Sun Liang, Chan Piu
Department of Neurology, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Department of Neurobiology and Neurology, Xuanwu Hospital of Capital MedicalUniversity, Beijing, China.
Department of Neurobiology and Neurology, Xuanwu Hospital of Capital MedicalUniversity, Beijing, China; National Clinical Research Center for Geriatric Disorders, Beijing, China.
Clin Neurol Neurosurg. 2018 Jun;169:174-177. doi: 10.1016/j.clineuro.2018.04.016. Epub 2018 Apr 22.
Visual dysfunctions are frequent and have several manifestations in idiopathic Parkinson's disease (PD). However, the characteristics of these complications in LRRK2 (leucine-rich kinase 2)-associated PD patients still lack systematic research. The purpose of this study is to assess visual functions of LRRK2-associated PD patients.
Twenty-five (25) PD patients with LRRK2 R1628P and G2385R variants were included in the study and compared to 28 PD patients without these variants and 28 age-matched healthy controls. The genotypes of PD patients were kept double-blinded. Information on age, sex, disease duration, the movement disorder society-unified Parkinson's disease rating scale (MDS-UPDRS), Hoehn and Yahr staging scale (H&Y), Mini-Mental Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were included. Visual functions assessment included color perception, contrast sensitivity and stereopsis.
PD patients with or without LRRK2 R1628P and G2385R variants have declined contrast sensitivity, diminished color discrimination and damaged stereopsis. There was no significant difference in retinal level visual deficiency (color discrimination and contrast sensitivity) between PD with LRRK2 variants and those without, but cortex level visual function, i.e. stereopsis is better in PD with LRRK2 variants than non-carrier PD patients. The associated factors of stereopsis are different. The stereopsis is associated with MoCA scores independently in non-carrier PD patients, but with UPDRSIII scores in LRRK2-associated PD patients.
Visual functions are similarly affected in PD patients with and without LRRK2 R1628P and G2385R variants, but LRRK2-associated PD patients have better stereopsis than idiopathic PD patients.
视觉功能障碍在特发性帕金森病(PD)中很常见且有多种表现。然而,LRRK2(富含亮氨酸激酶2)相关的PD患者中这些并发症的特征仍缺乏系统研究。本研究的目的是评估LRRK2相关PD患者的视觉功能。
本研究纳入了25例携带LRRK2 R1628P和G2385R变异的PD患者,并与28例无这些变异的PD患者以及28例年龄匹配的健康对照进行比较。PD患者的基因型保持双盲。纳入了年龄、性别、病程、运动障碍协会统一帕金森病评定量表(MDS-UPDRS)、霍恩和雅尔分期量表(H&Y)、简易精神状态检查(MMSE)和蒙特利尔认知评估(MoCA)等信息。视觉功能评估包括颜色感知、对比敏感度和立体视觉。
携带或不携带LRRK2 R1628P和G2385R变异的PD患者对比敏感度均下降、颜色辨别能力减弱且立体视觉受损。携带LRRK2变异的PD患者与未携带变异的PD患者在视网膜水平的视觉缺陷(颜色辨别和对比敏感度)方面无显著差异,但皮质水平的视觉功能,即立体视觉在携带LRRK2变异的PD患者中比非携带者PD患者更好。立体视觉的相关因素不同。在非携带者PD患者中,立体视觉与MoCA评分独立相关,但在LRRK2相关的PD患者中与UPDRSIII评分相关。
携带和不携带LRRK2 R1628P和G2385R变异的PD患者视觉功能受到类似影响,但LRRK2相关的PD患者比特发性PD患者具有更好的立体视觉。