Montfoort Inger, Kelders Willem P A, van der Geest Jos N, Schipper Inger B, Feenstra Louw, de Zeeuw Chris I, Frens Maarten A
Department of Neuroscience, Erasmus MC Rotterdam, The Netherlands.
Invest Ophthalmol Vis Sci. 2006 Jul;47(7):2881-4. doi: 10.1167/iovs.05-1561.
In the past few decades, the automobile has become an increasingly more popular means of transport, which has led to an increasing number of rear-end collisions and consequently has resulted in more patients with whiplash-associated disorders (WADs). Recently, it was found that the gain of one of the ocular stabilization reflexes-the cervico-ocular reflex (COR)-is elevated in patients with whiplash injury. The COR responds to proprioceptive signals from the neck and acts in conjunction with the vestibulo-ocular reflex (VOR) and the optokinetic reflex (OKR) to preserve stable vision on the retina during head motion. Therefore, an investigation was conducted to determine whether the reported elevation of the COR in WADs is accompanied by changes in VOR or OKR.
Eye movements of 13 patients and 18 age-matched healthy controls were recorded with an infrared eye-tracking device.
Analysis confirmed a significant increase in COR gain in whiplash patients. Meanwhile the VOR and OKR gains remained the same. No correlation was found between the gains of the reflexes in individual patients. This is in contrast to earlier observations in elderly subjects and subjects with labyrinthine defects, who showed increases in COR gain and decreases in VOR gain.
Impaired neck motion, altered proprioception of the neck, or disorganization in the process of VOR plasticity could explain the lack of change in VOR gain.
在过去几十年中，汽车已成为越来越受欢迎的交通工具，这导致追尾碰撞事故越来越多，进而致使更多的挥鞭样损伤相关疾病（WADs）患者。最近发现，挥鞭样损伤患者的一种眼动稳定反射——颈眼反射（COR）增益升高。COR对来自颈部的本体感觉信号作出反应，并与前庭眼反射（VOR）和视动反射（OKR）协同作用，以在头部运动期间保持视网膜上的稳定视觉。因此，开展了一项研究以确定WADs中所报道的COR增益升高是否伴有VOR或OKR的变化。
使用红外眼动追踪设备记录13例患者和18例年龄匹配的健康对照者的眼动。
分析证实，挥鞭样损伤患者的COR增益显著增加。同时，VOR和OKR增益保持不变。在个体患者中，未发现这些反射增益之间存在相关性。这与对老年受试者和有迷路缺陷受试者的早期观察结果相反，后者表现为COR增益增加和VOR增益降低。
颈部运动受损、颈部本体感觉改变或VOR可塑性过程紊乱可以解释VOR增益缺乏变化的原因。
