Leyland Louise-Ann, Bremner Fion D, Mahmood Ribeya, Hewitt Sam, Durteste Marion, Cartlidge Molly R E, Lai Michelle M-M, Miller Luke E, Saygin Ayse P, Keane Pearse A, Schrag Anette E, Weil Rimona S
Dementia Research Centre (L-AL, RM, RSW), Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology (FDB, MM-ML), National Hospital for Neurology and Neurosurgery, University College London Hospitals, London, United Kingdom; Institute of Neurology (SH, MD, MREC), University College London, UCL, United Kingdom; School of Biomedical Sciences (MREC), Biological Sciences, Leeds University, United Kingdom; ImpAct (LEM), Lyon Neuroscience Research Center, France; Department of Cognitive Science (APS), University of California, San Diego; Kavli Institute for Brain and Mind (APS), University of California, San Diego; Institute of Ophthalmology (PAK), UCL, United Kingdom; Moorfields Eye Hospital (PAK), London, United Kingdom; Department of Clinical Neuroscience (AES), Institute of Neurology, UCL Hampstead Campus, London, United Kingdom; Movement Disorders Consortium (AES, RSW), UCL, United Kingdom; and The Wellcome Centre for Human Neuroimaging (RSW), Institute of Neurology, University College London, United Kingdom.
Neurol Clin Pract. 2020 Feb;10(1):29-39. doi: 10.1212/CPJ.0000000000000719.
To assess the role of visual measures and retinal volume to predict the risk of Parkinson disease (PD) dementia.
In this cohort study, we collected visual, cognitive, and motor data in people with PD. Participants underwent ophthalmic examination, retinal imaging using optical coherence tomography, and visual assessment including acuity and contrast sensitivity and high-level visuoperception measures of skew tolerance and biological motion. We assessed the risk of PD dementia using a recently described algorithm that combines age at onset, sex, depression, motor scores, and baseline cognition.
One hundred forty-six people were included in the study (112 with PD and 34 age-matched controls). The mean disease duration was 4.1 (±2·5) years. None of these participants had dementia. Higher risk of dementia was associated with poorer performance in visual measures (acuity: ρ = 0.29, = 0.0024; contrast sensitivity: ρ = -0.37, < 0.0001; skew tolerance: ρ = -0.25, = 0.0073; and biological motion: ρ = -0.26, = 0.0054). In addition, higher risk of PD dementia was associated with thinner retinal structure in layers containing dopaminergic cells, measured as ganglion cell layer (GCL) and inner plexiform layer (IPL) thinning (ρ = -0.29, = 0.0021; ρ = -0.33, = 0.00044). These relationships were not seen for the retinal nerve fiber layer that does not contain dopaminergic cells and were not seen in unaffected controls.
Visual measures and retinal structure in dopaminergic layers were related to risk of PD dementia. Our findings suggest that visual measures and retinal GCL and IPL volumes may be useful to predict the risk of dementia in PD.
评估视觉测量指标和视网膜体积在预测帕金森病（PD）痴呆风险中的作用。
在这项队列研究中，我们收集了帕金森病患者的视觉、认知和运动数据。参与者接受了眼科检查、使用光学相干断层扫描的视网膜成像，以及包括视力、对比敏感度和斜视耐受性及生物运动等高级视觉感知测量的视觉评估。我们使用一种最近描述的算法评估帕金森病痴呆风险，该算法结合了发病年龄、性别、抑郁、运动评分和基线认知情况。
146人纳入研究（112例帕金森病患者和34例年龄匹配的对照）。平均病程为4.1（±2.5）年。这些参与者均无痴呆。痴呆风险较高与视觉测量指标表现较差相关（视力：ρ = 0.29，P = 0.0024；对比敏感度：ρ = -0.37，P < 0.0001；斜视耐受性：ρ = -0.25，P = 0.0073；生物运动：ρ = -0.26，P = 0.0054）。此外，帕金森病痴呆风险较高与含有多巴胺能细胞的层中视网膜结构变薄有关，以神经节细胞层（GCL）和内网状层（IPL）变薄衡量（ρ = -0.29，P = 0.0021；ρ = -0.33，P = 0.00044）。对于不含多巴胺能细胞的视网膜神经纤维层，未观察到这些关系，在未受影响的对照中也未观察到。
多巴胺能层的视觉测量指标和视网膜结构与帕金森病痴呆风险相关。我们的研究结果表明，视觉测量指标以及视网膜GCL和IPL体积可能有助于预测帕金森病患者的痴呆风险。
