Sartucci F, Porciatti Vittorio
Department of Neuroscience, Neurological Clinic, Pisa University Medical School, Pisa, Italy.
J Clin Neurophysiol. 2006 Oct;23(5):431-5. doi: 10.1097/01.wnp.0000216127.53517.4d.
The differential dysfunction of chromatic and achromatic visual pathways in early Parkinson's disease (PD) was evaluated by means of visual-evoked potentials (VEPs) recorded in 12 patients (mean age 60.1 +/- 8.3 years; range 46 to 74 years) in the early stages of PD and not yet undergoing treatment with L-dopa, and in 12 age-matched controls. Visual stimuli were full-field (14 deg) equiluminant red-green (R-G), blue-yellow (B-Y), and black-white (B-W) sinusoidal gratings of two cycles per degree, presented in onset (300 milliseconds)--offset (700 milliseconds) mode, at two contrast (K) levels (90% and 25%). The VEP mean latencies were significantly more delayed in PD patients than in controls for chromatic than for luminance stimuli, in particular for B-Y stimuli of low contrast (K90%: B-W = 6.6 milliseconds, R-G = 3.34 milliseconds, B-Y = 15.48 milliseconds; K25%: B-W = 7.8 milliseconds, R-G = 14.8 milliseconds, B-Y = 28.9). Latencies of chromatic VEPs were more variable that achromatic VEP latencies in both normal subjects and PD patients. Therefore, the frequency of latency abnormalities (within 30%) was not significantly different for the three visual stimuli. Our results show that, in addition to achromatic VEPs, chromatic VEPs are impaired in early PD patients not yet undergoing L-dopa therapy, indicating an acquired color deficiency in these patients. The greater delay for the B-Y VEPs suggests a higher vulnerability of visual blue-cone pathway in the early stages of the disease. However, the overall sensitivity of chromatic VEPs in detecting early visual impairment in PD is comparable with that of achromatic VEPs.
通过记录12例早期帕金森病(PD)患者(平均年龄60.1±8.3岁;范围46至74岁)和12例年龄匹配的对照者的视觉诱发电位(VEP),评估了早期帕金森病中彩色和非彩色视觉通路的差异性功能障碍。这些帕金森病患者处于疾病早期,尚未接受左旋多巴治疗。视觉刺激为全场(14度)等亮度的红-绿(R-G)、蓝-黄(B-Y)和黑-白(B-W)正弦光栅,每度两个周期,以起始(300毫秒)-终止(700毫秒)模式呈现,有两种对比度(K)水平(90%和25%)。与对照者相比,帕金森病患者彩色刺激的VEP平均潜伏期比亮度刺激的潜伏期显著延迟,特别是低对比度(K90%:B-W = 6.6毫秒,R-G = 3.34毫秒,B-Y = 15.48毫秒;K25%:B-W = 7.8毫秒,R-G = 14.8毫秒,B-Y = 28.9毫秒)的B-Y刺激。在正常受试者和帕金森病患者中,彩色VEP的潜伏期比非彩色VEP的潜伏期更具变异性。因此,三种视觉刺激的潜伏期异常频率(在30%以内)没有显著差异。我们的结果表明,除了非彩色VEP外,尚未接受左旋多巴治疗的早期帕金森病患者的彩色VEP也受损,这表明这些患者存在后天性色觉缺陷。B-Y VEP的更大延迟表明在疾病早期视觉蓝锥通路更易受损。然而,彩色VEP在检测帕金森病早期视觉损害方面的总体敏感性与非彩色VEP相当。