Panyakaew Pattamon, Anan Chanawat, Bhidayasiri Roongroj
Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand.
Chulalongkorn Center of Excellence on Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles 90095, USA.
J Neurol Sci. 2015 Feb 15;349(1-2):214-9. doi: 10.1016/j.jns.2015.01.022. Epub 2015 Jan 27.
Postural instability is often experienced in the late stages of PD and is a marker of disease progression. Little information is available on the role of visual inputs as an adaptive strategy to compensate for postural instability in PD. The purpose of this study was to determine visual dependency for postural control in early PD.
Thirty early PD subjects without postural complaints and 30 matched controls were evaluated for subtle postural instability using static posturography under eyes opened and eyes closed conditions.
No significant differences between groups were observed under eyes opened condition. In eyes closed condition, there was significantly greater mean sway in the mediolateral direction (p=0.01), mean sway velocity (p=0.03), lateral sway velocity (p=0.04), and sway area (p=0.04) in PD than in the control subjects. 95% confidence ellipse of mean sway was largest in PD patients with eyes closed. A strong and significant correlation was observed between disease duration and mean mediolateral sway, sway area, mean sway and lateral sway velocity, and a moderate correlation was shown between Hoehn & Yahr stage and mean mediolateral sway, and sway area.
Our findings suggest that visual dependency exists in early PD and visual deprivation task can help identify subclinical postural instability.
姿势不稳常在帕金森病(PD)晚期出现,是疾病进展的一个标志。关于视觉输入作为一种补偿PD姿势不稳的适应性策略的作用,目前所知甚少。本研究的目的是确定早期PD患者姿势控制对视觉的依赖程度。
对30名无姿势主诉的早期PD患者和30名匹配的对照组进行评估,在睁眼和闭眼条件下使用静态姿势描记法检测细微的姿势不稳情况。
在睁眼条件下,两组之间未观察到显著差异。在闭眼条件下,PD患者在内外侧方向的平均摆动(p = 0.01)、平均摆动速度(p = 0.03)、外侧摆动速度(p = 0.04)和摆动面积(p = 0.04)均显著大于对照组。PD患者闭眼时平均摆动的95%置信椭圆最大。病程与平均内外侧摆动、摆动面积、平均摆动和外侧摆动速度之间存在强且显著的相关性,Hoehn & Yahr分期与平均内外侧摆动和摆动面积之间存在中度相关性。
我们的研究结果表明,早期PD存在视觉依赖,视觉剥夺任务有助于识别亚临床姿势不稳。