Hipp Géraldine, Diederich Nico J, Pieria Vannina, Vaillant Michel
Department of Neurology, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg.
Department of Neurology, Centre Hospitalier de Luxembourg, Luxembourg-City, Luxembourg; Luxembourg Centre for Systems Biomedicine, University of Luxembourg, Esch-Belval, Luxembourg.
J Neurol Sci. 2014 Mar 15;338(1-2):178-82. doi: 10.1016/j.jns.2013.12.047. Epub 2014 Jan 9.
In early stages of idiopathic Parkinson's disease (IPD), lower order vision (LOV) deficits including reduced colour and contrast discrimination have been consistently reported. Data are less conclusive concerning higher order vision (HOV) deficits, especially for facial emotion recognition (FER). However, a link between both visual levels has been hypothesized.
To screen for both levels of visual impairment in early IPD.
We prospectively recruited 28 IPD patients with disease duration of 1.4+/-0.8 years and 25 healthy controls. LOV was evaluated by Farnsworth-Munsell 100 Hue Test, Vis-Tech and Pelli-Robson test. HOV was examined by the Ekman 60 Faces Test and part A of the Visual Object and Space recognition test.
IPD patients performed worse than controls on almost all LOV tests. The most prominent difference was seen for contrast perception at the lowest spatial frequency (p=0.0002). Concerning FER IPD patients showed reduced recognition of "sadness" (p=0.01). "Fear" perception was correlated with perception of low contrast sensitivity in IPD patients within the lowest performance quartile. Controls showed a much stronger link between "fear" perception" and low contrast detection.
At the early IPD stage there are marked deficits of LOV performances, while HOV performances are still intact, with the exception of reduced recognition of "sadness". At this stage, IPD patients seem still to compensate the deficient input of low contrast sensitivity, known to be pivotal for appreciation of negative facial emotions and confirmed as such for healthy controls in this study.
在特发性帕金森病（IPD）的早期阶段，一直有报道称存在包括颜色和对比度辨别能力下降在内的低阶视觉（LOV）缺陷。关于高阶视觉（HOV）缺陷的数据尚无定论，尤其是面部情绪识别（FER）方面。然而，有人推测这两个视觉水平之间存在联系。
筛查早期IPD患者的两个视觉水平的损伤情况。
我们前瞻性招募了28例病程为1.4±0.8年的IPD患者和25名健康对照者。通过Farnsworth-Munsell 100色相测试、Vis-Tech测试和佩利-罗布森测试评估低阶视觉。通过埃克曼60张面部表情测试和视觉物体与空间识别测试的A部分检查高阶视觉。
在几乎所有低阶视觉测试中，IPD患者的表现均比对照组差。在最低空间频率下的对比度感知方面差异最为显著（p = 0.0002）。关于面部情绪识别，IPD患者对“悲伤”表情的识别能力下降（p = 0.01）。在表现最差的四分位数范围内，IPD患者中“恐惧”感知与低对比度敏感度感知相关。对照组中“恐惧”感知与低对比度检测之间的联系更为紧密。
在IPD早期阶段，低阶视觉表现存在明显缺陷，而高阶视觉表现除了对“悲伤”表情的识别能力下降外仍保持完好。在这个阶段，IPD患者似乎仍在补偿低对比度敏感度的不足输入，低对比度敏感度已知对负面面部情绪的感知至关重要，本研究中健康对照者也证实了这一点。
