眨眼反射恢复循环的不对称指数可区分帕金森病与非典型帕金森综合征。
Asymmetry index of Blink Reflex Recovery Cycle differentiates Parkinson's disease from atypical Parkinsonian syndromes.
机构信息
Department of Medical, Surgical Sciences and Advanced Technologies GF Ingrassia, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
Section of Pharmacology, Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
出版信息
J Neurol. 2020 Jun;267(6):1859-1863. doi: 10.1007/s00415-020-09900-6. Epub 2020 May 11.
BACKGROUND
Differential diagnosis between Parkinson's disease (PD) and atypical Parkinsonian syndromes (APS), such as multiple system atrophy (MSA) and progressive supranuclear palsy (PSP), is often difficult because of overlap of common clinical features. We evaluated R2 Blink Reflex Recovery Cycle (R2BRRC) in drug-naive PD patients and in MSA and PSP patients to differentiate early PD from APS.
METHODS
We investigated 43 patients: 15 drug-naive PD patients, 16 MSA patients, and 12 PSP patients. R2BRRC was evaluated bilaterally at interstimulus intervals (ISIs) of 100, 150, 200, 300, 400, 500, and 750 ms. An asymmetry index (AI) of R2BRRC for each ISI was computed.
RESULTS
R2BRRC of PD patients showed an increased brainstem excitability for less affected side (LAS) stimulation at ISIs of 100, 150, 200 (p < 0.001), and 300 ms (p = 0.03) compared to more affected side (MAS) stimulation, whereas no differences between LAS and MAS stimulation were found in APS. AI of 0.87 at ISI of 100 ms differentiated PD from MSA with a sensitivity of 86.7% and a specificity of 100%, whereas AI of 0.78 at ISI of 100 ms permitted to discriminate PD from PSP with a sensitivity of 86.7% and a specificity of 91.7%.
CONCLUSION
AI of R2BRRC may represent a reliable tool in differentiating PD from APS, especially at the early stage of the disease.
背景
由于常见临床特征的重叠，帕金森病 (PD) 和非典型帕金森综合征 (APS) 之间的鉴别诊断（如多系统萎缩症 [MSA] 和进行性核上性麻痹 [PSP]）通常较为困难。我们评估了未经药物治疗的 PD 患者、MSA 患者和 PSP 患者的 R2 眨眼反射恢复循环 (R2BRRC)，以区分早期 PD 和 APS。
方法
我们研究了 43 名患者：15 名未经药物治疗的 PD 患者、16 名 MSA 患者和 12 名 PSP 患者。在刺激间隔 (ISI) 为 100、150、200、300、400、500 和 750ms 时，分别双侧评估 R2BRRC。计算每个 ISI 的 R2BRRC 不对称指数 (AI)。
结果
PD 患者的 R2BRRC 显示，在 ISI 为 100、150、200（p<0.001）和 300ms（p=0.03）时，未受影响侧（LAS）刺激的脑干兴奋性增加，而在 APS 中，LAS 和 MAS 刺激之间没有差异。在 ISI 为 100ms 时，AI 为 0.87 可将 PD 与 MSA 区分开来，其敏感性为 86.7%，特异性为 100%，而在 ISI 为 100ms 时，AI 为 0.78 可将 PD 与 PSP 区分开来，其敏感性为 86.7%，特异性为 91.7%。
结论
R2BRRC 的 AI 可能是区分 PD 和 APS 的可靠工具，尤其是在疾病的早期阶段。
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