Rekik Arwa, Mrabet Saloua, Kacem Imen, Nasri Amina, Ben Djebara Mouna, Gargouri Amina, Gouider Riadh
Department of Neurology, Clinical Investigation Centre Neurosciences and Mental Health, Razi University Hospital, Manouba, Tunisia.
Faculty of Medicine, University Tunis El Manar, Tunis, Tunisia.
Neuroophthalmology. 2022 Mar 2;46(4):227-235. doi: 10.1080/01658107.2022.2038638. eCollection 2022.
Few studies have reported abnormal ocular movements in cases of amyotrophic lateral sclerosis (ALS) and their link with other disease features. Our study aimed to describe and analyse eye movement abnormalities in ALS patients. Specifically, we set out to investigate the correlation between non-motor signs and oculomotor impairment in order to understand the pathogenesis of the disease. All ALS patients seen from 2018 to 2020 in the department of Neurology of Razi hospital underwent the recording of saccadic eye movements. Results were compared with healthy controls. Sixty-two patients were included. Altered saccadic eye movements (72.6%) correlated with tongue atrophy and bladder dysfunction. The most common finding was altered smooth pursuit (56.5%), which showed correlation with bladder dysfunction and altered frontal assessment battery (FAB) scores. Prolonged latencies of horizontal saccades (34%) correlated with sensory and extrapyramidal signs. Our study is the first to examine the characteristics of eye movements in a large African cohort of ALS patients and to show correlations with extra-motor clinical signs. Our findings showed extra-motor cortex dysfunction in ALS with greater frequency of eye movement abnormalities in comparison with previous studies. Altered horizontal pursuit, the core abnormality, confirmed the extension of the neurodegenerative process to the frontal and prefrontal cortices. Prolonged horizontal saccade latencies reflect mainly the involvement of the parietal eye field. Anti-saccadic abnormalities were the least common finding and showed, paradoxically, no link with executive dysfunction.
很少有研究报道肌萎缩侧索硬化症（ALS）患者的眼球运动异常及其与其他疾病特征的联系。我们的研究旨在描述和分析ALS患者的眼球运动异常。具体而言，我们着手研究非运动症状与动眼神经功能障碍之间的相关性，以了解该疾病的发病机制。2018年至2020年期间在拉齐医院神经科就诊的所有ALS患者均接受了扫视眼球运动记录。结果与健康对照进行比较。纳入了62例患者。改变的扫视眼球运动（72.6%）与舌肌萎缩和膀胱功能障碍相关。最常见的发现是平稳跟踪改变（56.5%），其与膀胱功能障碍和额叶评估量表（FAB）评分改变相关。水平扫视潜伏期延长（34%）与感觉和锥体外系体征相关。我们的研究首次在大量非洲ALS患者队列中检查眼球运动特征，并显示与运动外临床体征的相关性。我们的研究结果表明，ALS患者存在运动外皮质功能障碍，与先前的研究相比，眼球运动异常的发生率更高。水平跟踪改变这一核心异常证实了神经退行性过程扩展至额叶和前额叶皮质。水平扫视潜伏期延长主要反映顶叶眼区受累。反扫视异常是最不常见的发现，而且矛盾的是，与执行功能障碍无关。
