2%, and versus. 2.5%, p < .05, in PD, MSA, versus. controls, respectively). The reflexive saccade test showed that MSA patients showing a prominent higher incidence of the abnormal saccade (63.6%, both hypometria and hypermetria) than that of PD patients and controls (33.3%, 7.5%, respectively, hypometria) (p < .05). The SPM test showed PD patients had mildly decreased gain among whom 28.1% presenting \"saccade intrusions\"; and that MSA patients had the significant decreased gain with 51.5% presenting \"catch-up saccades\"(p < .05). Only MSA patients showed gaze-evoked nystagmus (24.2%), square-wave jerks (6.1%) in gaze-holding test (p < .05).
A panel of eye movements tests may help to differentiate PD from MSA. The combined presence of hypometria and hypermetria in saccadic eye movement, the impaired gain of smooth pursuit movement with \"catch-up saccades,\" gaze-evoked nystagmus, square-wave jerks in gaze-holding test, and multiple-step pattern in MGS may provide clues to the diagnosis of MSA.