Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan.
Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan; Department of Neurodegenerative and Demented Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Home Medical Care System Based on Information and Communication Technology, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Drug Development for Parkinson's Disease, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of PRO-Based Integrated Data Analysis in Neurological Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Research and Therapeutics for Movement Disorders, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Parkinsonism Relat Disord. 2022 Nov;104:30-34. doi: 10.1016/j.parkreldis.2022.09.002. Epub 2022 Sep 27.
The mechanism of Pisa syndrome in Parkinson's disease (PD) is unclear. We aimed to analyze the spatial perception of patients with PD with Pisa syndrome using virtual reality.
In total, 16 patients with Pisa syndrome, 16 age-matched patients without Pisa syndrome, and 16 age-matched controls were included. They viewed the virtual room gradually tilting to different 8 directions randomized across trials. The 75% discrimination threshold angle and the mean tilting discrimination angle for each direction were evaluated. Participants' lateral trunk deviation was measured using Kinect. Neuropsychological status was evaluated, using the Mini-Mental Status Examination (MMSE), the Japanese version of the Montreal-Cognitive Assessment, Frontal Assessment Battery, and the color-word interference task of the Stroop test. Visuospatial abilities were assessed using Benton Judgement of Line Orientation, and vestibular function was evaluated using Subjective Visual Vertical (SVV).
The 75% discrimination threshold in the tilting discrimination angle was larger in all directions for those in the Pisa syndrome group compared to patients in the without Pisa syndrome group and those in the control group. There were significant differences between the three groups for Front-Right, Right, and Back. Patients with Pisa syndrome showed a significantly worse performance in these tests compared with controls and tended to have worse SVV performance compared with patients without Pisa syndrome.
The present findings support the hypothesis of visuo-spatial disability and/or attentional impairment in patients with Pisa syndrome.
帕金森病（PD）中 Pisa 综合征的发病机制尚不清楚。我们旨在使用虚拟现实分析 Pisa 综合征 PD 患者的空间感知。
共纳入 16 例 Pisa 综合征患者、16 例年龄匹配无 Pisa 综合征患者和 16 例年龄匹配对照者。他们观看逐渐向不同 8 个方向倾斜的虚拟房间，试验随机排列。评估每个方向的 75%辨别阈值角和平均倾斜辨别角。使用 Kinect 测量参与者的躯干侧向偏斜。采用简易精神状态检查（MMSE）、蒙特利尔认知评估日本版、额叶评估量表和 Stroop 色词干扰任务评估神经心理状态。使用 Benton 线定向判断评估视空间能力，使用主观垂直视觉（SVV）评估前庭功能。
与无 Pisa 综合征组和对照组相比，Pisa 综合征组在所有方向的倾斜辨别角的 75%辨别阈值均较大。三组间在 Front-Right、Right 和 Back 方向存在显著差异。与对照组相比，Pisa 综合征患者在这些测试中表现明显较差，且与无 Pisa 综合征患者相比，SVV 表现也较差。
本研究结果支持 Pisa 综合征患者存在视空间障碍和/或注意力损害的假说。
