Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
J Neurol. 2021 Sep;268(9):3467-3475. doi: 10.1007/s00415-021-10522-9. Epub 2021 Mar 21.
The eponymous feature of progressive supranuclear palsy (PSP) is oculomotor impairment which is one of the relevant domains in the Movement Disorder Society diagnostic criteria.
We aimed to investigate the value of specific video-oculographic parameters for the use as diagnostic markers in PSP.
An analysis of video-oculography recordings of 100 PSP patients and 49 age-matched healthy control subjects was performed. Gain of smooth pursuit eye movement and latency, gain, peak eye velocity, asymmetry of downward and upward velocities of saccades as well as rate of saccadic intrusions were analyzed.
Vertical saccade velocity and saccadic intrusions allowed for the classification of about 70% and 56% of the patients, respectively. By combining both parameters, almost 80% of the PSP patients were covered, while vertical velocity asymmetry was observed in approximately 34%. All parameters had a specificity of above 95%. The sensitivities were lower with around 50-60% for the velocity and saccadic intrusions and only 27% for vertical asymmetry.
In accordance with oculomotor features in the current PSP diagnostic criteria, video-oculographic assessment of vertical saccade velocity and saccadic intrusions resulted in very high specificity. Asymmetry of vertical saccade velocities, in the opposite, did not prove to be useful for diagnostic purposes.
进行性核上性麻痹(PSP)的特征性表现为眼球运动障碍,这是运动障碍协会诊断标准中的相关领域之一。
我们旨在研究特定视频眼动图参数在 PSP 中的诊断标记物中的应用价值。
对 100 例 PSP 患者和 49 名年龄匹配的健康对照者的视频眼动记录进行了分析。分析了平稳追踪眼动的增益和潜伏期、增益、峰值眼速度、上下向眼球跳动速度的不对称性以及眼球跳动侵入率。
垂直眼球跳动速度和眼球跳动侵入可以分别对约 70%和 56%的患者进行分类。通过结合这两个参数,几乎可以涵盖 80%的 PSP 患者,而大约 34%的患者表现出垂直速度的不对称性。所有参数的特异性均高于 95%。速度和眼球跳动侵入的敏感性约为 50-60%,而垂直不对称性的敏感性仅为 27%。
与当前 PSP 诊断标准中的眼球运动特征一致,垂直眼球跳动速度和眼球跳动侵入的视频眼动评估具有非常高的特异性。相反,垂直眼球跳动速度的不对称性对于诊断目的并没有证明是有用的。