Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea.
Mov Disord. 2023 Dec;38(12):2291-2301. doi: 10.1002/mds.29623. Epub 2023 Oct 17.
Evaluating eye movements in Parkinson's disease (PD) provides valuable insights into the underlying pathophysiological changes.
The aim was to investigate the relationship between monoaminergic degeneration and ocular motor abnormalities in de novo PD.
Drug-naive PD patients who underwent N-(3-[ F]fluoropropyl)-2-carbomethoxy-3-(4-iodophenyl) nortropane positron emission tomography scans and video-oculography at diagnosis were eligible. Measurements of saccadic accuracy, latency, and smooth pursuit gain and square wave jerk frequency were collected. Patients underwent Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and detailed cognitive tests. We investigated the associations between ocular motor measurements and specific tracer uptake ratios (SUR) in the caudate nucleus, anterior and posterior putamen, thalamus, and dorsal raphe nuclei, along with motor and cognitive symptoms.
One-hundred twenty-four subjects were included in this study. Saccadic accuracy was positively associated with parkinsonian motor severity expressed as Hoehn and Yahr stages, MDS-UPDRS Part III scores, and subscores for bradykinesia and rigidity but not with tremor scores (P < 0.05). Saccadic accuracy correlated with poor performances in the Rey-Complex-Figure copy, and latency with the Digit Symbol Coding and the Montreal Cognitive Assessment scores (P < 0.05). Prolonged saccadic latency correlated with reduced thalamic SUR, whereas decreased saccadic accuracy correlated with reduced SUR in the anterior and posterior putamen (P < 0.05). Reduced smooth pursuit gain showed associations with reduced SUR in the dorsal raphe, a serotonin-predominant region, but did not correlate with parkinsonism severity scores.
Defective dopaminergic and nondopaminergic neural systems may discretely influence ocular motor function in de novo PD patients. © 2023 International Parkinson and Movement Disorder Society.
评估帕金森病（PD）患者的眼球运动情况可深入了解潜在的病理生理变化。
本研究旨在探讨初发 PD 患者中单胺能神经退行性变与眼球运动异常的关系。
纳入诊断时接受 N-[3-[F]氟丙基]-2-羧甲氧基-3-[4-碘苯基]去甲托烷正电子发射断层扫描（PET）和视频眼动描记术检查且未服用药物的 PD 患者。采集扫视准确性、潜伏期和平滑追随增益以及方波惊跳频率等眼动测量值。患者接受运动障碍协会统一帕金森病评定量表（MDS-UPDRS）和详细认知测试。我们研究了眼球运动测量值与尾状核、前、后壳核、丘脑和中缝背核特定示踪剂摄取比值（SUR），以及运动和认知症状之间的相关性。
本研究共纳入 124 例受试者。扫视准确性与帕金森病严重程度呈正相关，表现为 Hoehn 和 Yahr 分期、MDS-UPDRS 第三部分评分以及运动迟缓与僵硬亚评分，但与震颤评分无关（P<0.05）。扫视准确性与 Rey 复杂图形复制试验的较差表现相关，潜伏期与数字符号编码和蒙特利尔认知评估评分相关（P<0.05）。潜伏期延长与丘脑 SUR 降低相关，而扫视准确性降低与前、后壳核 SUR 降低相关（P<0.05）。平滑追随增益降低与中缝背核 SUR 降低相关，中缝背核是一个以 5-羟色胺为主的区域，但与帕金森病严重程度评分无相关性。
多巴胺能和非多巴胺能神经传递系统的缺陷可能会分别影响初发 PD 患者的眼球运动功能。 © 2023 国际帕金森病和运动障碍协会。
