Garbutt Siobhan, Matlin Alisa, Hellmuth Joanna, Schenk Ana K, Johnson Julene K, Rosen Howard, Dean David, Kramer Joel, Neuhaus John, Miller Bruce L, Lisberger Stephen G, Boxer Adam L
Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA 94143-1207, USA.
Brain. 2008 May;131(Pt 5):1268-81. doi: 10.1093/brain/awn047. Epub 2008 Mar 24.
Frontotemporal lobar degeneration (FTLD) often overlaps clinically with corticobasal syndrome (CBS) and progressive supranuclear palsy (PSP), both of which have prominent eye movement abnormalities. To investigate the ability of oculomotor performance to differentiate between FTLD, Alzheimer's disease, CBS and PSP, saccades and smooth pursuit were measured in three FTLD subtypes, including 24 individuals with frontotemporal dementia (FTD), 19 with semantic dementia (SD) and six with progressive non-fluent aphasia (PA), as compared to 28 individuals with Alzheimer's disease, 15 with CBS, 10 with PSP and 27 control subjects. Different combinations of oculomotor abnormalities were identified in all clinical syndromes except for SD, which had oculomotor performance that was indistinguishable from age-matched controls. Only PSP patients displayed abnormalities in saccade velocity, whereas abnormalities in saccade gain were observed in PSP > CBS > Alzheimer's disease subjects. All patient groups except those with SD were impaired on the anti-saccade task, however only the FTLD subjects and not Alzheimer's disease, CBS or PSP groups, were able to spontaneously self-correct anti-saccade errors as well as controls. Receiver operating characteristic statistics demonstrated that oculomotor findings were superior to neuropsychological tests in differentiating PSP from other disorders, and comparable to neuropsychological tests in differentiating the other patient groups. These data suggest that oculomotor assessment may aid in the diagnosis of FTLD and related disorders.
额颞叶变性（FTLD）在临床上常与皮质基底节综合征（CBS）和进行性核上性麻痹（PSP）重叠，后两者均有明显的眼球运动异常。为了研究眼球运动表现区分FTLD、阿尔茨海默病、CBS和PSP的能力，对三种FTLD亚型进行了扫视和平稳跟踪测量，包括24例额颞叶痴呆（FTD）患者、19例语义性痴呆（SD）患者和6例进行性非流利性失语（PA）患者，并与28例阿尔茨海默病患者、15例CBS患者、10例PSP患者以及27名对照者进行比较。除SD外，所有临床综合征均发现了不同组合的眼球运动异常，SD患者的眼球运动表现与年龄匹配的对照者无差异。只有PSP患者的扫视速度异常，而扫视增益异常在PSP患者中比CBS患者中更常见，在CBS患者中又比阿尔茨海默病患者中更常见。除SD患者组外，所有患者组在反扫视任务中均受损，然而只有FTLD患者组而非阿尔茨海默病、CBS或PSP患者组能够像对照者一样自发地自我纠正反扫视错误。受试者工作特征统计显示，眼球运动检查结果在区分PSP与其他疾病方面优于神经心理学测试，在区分其他患者组方面与神经心理学测试相当。这些数据表明，眼球运动评估可能有助于FTLD及相关疾病的诊断。
