Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.
Vision Science Graduate Group, University of California, Berkeley, Berkeley, CA, USA.
Mult Scler. 2020 Mar;26(3):343-353. doi: 10.1177/1352458519894712. Epub 2020 Feb 7.
Objective tools for prognosis and disease progression monitoring in multiple sclerosis (MS) are lacking. The visuomotor system could be used to track motor dysfunction at the micron scale through the monitoring of fixational microsaccades.
The aim of this study was to evaluate whether microsaccades are correlated with standard MS disability metrics and to assess whether these methods play a predictive role in MS disability.
We used a custom-built retinal eye tracker, the tracking scanning laser ophthalmoscope (TSLO), to record fixation in 111 participants with MS and 100 unaffected controls.
In MS participants, a greater number of microsaccades showed significant association with higher Expanded Disability Status Scale score (EDSS, < 0.001), nine-hole peg test (non-dominant: = 0.006), Symbol Digit Modalities Test (SMDT, = 0.014), and Functional Systems Scores (FSS) including brainstem ( = 0.005), cerebellar ( = 0.011), and pyramidal ( = 0.009). Both brainstem FSS and patient-reported fatigue showed significant associations with microsaccade number, amplitude, and peak acceleration. Participants with MS showed a statistically different average number ( = 0.020), peak vertical acceleration ( = 0.003), and vertical amplitude ( < 0.001) versus controls. Logistic regression models for MS disability were created using TSLO microsaccade metrics and paraclinical tests with ⩾80% accuracy.
Microsaccades provide objective measurements of MS disability level and disease worsening.
多发性硬化症（MS）缺乏预后和疾病进展监测的客观工具。视动系统可以通过监测固视微扫视来跟踪微米级的运动功能障碍。
本研究旨在评估微扫视是否与 MS 残疾标准相关，并评估这些方法在 MS 残疾中的预测作用。
我们使用定制的视网膜眼跟踪器，即跟踪扫描激光检眼镜（TSLO），记录了 111 名 MS 患者和 100 名未受影响的对照者的固视情况。
在 MS 患者中，更多的微扫视与更高的扩展残疾状况量表评分（EDSS，<0.001）、九孔钉测试（非优势手：=0.006）、符号数字模态测试（SMDT，=0.014）以及包括脑干（=0.005）、小脑（=0.011）和锥体（=0.009）在内的功能系统评分有显著相关性。脑干 FSS 和患者报告的疲劳与微扫视数量、幅度和峰值加速度均有显著相关性。MS 患者的平均微扫视数量（=0.020）、垂直峰值加速度（=0.003）和垂直幅度（<0.001）与对照组存在统计学差异。使用 TSLO 微扫视指标和 ⩾80%准确性的临床前测试创建了 MS 残疾的逻辑回归模型。
微扫视为 MS 残疾水平和疾病恶化提供了客观的测量。
