Department of Neurology, University Hospitals, Cleveland, USA.
Department of Neurology, Seoul National University College of Medicine, Bundang, South Korea.
J Neurol Sci. 2022 Dec 15;443:120472. doi: 10.1016/j.jns.2022.120472. Epub 2022 Oct 27.
Eye movements are fundamental diagnostic and progression markers of various neurological diseases, including those affecting the cerebellum. Despite the high prevalence of abnormal eye movements in patients with cerebellar disorders, the traditional rating scales do not focus on abnormal eye movements. We formed a consortium of neurologists focusing on cerebellar disorders. The consortium aimed to design and validate a novel Scale for Ocular motor Disorders in Ataxia (SODA). The primary purpose of the scale is to determine the extent of ocular motor deficits due to various phenomenologies. A higher score on the scale would suggest a broader range of eye movement deficits. The scale was designed such that it is easy to implement by non-specialized neurological care providers. The scale was not designed to measure each ocular motor dysfunction's severity objectively. Our validation studies revealed that the scale reliably measured the extent of saccade abnormalities and nystagmus. We found a lack of correlation between the total SODA score and the total International Cooperative Ataxia Rating Scale (ICARS), Scale for Assessment and Rating of Ataxia (SARA), or Brief Ataxia Rating Scale (BARS). One explanation is that conventionally reported scales are not dedicated to eye movement disorders; and when present, the measure of ocular motor function is only one subsection of the ataxia rating scales. It is also possible that the severity of ataxias does not correlate with eye movement abnormalities. Nevertheless, the SODA met the consortium's primary goal: to prepare a simple outcome measure that can identify ocular motor dysfunction in patients with cerebellar ataxia.
眼球运动是各种神经疾病的基本诊断和进展标志物,包括影响小脑的疾病。尽管小脑疾病患者的眼球运动异常发生率很高,但传统的评分量表并不关注异常眼球运动。我们成立了一个专注于小脑疾病的神经病学家联盟。该联盟旨在设计和验证一种新的小脑共济失调眼球运动障碍量表(SODA)。该量表的主要目的是确定各种表型引起的眼球运动缺陷的程度。该量表的得分越高,表明眼球运动缺陷的范围越广。该量表设计为便于非专业神经科护理人员实施。该量表不是为了客观测量每个眼球运动功能障碍的严重程度而设计的。我们的验证研究表明,该量表可靠地测量了眼球扫视异常和眼球震颤的程度。我们发现 SODA 总评分与国际合作共济失调评分量表(ICARS)、共济失调评估和评分量表(SARA)或简短共济失调评分量表(BARS)的总评分之间没有相关性。一种解释是,传统报告的量表并非专门用于眼球运动障碍;而且当存在时,眼球运动功能的测量只是共济失调评分量表的一个小节。也有可能共济失调的严重程度与眼球运动异常不相关。然而,SODA 满足了联盟的主要目标:制定一种简单的结果测量方法,可以识别小脑共济失调患者的眼球运动功能障碍。