Department of Neurology, Seoul National University Hospital & Seoul National University College of Medicine, Seoul, South Korea.
Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University, Seoul 03080, Republic of Korea.
Neurosci Lett. 2023 Aug 24;812:137356. doi: 10.1016/j.neulet.2023.137356. Epub 2023 Jun 22.
There is a need for development of reliable and accessible clinical biomarker for detecting cognitive dysfunction in PD. This study aimed to investigate whether involuntary head rotation during the saccade test could serve as a potential biomarker for screening cognitive dysfunction in PD.
A total of 27 PD patients and nine age- and sex-matched healthy controls were prospectively enrolled in this study. A custom-designed gyroscope was attached to the forehead of each participant, and a saccade test consisting of 20 trials was conducted. The entire test was recorded on video, and two movement disorder experts independently rated the degree of head rotation, blinded to the patients' clinical information. The peak angular velocity of head rotation was derived from the gyroscope data. Participants underwent Montreal Cognitive Assessment (MoCA) as the cognitive evaluation. Correlation analysis was performed to assess the relationship between head rotation and MoCA scores.
The mean peak angular velocity of head rotation significantly correlated with the MoCA scores (R = -0.52, p = 0.0023) including age, sex, disease duration, and education duration as cofactors. The optimal peak angular velocity thresholds for head rotation, which aligned with the manual ratings, were determined to be 5°/s and 10°/s for raters 1 and 2, respectively. The MoCA scores exhibited significant correlations with the number of head rotations, using both the 5°/s (R = -0.36, p = 0.042) and 10°/s (R = -0.49, p = 0.0048) thresholds. Furthermore, the mean angular velocity of the head demonstrated a 100% positive predictive value and specificity for the detection of cognitive impairment (MoCA < 26), based on the cut-offs of 5°/s and 10°/s.
Inability to suppress head rotation during saccades may serve as a potential clinical biomarker for screening cognitive dysfunction in PD.
需要开发可靠且易于获取的临床生物标志物，以检测 PD 患者的认知功能障碍。本研究旨在探讨扫视试验中无意识的头部转动是否可以作为筛查 PD 患者认知功能障碍的潜在生物标志物。
本研究前瞻性纳入了 27 名 PD 患者和 9 名年龄和性别匹配的健康对照者。每个参与者的额头上都贴有一个定制的陀螺仪，进行 20 次扫视试验。整个测试都被录像记录下来，两名运动障碍专家独立对头部转动的程度进行评分，且对患者的临床信息不知情。头部转动的峰值角速度由陀螺仪数据得出。参与者接受蒙特利尔认知评估（MoCA）作为认知评估。进行相关性分析以评估头部转动与 MoCA 评分之间的关系。
头部转动的平均峰值角速度与 MoCA 评分显著相关（R=-0.52，p=0.0023），包括年龄、性别、疾病持续时间和教育持续时间等协变量。与手动评分一致的最佳头部转动峰值角速度阈值为 5°/s 和 10°/s，分别对应评分者 1 和 2。MoCA 评分与使用 5°/s（R=-0.36，p=0.042）和 10°/s（R=-0.49，p=0.0048）阈值的头部转动次数均显著相关。此外，头部平均角速度在基于 5°/s 和 10°/s 的截断值时，对认知障碍（MoCA<26）的检测具有 100%的阳性预测值和特异性。
扫视时无法抑制头部转动可能是筛查 PD 患者认知功能障碍的潜在临床生物标志物。
