Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, South Korea.
Department of Neurology, Kyungpook National University School of Medicine, Daegu, 41404, South Korea.
Parkinsonism Relat Disord. 2019 Aug;65:234-237. doi: 10.1016/j.parkreldis.2019.05.003. Epub 2019 May 5.
Although autonomic dysfunction is the prominent clinical feature in multiple system atrophy (MSA), little is known about the pupillary autonomic aspect of MSA. We aimed to evaluate pupillary autonomic function in MSA patients using dynamic pupillometry, which can quantify the pupillary light reflex.
Dynamic pupillometry parameters were compared in 21 MSA patients and 21 healthy controls. Pupillometric parameters were correlated with total Unified Multiple System Atrophy Rating Scale (UMSARS) scores and autonomic symptom severity.
Average constriction (p = 0.034) and dilation (p = 0.003) velocities were significantly slowed in MSA patients compared with controls. Total UMSARS correlated with the average constriction (r = -0.527, p = 0.017) and maximum constriction (r = -0.658, p = 0.003) velocities. Autonomic symptom severity correlated with average constriction (r = -0.544, p = 0.013), maximum constriction (r = -0.607, p = 0.005) and average dilation (r = -0.499, p = 0.025) velocities.
Dynamic pupillometry may provide useful information about pupillary autonomic dysfunction, which correlated with the clinical severity, in patients with MSA.
尽管自主神经功能障碍是多系统萎缩（MSA）的突出临床特征，但对 MSA 的瞳孔自主方面知之甚少。我们旨在使用可量化瞳孔光反射的动态瞳孔测量法评估 MSA 患者的瞳孔自主功能。
比较了 21 例 MSA 患者和 21 例健康对照者的动态瞳孔测量参数。瞳孔测量参数与总统一多系统萎缩评定量表（UMSARS）评分和自主症状严重程度相关。
与对照组相比，MSA 患者的平均收缩（p=0.034）和扩张（p=0.003）速度明显减慢。总 UMSARS 与平均收缩（r=-0.527，p=0.017）和最大收缩（r=-0.658，p=0.003）速度相关。自主症状严重程度与平均收缩（r=-0.544，p=0.013）、最大收缩（r=-0.607，p=0.005）和平均扩张（r=-0.499，p=0.025）速度相关。
动态瞳孔测量法可能为 MSA 患者的瞳孔自主功能障碍提供有用信息，且与临床严重程度相关。
