Büttner T, Müller T, Kuhn W
Department of Neurology, Ruhr University Bochum, St. Josef-Hospital, Federal Republic of Germany.
J Neural Transm (Vienna). 2000;107(1):87-94. doi: 10.1007/s007020050007.
The effect of apomorphine on visual functions in Parkinson's disease (PD) was evaluated by use of a static contrast sensitivity test (VCTS charts), a colour discrimination test (Farnsworth-Munsell 100 Hue test) and the examination of achromatic and chromatic contour perception. 31 patients (14 male, 17 female; mean age 60.9 +/- 9.2 years) with idiopathic PD were tested before and after an individual dosage of subcutaneously applied apomorphine showing a significant effect on motor function during the whole experiment. The achromatic spatial contrast sensitivity improved significantly after apomorphine injection with respect to all spatial frequencies. The improvement of colour discrimination after apomorphine application was minimal and not statistically significant. The small advantage of apomorphine with respect to colour discrimination may be explained by negative cognitive side-effects of apomorphine interfering with the test performance. The achromatic contour perception before and after apomorphine injection was unaltered. The contour fusion latency for the green stimulus was shortened, the latency for the rest of the examined coloured stimuli was delayed (= normalized) after apomorphine application. We conclude that apomorphine may be used as a test-drug for the examination of the dopaminergic response of the visual system in patients with PD. The improvement of basal visual functions by dopaminergic stimulation with apomorphine underlines the role of dopamine deficiency for visual dysfunction in PD.
通过使用静态对比敏感度测试(VCTS 图表)、颜色辨别测试(法恩斯沃思 - 芒塞尔 100 色调测试)以及对消色差和彩色轮廓感知的检查,评估了阿扑吗啡对帕金森病(PD)患者视觉功能的影响。31 例特发性 PD 患者(14 名男性,17 名女性;平均年龄 60.9±9.2 岁)在皮下注射个体化剂量的阿扑吗啡前后接受了测试,在整个实验过程中,该剂量的阿扑吗啡对运动功能有显著影响。注射阿扑吗啡后,所有空间频率下的消色差空间对比敏感度均显著提高。应用阿扑吗啡后颜色辨别能力的改善极小且无统计学意义。阿扑吗啡在颜色辨别方面的微小优势可能是由于其负面认知副作用干扰了测试表现所致。注射阿扑吗啡前后的消色差轮廓感知未发生改变。应用阿扑吗啡后,绿色刺激的轮廓融合潜伏期缩短,其余检查的彩色刺激的潜伏期延迟(= 恢复正常)。我们得出结论,阿扑吗啡可作为一种测试药物,用于检查 PD 患者视觉系统的多巴胺能反应。阿扑吗啡多巴胺能刺激改善基础视觉功能,突出了多巴胺缺乏在 PD 视觉功能障碍中的作用。