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全面的视觉电生理测量发现酒精成瘾导致的人类关键性变化:酒精性视力下降早期预防的临床价值。

Comprehensive visual electrophysiological measurements discover crucial changes caused by alcohol addiction in humans: Clinical values in early prevention of alcoholic vision decline.

机构信息

Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Peking University Eye Center, Peking University Third Hospital, Beijing, China.

Faculty of Environment and Life, Beijing University of Technology, Beijing, China.

出版信息

Front Neural Circuits. 2022 Aug 11;16:912883. doi: 10.3389/fncir.2022.912883. eCollection 2022.

Abstract

Alcohol addiction often compromises vision by impairing the visual pathway, particularly the retina and optic nerve. Vision decline in alcoholics consists of a sequential transition from reversible functional deterioration of the visual pathway to irreversible clinical vision degeneration or vision loss. Thus, the control of alcoholic vision decline should focus on prevention before permanent damage occurs. Visual electrophysiology is a promising method for early detection of retinal dysfunction and optic neuropathy, including full-field electroretinography (ffERG) and pattern-reversal visual evoked potential (PR-VEP). So far, however, research studying the electrophysiological characteristics in the preclinical stage of vision decline caused by alcohol addiction is still lacking. Here we conducted a retrospective study with 11 alcoholics and 14 matched control individuals to address this need. We had performed comprehensive visual electrophysiological tests, including ffERG and PR-VEP. We next analyzed all electrophysiological parameters using multivariate statistical analyses and discovered some highly sensitive alterations to alcohol addiction. We found severely reduced amplitudes in scotopic ffERG oscillatory potentials (OPs) in alcohol addicts. These changes indicate the alcohol-induced disturbances of amacrine cells and retinal circulation. In subjects with alcohol addiction, the amplitudes of b-waves diminish significantly in scotopic but not photopic ffERG, implying the impaired function of the retinal rod system and the dysfunction of the inner retina. PR-VEPs elicited by checkerboard stimuli with large 1 degree (°) checks mainly reflect the state of the optic nerve and ganglion cells, and PR-VEPs provoked by small 0.25° checks mainly reflect the function of the macular. We performed both measurements and observed a robust amplitude reduction in all three peaks (N75-P100, P100-N135) and a significant peak time extension in P100. Our research provides an affordable and non-invasive tool to accurately evaluate visual pathway conditions in alcohol addicts and help clinicians take targeted treatment.

摘要

酒精成瘾常通过损害视觉通路,特别是视网膜和视神经,导致视力受损。酗酒者的视力下降包括从视觉通路的可逆性功能恶化到不可逆转的临床视力恶化或视力丧失的连续转变。因此,控制酒精性视力下降应侧重于在永久性损害发生之前进行预防。视觉电生理学是一种早期检测视网膜功能障碍和视神经病变的有前途的方法,包括全视野视网膜电图(ffERG)和图形翻转视觉诱发电位(PR-VEP)。然而,到目前为止,研究酒精成瘾引起的视力下降临床前阶段的电生理特征的研究仍然缺乏。在这里,我们进行了一项回顾性研究,纳入了 11 名酗酒者和 14 名匹配的对照组个体。我们进行了全面的视觉电生理学测试,包括 ffERG 和 PR-VEP。接下来,我们使用多变量统计分析分析了所有电生理参数,并发现了一些对酒精成瘾高度敏感的改变。我们发现,酒精成瘾者的暗视野 ffERG 中振荡电位(OP)的振幅严重降低。这些变化表明,酒精会干扰无长突细胞和视网膜循环。在酒精成瘾者中,暗视野 ffERG 的 b 波振幅在暗视野中显著降低,但在明视野中不降低,这表明视网膜杆系统的功能受损和内视网膜的功能障碍。大 1 度(°)棋盘刺激诱发的 PR-VEPs 主要反映视神经和节细胞的状态,而小 0.25°检查刺激诱发的 PR-VEPs 主要反映黄斑的功能。我们进行了这两种测量,并观察到所有三个峰值(N75-P100、P100-N135)的振幅明显降低,以及 P100 的峰值时间显著延长。我们的研究提供了一种经济实惠且非侵入性的工具,可准确评估酒精成瘾者的视觉通路状况,并帮助临床医生进行有针对性的治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0f3/9403052/a958572d36dd/fncir-16-912883-g001.jpg

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