Buhmann Carsten, Kraft Stefanie, Hinkelmann Kim, Krause Sven, Gerloff Christian, Zangemeister Wolfgang H
Department of Neurology, University Clinic Hamburg-Eppendorf, Hamburg, Germany.
Eur Neurol. 2015;73(5-6):283-93. doi: 10.1159/000381335. Epub 2015 Apr 24.
In patients with Parkinson's disease (PD) we aimed at differentiating the relation between selective visual attention, deficits of programming and dynamics of saccadic eye movements while searching for a target and hand-reaction time as well as hand-movement time. Visual attention is crucial for concentrating selectively on one aspect of the visual field while ignoring other aspects. Eye movements are anatomically and functionally related to mechanisms of visual attention. Saccadic dysfunction might confound selective visual attention in PD.
We studied visual selective attention in 22 medicated PD patients (clinical ON status, mild to moderate disease severity) and 22 age matched controls. We looked for possible interferences through oculomotor deficits. Two tasks were compared: free viewing of photographs and time optimal visual search of a hidden target. Visual search times (VST), task related dynamics of saccades, and hand-reaction and hand-movement times were analyzed.
In the free viewing task mild to moderately affected PD patients did not differ statistically from healthy subjects with respect to saccade dynamics. However, patients differed significantly from healthy subjects in the time optimal visual search task with 25% lower rates of successful searches. Hand movement reaction time did not differ in both groups, whereas hand movement execution time was significantly prolonged in PD patients.
Saccadic oculomotor control and hand movement reaction times were intact, whereas in our less severely affected treated PD patients, visual selective attention was not. The highly reduced successful search rate might be related to disturbed programming and delayed execution of saccades during time optimal visual search due to decreased execution of serial-order sequential generation of saccades.
在帕金森病（PD）患者中，我们旨在区分选择性视觉注意力、扫视眼动的编程和动力学缺陷与寻找目标时的手部反应时间以及手部运动时间之间的关系。视觉注意力对于有选择地专注于视野的一个方面而忽略其他方面至关重要。眼球运动在解剖学和功能上与视觉注意力机制相关。扫视功能障碍可能会混淆PD患者的选择性视觉注意力。
我们研究了22名接受药物治疗的PD患者（临床开期状态，疾病严重程度为轻度至中度）和22名年龄匹配的对照组的视觉选择性注意力。我们寻找动眼神经缺陷可能产生的干扰。比较了两项任务：自由观看照片和对隐藏目标进行时间最优视觉搜索。分析了视觉搜索时间（VST）、与任务相关的扫视动力学以及手部反应时间和手部运动时间。
在自由观看任务中，轻度至中度受影响的PD患者在扫视动力学方面与健康受试者无统计学差异。然而，在时间最优视觉搜索任务中，患者与健康受试者有显著差异，成功搜索率低25%。两组的手部运动反应时间无差异，而PD患者的手部运动执行时间显著延长。
扫视动眼神经控制和手部运动反应时间是完整的，而在我们受影响较轻的接受治疗的PD患者中，视觉选择性注意力并非如此。成功搜索率的大幅降低可能与时间最优视觉搜索期间扫视的编程紊乱和执行延迟有关，这是由于扫视序列顺序生成的执行减少所致。
