Sartucci F, Orlandi G, Bonuccelli U, Borghetti D, Murri L, Orsini C, Domenici L, Porciatti V
Department of Neuroscience, Clinical Neurology, Pisa University Medical School, Italy.
Neurol Sci. 2006 Feb;26(6):395-401. doi: 10.1007/s10072-006-0522-1.
Idiopathic Parkinson's disease (IPD) patients have abnormal visual evoked potentials (VEPs) and pattern electroretinograms (PERGs), attributed to dopaminergic transmission deficiency in visual pathway, probably the retina. VEP abnormalities are not reported in multiple system atrophy (MSA). The aim of this study was to investigate and compare chromatic (Ch) red-green (R-G) and blue-yellow (B-Y), and luminance yellow-black (Y-Bk) PERGs in patients with MSA and IPD. We investigated 6 MSA patients (mean age: 62+/-7.4 years) not undergoing any pharmacological treatment, as well as 12 early IPD patients (mean age: 60.1+/-8.3 years) and 12 age-matched normal observers. ChPERGs were recorded monocularly in response to full-field equiluminant R-G, B-Y and Y-Bk horizontal gratings. In MSA only responses to R-G stimuli showed minimal insignificant changes (slight but not significant amplitude reduction without any significant latency delay); no significant abnormality was detected for B-Y and luminance Y-Bk stimuli. By contrast, in IPD all responses were reduced in amplitude and delayed in latency, above all for B-Y stimuli. Present data indicate that both chromatic and achromatic PERGs are virtually unaffected in MSA, whereas in early IPD they are clearly impaired, suggesting different pathogenic retinal mechanisms and a useful simple tool for distinguishing MSA from IPD.
特发性帕金森病(IPD)患者存在异常的视觉诱发电位(VEP)和图形视网膜电图(PERG),这归因于视觉通路(可能是视网膜)中多巴胺能传递缺陷。多系统萎缩(MSA)患者未报告有VEP异常。本研究的目的是调查和比较MSA和IPD患者的彩色(Ch)红-绿(R-G)、蓝-黄(B-Y)以及亮度黄-黑(Y-Bk)PERG。我们调查了6例未接受任何药物治疗的MSA患者(平均年龄:62±7.4岁)、12例早期IPD患者(平均年龄:60.1±8.3岁)以及12名年龄匹配的正常观察者。单眼记录ChPERG,以响应全视野等亮度的R-G、B-Y和Y-Bk水平光栅。在MSA患者中,仅对R-G刺激的反应显示出极小的无显著意义的变化(幅度轻微降低但不显著,且无任何显著的潜伏期延迟);对B-Y和亮度Y-Bk刺激未检测到显著异常。相比之下,在IPD患者中,所有反应的幅度均降低且潜伏期延迟,尤其是对B-Y刺激。目前的数据表明,彩色和非彩色PERG在MSA中基本未受影响,而在早期IPD中则明显受损,这表明存在不同的视网膜致病机制,并且是一种区分MSA和IPD的有用的简单工具。