Unité de Recherche Clinique - Centre Mémoire, chef de service Pr Pesce, Centre de Gérontologie Clinique RAINIER III, Centre Hospitalier Princesse Grace, Avenue Pasteur, 98000 Monaco, Monaco.
Unité de Recherche Clinique - Centre Mémoire, chef de service Pr Pesce, Centre de Gérontologie Clinique RAINIER III, Centre Hospitalier Princesse Grace, Avenue Pasteur, 98000 Monaco, Monaco.
Mult Scler Relat Disord. 2020 May;40:101969. doi: 10.1016/j.msard.2020.101969. Epub 2020 Jan 28.
Eye movement abnormalities (EMA) are common in multiple sclerosis (MS). However, type and severity according to the MS stage are poorly known, especially in Radiologically Isolated Syndrome (RIS) and in Clinically Isolated Syndrome (CIS). Although MRI has been included in the MS diagnostic criteria, there may be clinical-radiological dissociation.
To analyze by video-oculography (VOG) prevalence of EMA in different MS phenotypes and study correlations with brain and cervical cord MRI T2 lesions location.
76 participants were prospectively recruited (12 RIS, 10 CIS, 11 relapsing-remitting-MS, 10 secondary progressive-MS, 10 primary progressive MS and 23 gender and age-matched healthy controls). We analyzed fixations, anti-saccades, horizontal and vertical reflex saccades and smooth pursuit.
EMA were frequent and of gradual severity from RIS to progressive forms. Internuclear ophthalmoplegia (INO) and centripetal hypermetria were strong arguments for the diagnosis of a demyelinating disorder versus a control population. Some EMA were linked to infratentorial T2 lesion location, but others like INO were not.
This study confirm that EMA are common in all MS phenotypes, even at the earliest stages. VOG can be useful to detect demyelinating process at preclinical stage by highlighting subclinical EMA even in absence of characteristic lesions visible on MRI.
眼球运动异常（EMA）在多发性硬化症（MS）中很常见。然而，根据 MS 阶段的类型和严重程度知之甚少，特别是在孤立综合征（RIS）和临床孤立综合征（CIS）中。尽管 MRI 已被纳入 MS 的诊断标准，但可能存在临床-放射学分离。
通过视频眼动描记术（VOG）分析不同 MS 表型中 EMA 的患病率，并研究其与脑和颈髓 MRI T2 病变位置的相关性。
前瞻性招募了 76 名参与者（12 名 RIS、10 名 CIS、11 名复发缓解型 MS、10 名继发进展型 MS、10 名原发进展型 MS 和 23 名性别和年龄匹配的健康对照者）。我们分析了注视、反跳、水平和垂直反射性眼球运动和平滑追踪。
EMA 很常见，从 RIS 到进行性形式逐渐加重。核间眼肌麻痹（INO）和向心性超高速是将脱髓鞘疾病与对照组区分开来的有力证据。一些 EMA 与小脑下 T2 病变位置有关，但其他如 INO 则无关。
这项研究证实，EMA 在所有 MS 表型中都很常见，即使在早期阶段也是如此。VOG 可用于通过突出亚临床 EMA 来检测临床前阶段的脱髓鞘过程，即使在 MRI 上没有可见的特征性病变的情况下也是如此。
