Leśniak Marcin, Członkowska Anna, Seniów Joanna
2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
Mov Disord. 2008 Oct 30;23(14):2067-73. doi: 10.1002/mds.22276.
Neurological symptoms in Wilson's disease (WD) may include oculomotor abnormalities. However, to date, eye movements in WD patients were rarely investigated and the data concerning this issue are sparse. The purpose of this study was to evaluate reflexive and voluntary eye movements in WD patients. We examined horizontal saccadic and smooth pursuit eye movements using infra-red oculography in 50 WD patients, including 29 neurologically symptomatic (WDn) and 21 asymptomatic ones (WDa), and in 29 healthy controls. We found statistically significant increase in mean antisaccadic latency (378 ms) and in mean antisaccadic error rate (22.5) in the WDn group, when compared with WDa group (317 ms and 9.1, respectively) and controls (318 ms and 9.7, respectively). In contrast, there were no statistically significant differences in mean latency of prosaccades and in size of the gap effect. Patients with neurological manifestations had also abnormal smooth pursuit-increased number of saccadic intrusions (mean: 8.6) and decreased gain (mean: 0.69) comparing with WDa patients (4.1 and 0.83, respectively) and controls (2.2 and 0.91, respectively). The data suggest that WD is associated both with impairment of voluntary control of saccades and with disturbed smooth pursuit eye movements while reflexive saccades seem to be preserved.
威尔逊病（WD）的神经症状可能包括眼球运动异常。然而，迄今为止，WD患者的眼动情况很少被研究，关于这个问题的数据也很稀少。本研究的目的是评估WD患者的反射性和自主性眼动。我们使用红外眼动仪检查了50例WD患者（包括29例有神经症状的患者（WDn）和21例无症状患者（WDa））以及29名健康对照者的水平扫视和平稳跟踪眼动。我们发现，与WDa组（平均反扫视潜伏期分别为317毫秒，错误率为9.1）和对照组（平均反扫视潜伏期分别为318毫秒，错误率为9.7）相比，WDn组的平均反扫视潜伏期（378毫秒）和平均反扫视错误率（22.5）有统计学意义的增加。相比之下，顺向扫视的平均潜伏期和差距效应的大小没有统计学意义上的差异。与WDa患者（分别为4.1和0.83）和对照组（分别为2.2和0.91）相比，有神经表现的患者的平稳跟踪也异常，扫视侵入次数增加（平均：8.6），增益降低（平均：0.69）。数据表明，WD与扫视的自主控制受损和平稳跟踪眼动障碍有关，而反射性扫视似乎保留。
