Department of Medicine, University of Otago Christchurch, 2 Riccarton Avenue, Christchurch 8011, New Zealand. tim.anderson@ otago.ac.nz
Nat Rev Neurol. 2013 Feb;9(2):74-85. doi: 10.1038/nrneurol.2012.273. Epub 2013 Jan 22.
The neural pathways and brain regions involved in eye movements during ocular fixation and gaze control include the cerebrum, brainstem and cerebellum, and abnormal eye movements can indicate the presence of neurodegeneration. In some patients, oculomotor signs are key to making a diagnosis. Careful clinical examination of eye movements in patients with neurodegenerative disorders is, therefore, an invaluable adjunct to neurological and cognitive assessments. Eye movement recordings in the laboratory are generally not necessary for diagnostic purposes, but can be a useful addition to the clinical examination. Laboratory recordings of eye movements can provide valuable information about disease severity, progression or regression in neurodegenerative disease, and hold particular promise for objective evaluation of the efficacy of putative neuroprotective and neurorestorative therapies. For example, aspects of saccade performance can be tested to probe both motor and cognitive aspects of oculomotor behaviour. This Review describes the oculomotor features of the major age-related movement disorders, including Parkinson disease, Huntington disease, dementia and other neurodegenerative disorders. Findings in presymptomatic individuals and changes associated with disease progression are discussed.
眼球固定和凝视控制期间涉及眼球运动的神经通路和脑区包括大脑、脑干和小脑，异常眼球运动可表明存在神经退行性变。在一些患者中，眼动体征是做出诊断的关键。因此，仔细检查神经退行性疾病患者的眼球运动是对神经和认知评估的宝贵补充。出于诊断目的，实验室中的眼球运动记录通常不是必需的，但可以作为临床检查的有益补充。实验室中的眼球运动记录可提供有关神经退行性疾病中疾病严重程度、进展或消退的有价值信息，并且对客观评估潜在神经保护和神经修复治疗的疗效具有特别的意义。例如，可以测试眼跳表现的各个方面，以探究眼球运动行为的运动和认知方面。本综述描述了主要与年龄相关的运动障碍的眼球运动特征，包括帕金森病、亨廷顿病、痴呆和其他神经退行性疾病。讨论了在症状前个体中的发现以及与疾病进展相关的变化。
