Yousef Andrew, Devereux Michael, Gourraud Pierre-Antoine, Jonzzon Soren, Suleiman Leena, Waubant Emmanuelle, Green Ari, Graves Jennifer S
1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
2 Université de Nantes, INSERM, Centre de Recherche en Transplantation et Immunologie, Nantes, France.
J Child Neurol. 2019 Jan;34(1):38-43. doi: 10.1177/0883073818807787. Epub 2018 Nov 21.
Efferent visual dysfunction in children could lead to impaired quality of life at home and school. Eye-tracking can detect subtle efferent dysfunction missed on bedside examination but has not been validated in the pediatric multiple sclerosis population.
We sought to determine the feasibility of eye-tracking in children and associations with multiple sclerosis.
Participants meeting criteria for pediatric multiple sclerosis without acute efferent vision abnormalities and healthy controls were recruited. Multiple sclerosis participants underwent a clinical assessment and saccade and antisaccade testing paradigms. Intraclass correlation coefficients were generated for intertest repeatability. Adjusting for age and intereye correlations, generalized estimating equations compared latencies with case status, Expanded Disability Status Scale and Symbol Digit Modalities Test (SDMT) scores.
We eye-tracked 15 children with multiple sclerosis (n = 30 eyes, mean age 15.6 ± 2.1, mean disease duration 3.9 years, median Expanded Disability Status Scale 1.5) compared to 6 healthy controls (n = 12 eyes, age 14.3 ± .95). The intraclass correlation coefficient for repeated trials was 0.85. Adjusting for age, saccadic latency was 60 milliseconds (ms) longer for cases than controls (95% confidence interval = 26.4, 93.8; P = .0005). For antisaccadic latency, we observed a similar trend of 60 ms longer for cases than controls ( P = .06).
Eye-tracking is a short noninvasive examination, and high intertest repeatability supports use of eye-tracking technology in pediatric multiple sclerosis. Longer saccadic latencies were seen in children with multiple sclerosis despite short disease duration and low Expanded Disability Status Scale scores.
儿童传出性视觉功能障碍可导致家庭和学校生活质量受损。眼动追踪可检测到床边检查遗漏的细微传出性功能障碍，但尚未在儿童多发性硬化症人群中得到验证。
我们旨在确定眼动追踪在儿童中的可行性以及与多发性硬化症的关联。
招募符合儿童多发性硬化症标准且无急性传出性视力异常的参与者以及健康对照。多发性硬化症参与者接受了临床评估、扫视和反扫视测试范式。生成类内相关系数以评估测试间的可重复性。在调整年龄和两眼相关性后，广义估计方程比较了反应潜伏期与病例状态、扩展残疾状态量表和符号数字模态测试（SDMT）分数。
我们对15名患有多发性硬化症的儿童（n = 30只眼，平均年龄15.6 ± 2.1岁，平均病程3.9年，扩展残疾状态量表中位数1.5）进行了眼动追踪，与6名健康对照（n = 12只眼，年龄14.3 ± 0.95岁）进行比较。重复试验的类内相关系数为0.85。调整年龄后，病例组的扫视潜伏期比对照组长60毫秒（ms）（95%置信区间 = 26.4，93.8；P = .0005）。对于反扫视潜伏期，我们观察到病例组比对照组长60 ms的类似趋势（P = .06）。
眼动追踪是一种简短的非侵入性检查，高测试间重复性支持在儿童多发性硬化症中使用眼动追踪技术。尽管病程短且扩展残疾状态量表分数低，但多发性硬化症儿童的扫视潜伏期更长。
