解读进行性核上性麻痹的扫视速度曲线：小脑/脑干潜在功能障碍的标志？
Deciphering the saccade velocity profile of progressive supranuclear palsy: A sign of latent cerebellar/brainstem dysfunction?
机构信息
Department of Medical Physiology, School of Medicine, Kyorin University, Tokyo, Japan; Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Department of Neurology, Graduate School of Medicine, University of Tokyo, Tokyo, Japan; Department of Neurology, Kyorin University Hospital, Tokyo, Japan.
出版信息
Clin Neurophysiol. 2022 Sep;141:147-159. doi: 10.1016/j.clinph.2020.12.023. Epub 2021 Feb 3.
OBJECTIVE
To study whether the velocity profile of horizontal saccades could be used as an indicator of brainstem and cerebellar output dysfunction, depending on progressive supranuclear palsy (PSP) subtype.
METHODS
We compared the velocity profiles in 32 PSP patients of various subtypes with 38 age-matched normal subjects, including Richardson syndrome (RS), PSP-parkinsonism (PSPp), and pure akinesia (PAGF), and cerebellar subtypes of PSP (PSPc).
RESULTS
PSP patients showed reduced peak velocity along with increased duration, especially in the deceleration phase. This alteration was more prominent for larger target eccentricities (20-30 degrees), and correlated with disease severity. The changes were most pronounced in PSPc patients, with irregular increases and decreases in velocity profile, followed by RS patients, whereas the change was smaller in PSPp and normal in PAGF patients.
CONCLUSIONS
Saccade velocity profile can be an indicator of brainstem and/or cerebellar output. Altered velocity profile of PSP patients may reflect the pathology in the brainstem, but may also reflect cerebellar dysfunction, most prominently in PSPc.
SIGNIFICANCE
Saccade velocity profile may be used as an indicator of latent cerebellar/brainstem dysfunction.
目的
研究水平性眼球扫视的速度特征能否作为一种指标，用以判断不同的进行性核上性麻痹（PSP）亚型的脑干和小脑输出功能障碍。
方法
我们比较了 32 名各亚型 PSP 患者（包括 Richardson 综合征（RS）、PSP-帕金森综合征（PSPp）和单纯运动不能（PAGF），以及 PSP 的小脑亚型（PSPc））与 38 名年龄匹配的正常受试者的速度特征。
结果
PSP 患者的峰值速度降低，减速阶段的时间延长，特别是在较大的目标偏心率（20-30 度）时更为明显。这种改变与疾病严重程度相关。PSPc 患者的速度特征改变最为明显，呈现不规则的波动，其次是 RS 患者，而 PSPp 患者改变较小，PAGF 患者则正常。
结论
眼球扫视的速度特征可以作为脑干和/或小脑输出的指标。PSP 患者扫视速度特征的改变可能反映了脑干的病理变化，但也可能反映了小脑功能障碍，在 PSPc 中最为明显。
意义
扫视速度特征可能作为一种潜在的小脑/脑干功能障碍的指标。
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