Fielding Joanne, Kilpatrick Trevor, Millist Lynette, White Owen
Centre for Neuroscience, University of Melbourne, Parkville, Victoria, Australia.
J Neurol Sci. 2009 Feb 15;277(1-2):32-6. doi: 10.1016/j.jns.2008.10.001. Epub 2008 Nov 1.
Ocular motor abnormalities are frequently reported in Multiple Sclerosis (MS), the most salient of which are well represented by the commonly used clinical measure, the EDSS. However, cognitive function, which is poorly represented by this scale, may also be ascertained from ocular motor measures, suggesting that an analysis of eye movements has the potential to extend and complement this more conventional measure. The generation of single and triple-step memory-guided saccades was investigated in 25 individuals with MS and a comparable number of neurologically healthy individuals matched for age and IQ. Experimental measures were correlated with a battery of neuropsychological tests evaluating attentional, working memory and executive processes, the cognitive domains most commonly compromised in MS. For single memory-guided saccades, MS patients were less accurate and generated more erroneous responses to non-target stimuli. Saccadic latencies were also prolonged. For triple-step memory-guided saccades, MS patients were less accurate and more variable. A number of significant correlations were revealed between measures of each of these characteristics and scores on the range of neuropsychological assessments. These ocular motor measures demonstrate considerable sensitivity with respect to evaluating cognitive function in MS, particularly working memory and inhibitory control processes. This suggests that they could represent the foundation of a user-friendly surrogate marker of disease severity and progression in MS.
眼动异常在多发性硬化症(MS)中经常被报道,其中最显著的异常在常用的临床测量指标扩展残疾状态量表(EDSS)中得到了很好的体现。然而,该量表对认知功能的体现较差,而认知功能也可以通过眼动测量来确定,这表明对眼动的分析有可能扩展和补充这种更为传统的测量方法。研究人员对25名MS患者以及数量相当、年龄和智商匹配的神经健康个体进行了单步和三步记忆引导扫视的研究。实验测量结果与一系列评估注意力、工作记忆和执行过程的神经心理学测试相关,这些认知领域在MS中最常受到损害。对于单步记忆引导扫视,MS患者的准确性较低,对非目标刺激产生的错误反应更多。扫视潜伏期也延长。对于三步记忆引导扫视,MS患者的准确性较低且变异性更大。这些特征的测量结果与一系列神经心理学评估的分数之间存在许多显著的相关性。这些眼动测量结果表明,在评估MS患者的认知功能方面,尤其是工作记忆和抑制控制过程方面,具有相当高的敏感性。这表明它们可能代表了一种易于使用的疾病严重程度和进展替代标志物的基础。