Hainline Clotilde, Rizzo John-Ross, Hudson Todd E, Dai Weiwei, Birkemeier Joel, Raynowska Jenelle, Nolan Rachel C, Hasanaj Lisena, Selesnick Ivan, Frohman Teresa C, Frohman Elliot M, Galetta Steven L, Balcer Laura J, Rucker Janet C
Department of Neurology, New York University School of Medicine, 240 East 38th Street, 20th Floor, New York, NY, 10016, USA.
Department of Rehabilitation Medicine, New York University School of Medicine, New York, NY, USA.
J Neurol. 2017 May;264(5):989-998. doi: 10.1007/s00415-017-8484-1. Epub 2017 Apr 7.
The King-Devick (K-D) test of rapid number naming is a visual performance measure that captures saccadic eye movements. Patients with multiple sclerosis (MS) have slowed K-D test times associated with neurologic disability and reduced quality of life. We assessed eye movements during the K-D test to identify characteristics associated with slowed times. Participants performed a computerized K-D test with video-oculography. The 25-Item National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) and its 10-Item Neuro-Ophthalmic Supplement measured vision-specific quality of life (VSQOL). Among 25 participants with MS (age 37 ± 10 years, range 20-59) and 42 controls (age 33 ± 9 years, range 19-54), MS was associated with significantly longer (worse) K-D times (58.2 ± 19.8 vs. 43.8 ± 8.6 s, P = 0.001, linear regression models, accounting for age). In MS, test times were slower among patients with higher (worse) Expanded Disability Status Scale scores (P = 0.01). Average inter-saccadic intervals (ISI) were significantly longer in MS participants compared to controls (362 ± 103 vs. 286 ± 50 ms, P = 0.001), and were highly associated with prolonged K-D times in MS (P = 0.006). MS participants generated greater numbers of saccades (P = 0.007). VSQOL scores were reduced in MS patients with longer (worse) K-D times (P = 0.04-0.001) and longer ISI (P = 0.002-0.001). Patients with MS have slowed K-D times that may be attributable to prolonged ISI and greater numbers of saccades. The K-D test and its requisite eye movements capture VSQOL and make rapid number naming a strong candidate efferent visual performance measure in MS.
King-Devick（K-D）快速数字命名测试是一种视觉表现测量方法，可捕捉眼球的扫视运动。多发性硬化症（MS）患者的K-D测试时间延长，这与神经功能障碍及生活质量下降有关。我们评估了K-D测试期间的眼球运动，以确定与测试时间延长相关的特征。参与者通过视频眼动图进行计算机化K-D测试。采用25项国家眼科研究所视觉功能问卷（NEI-VFQ-25）及其10项神经眼科补充问卷来测量特定视力相关生活质量（VSQOL）。在25名MS患者（年龄37±10岁，范围20 - 59岁）和42名对照者（年龄33±9岁，范围19 - 54岁）中，MS与显著更长（更差）的K-D测试时间相关（58.2±19.8秒对43.8±8.6秒，P = 0.001，线性回归模型，校正年龄因素）。在MS患者中，扩展残疾状态量表评分较高（较差）的患者测试时间较慢（P = 0.01）。与对照者相比，MS参与者的平均扫视间隔时间（ISI）显著更长（362±103毫秒对286±50毫秒，P = 0.001），并且与MS患者延长的K-D测试时间高度相关（P = 0.006）。MS参与者产生的扫视次数更多（P = 0.007）。K-D测试时间较长（较差）以及ISI较长的MS患者的VSQOL评分降低（P = 0.04 - 0.001）和（P = 0.002 - 0.001）。MS患者的K-D测试时间延长，这可能归因于ISI延长和扫视次数增加。K-D测试及其所需的眼球运动可反映VSQOL，使快速数字命名成为MS中一种强有力的传出视觉表现测量指标。
