Wu Chao, Chen Ding-Bang, Feng Li, Zhou Xiang-Xue, Zhang Ji-Wei, You Hua-Jing, Liang Xiu-Ling, Pei Zhong, Li Xun-Hua
Department of Neurology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory for Diagnosis and Treatment of Major Neurological Diseases, Guangzhou, Guangdong, China.
CNS Neurosci Ther. 2017 Apr;23(4):321-328. doi: 10.1111/cns.12676. Epub 2017 Feb 13.
To detect specific oculomotor deficits in preclinical stage of spinocerebellar ataxia type 3 (SCA3) and evaluate whether these abnormalities prove useful as potential biomarkers of disease progression.
A Chinese cohort of 56 patients with SCA3, including 12 preclinical carriers of SCA3 (pre-SCA3) and 44 manifest SCA3, and 26 healthy control individuals were recruited. We performed a detailed investigation on central oculomotor performance including fixation, gaze, smooth pursuit, prosaccade, and antisaccade using video-oculography.
Common oculomotor features of pre-SCA3 included square-wave jerk during central fixation and gaze holding, impaired vertical smooth pursuit, slow upward saccade, and increased antisaccade error rate. In our SCA3 cohort, all oculomotor parameters were correlated with the score of the Scale for the Assessment and Rating of Ataxia, whilst some of them were correlated with disease duration.
This study showed that a series of neuropathological changes reflected by oculomotor abnormalities appeared preferentially in preclinical stage of SCA3. Accordingly, objective oculomotor preclinical signs may be useful to detect the optimum time-point for therapeutic interventions in future clinical trials of SCA3. Larger and longitudinal data are warranted to confirm our results.
检测3型脊髓小脑共济失调(SCA3)临床前期特定的动眼神经缺陷,并评估这些异常是否可作为疾病进展的潜在生物标志物。
招募了一个中国队列,其中包括56例SCA3患者,其中12例为SCA3临床前携带者(pre-SCA3),44例为显性SCA3患者,以及26名健康对照个体。我们使用视频眼动图对包括注视、凝视、平稳跟踪、前扫视和反扫视在内的中枢动眼神经功能进行了详细研究。
pre-SCA3的常见动眼神经特征包括中央注视和凝视保持期间的方波急跳、垂直平稳跟踪受损、向上扫视缓慢以及反扫视错误率增加。在我们的SCA3队列中,所有动眼神经参数均与共济失调评估和评分量表得分相关,其中一些参数与疾病持续时间相关。
本研究表明,动眼神经异常所反映的一系列神经病理学变化优先出现在SCA3的临床前期。因此,客观的动眼神经临床前体征可能有助于在未来SCA3的临床试验中检测治疗干预的最佳时间点。需要更大规模的纵向数据来证实我们的结果。