Terravecchia Claudio, Mostile Giovanni, Chisari Clara Grazia, Contrafatto Federico, Salerno Andrea, Donzuso Giulia, Cicero Calogero Edoardo, Sciacca Giorgia, Nicoletti Alessandra, Zappia Mario
Department "G.F. Ingrassia", Section of Neurosciences, University of Catania, Via Santa Sofia 78, 95123, Catania, Italy.
Oasi Research Institute - IRCCS, Troina, Italy.
J Neurol. 2024 Dec 12;272(1):24. doi: 10.1007/s00415-024-12802-6.
L-dopa (LD) effects on visually guided saccades (VGS) have been poorly investigated in de novo Parkinson's disease (PD) patients through a standardized acute challenge test.
To assess the acute saccadic effects of LD as well as possible different patterns of VGS response to LD in a consistent population of de novo PD.
VGS were assessed among de novo PD at baseline and 2 h after the administration of LD/carbidopa 250/25 mg. Baseline instrumental assessments were compared with healthy controls (HCs).
Thirty-two de novo PD and 17 HCs were enrolled. PD patients showed lower upward velocities and amplitude than HCs, improving after LD administration. Two subgroups were identified among PD patients based on percent improvement or worsening of the most significant changing VGS parameter after LD administration: Group A (19 patients, showing improvement) and B (13 patients, showing worsening). Group A had at baseline reduced vertical, especially downward, velocities, gain and amplitude compared to Group B, with a significant improvement after LD. Conversely, in Group B, an LD-induced worsening effect on both horizontal and vertical VGS parameters was found. Comparing the two identified groups based on clinical-demographic characteristics, higher prevalence of female sex was found in Group B.
De novo PD patients presented prominent vertical VGS impairment which improved acutely after LD administration. Different patterns of acute saccadic responses to LD were also shown, suggesting a possible role of VGS in PD phenotyping.
左旋多巴（LD）对视觉引导扫视（VGS）的影响在初发帕金森病（PD）患者中，通过标准化急性激发试验的研究较少。
在初发PD患者群体中，评估LD的急性扫视效应以及VGS对LD可能的不同反应模式。
在基线时以及给予250/25mg LD/卡比多巴2小时后，对初发PD患者进行VGS评估。将基线仪器评估结果与健康对照（HCs）进行比较。
纳入32例初发PD患者和17例HCs。PD患者向上的速度和幅度低于HCs，给予LD后有所改善。根据LD给药后最显著变化的VGS参数改善或恶化的百分比，在PD患者中识别出两个亚组：A组（19例患者，表现为改善）和B组（13例患者，表现为恶化）。与B组相比，A组在基线时垂直速度，尤其是向下速度、增益和幅度降低，给予LD后有显著改善。相反，在B组中，发现LD对水平和垂直VGS参数均有恶化作用。根据临床人口统计学特征比较两个识别出的组，发现B组女性患病率较高。
初发PD患者存在明显的垂直VGS损害，给予LD后急性改善。还显示了对LD的急性扫视反应的不同模式，提示VGS在PD表型分型中可能起作用。
