Cohen Mikael, Hesse Solange, Polet Kevin, Louchart de la Chapelle Sandrine, Morisot Adeline, Bresch Saskia, Pesce Alain, Lebrun-Frenay Christine
Centre Hospitalier Universitaire Pasteur 2, Service de Neurologie, CRCSEP, Unité de Recherche Clinique Cote d'Azur (UR2CA-URRIS), 30 voie romaine Cedex, Nice 06002, France.
Unité de Recherche Clinique - Centre Mémoire, Centre de Gérontologie Clinique RAINIER III, Centre Hospitalier Princesse Grace, Avenue Pasteur, Monaco 98000, Monaco.
Mult Scler Relat Disord. 2022 Aug;64:103944. doi: 10.1016/j.msard.2022.103944. Epub 2022 Jun 6.
Video-oculography (VOG) could be useful for monitoring neurodegenerative diseases and multiple sclerosis (MS), as a high prevalence of subclinical eye movements abnormalities (EMA) has been previously reported, with a potential prognostic value regarding disease evolution. However, access to VOG is limited in clinical practice.
To evaluate the reliability of VOG recordings performed using eVOG, a mobile application developed on an iPad.
Patients with MS or related disease without clinically detectable EMA were enrolled in a cross-sectional study during which two VOG exams (classical VOG and eVOG) were performed on the same day. We examined reflex saccades, antisaccades, smooth pursuit and fixation. The total number of deficits, saccadic latencies and velocities, qualitative smooth pursuit were compared.
30 patients were included. The mean number of EMA per patient on classical VOG was 4.1 and 2.3 on eVOG. We found a statistical association between the number of EMA for each exam (r = 0.66, p < 0.0001). Saccades latencies (r = 0.57, p < 0.0001) and velocities (r = 0.45, p < 0.0001) were also well correlated. Assessing eVOG accuracy, we found a sensitivity ranging from 44% to 100% and a specificity ranging from 71% to 88.9% depending on the considered abnormality.
eVOG could be an easily accessible solution to screen MS patients for the presence of EMA. We plan to use eVOG on a larger cohort of patients, in a prospective study to assess the prognostic value of subclinical EMA in MS. We also plan to investigate the use of eVOG in other neurological conditions.
视频眼动图（VOG）可能有助于监测神经退行性疾病和多发性硬化症（MS），因为先前已有报道称亚临床眼动异常（EMA）的患病率很高，且对疾病进展具有潜在的预后价值。然而，在临床实践中，VOG的应用受到限制。
评估使用eVOG（一款在iPad上开发的移动应用程序）进行VOG记录的可靠性。
将无临床可检测到的EMA的MS或相关疾病患者纳入一项横断面研究，在同一天进行两次VOG检查（传统VOG和eVOG）。我们检查了反射性扫视、反扫视、平稳跟踪和注视。比较了缺陷总数、扫视潜伏期和速度、定性平稳跟踪情况。
纳入30例患者。每位患者在传统VOG上的EMA平均数为4.1，在eVOG上为2.3。我们发现每次检查的EMA数量之间存在统计学关联（r = 0.66，p < 0.0001）。扫视潜伏期（r = 0.57，p < 0.0001）和速度（r = 0.45，p < 0.0001）也具有良好的相关性。评估eVOG的准确性时，根据所考虑的异常情况，我们发现敏感性范围为44%至100%，特异性范围为71%至88.9%。
eVOG可能是一种易于获取的解决方案，用于筛查MS患者是否存在EMA。我们计划在一项前瞻性研究中，对更大规模的患者队列使用eVOG，以评估亚临床EMA在MS中的预后价值。我们还计划研究eVOG在其他神经系统疾病中的应用。
