视频眼震图对多系统萎缩眼动功能的定量评估。

Quantitative assessment of oculomotor function by videonystagmography in multiple system atrophy.

机构信息

Department of Neurology, Peking University First Hospital, Beijing 100034, China; Department of Neurology, Civil Aviation General Hospital, Beijing 100123, China.

Department of Neurology, Peking University First Hospital, Beijing 100034, China; Beijing Key Laboratory of Neurovascular Disease Discovery, Beijing 100034, China.

出版信息

Clin Neurophysiol. 2022 Sep;141:15-23. doi: 10.1016/j.clinph.2022.05.019. Epub 2022 Jun 21.

DOI:10.1016/j.clinph.2022.05.019

PMID:35809545

Abstract

OBJECTIVE

To quantitatively assess oculomotor impairments in multiple system atrophy (MSA) and to explore their correlation with clinical characteristics.

METHODS

We recruited 45 patients with MSA, including 21 with dominant ataxia (MSA-C), 24 with dominant parkinsonism (MSA-P), and 40 age-matched healthy controls. Detailed oculomotor performance in the horizontal direction was measured using videonystagmography (VNG).

RESULTS

We found that the proportion of abnormal eye movements in patients with MSA was 93.3% (37.7%, 51.1%, 73.3%, 71.1%, and 37.8% on fixation and gaze-holding, without fixation, saccade, smooth pursuit, and optokinetic nystagmus tests, respectively). Patients with MSA-C showed significantly lower gains in smooth pursuit test and optokinetic nystagmus test, and a higher incidence of hypermetria in the saccade test than patients with MSA-P (all P < 0.05). No oculomotor deficits were correlated with age, age of onset, sex, disease duration, or Unified Multiple System Atrophy Rating Scale (USMARS) (all r < 0.25, P > 0.1).

CONCLUSIONS

An extremely high incidence of oculomotor impairments could be observed using VNG in both the MSA-C and MSA-P subtypes, although there were some differences between them.

SIGNIFICANCE

A comprehensive oculomotor examination could serve as a valuable tool in the diagnostic workup of patients with MSA.

摘要

目的

定量评估多系统萎缩（MSA）中的眼球运动障碍，并探讨其与临床特征的相关性。

方法

我们招募了 45 名 MSA 患者，包括 21 名以共济失调为主型（MSA-C），24 名以帕金森病为主型（MSA-P），以及 40 名年龄匹配的健康对照者。使用视频眼震图（VNG）详细测量水平方向的眼球运动表现。

结果

我们发现，MSA 患者的异常眼球运动比例为 93.3%（固定和凝视时为 37.7%、51.1%，无固定时为 73.3%，扫视时为 71.1%，平滑追踪时为 37.8%）。MSA-C 患者在平滑追踪和视动性眼震测试中的增益明显较低，而在扫视测试中的高发性过冲发生率高于 MSA-P 患者（均 P<0.05）。眼球运动缺陷与年龄、发病年龄、性别、病程或统一多系统萎缩评定量表（USMARS）评分均无相关性（均 r<0.25，P>0.1）。