Buonocore Jolanda, Facchin Alessio, Crasà Marianna, Sgrò Giulia, Cristofaro Alessia, Quattrone Aldo, Quattrone Andrea
Institute of Neurology, Department of Medical and Surgical Sciences, Magna Graecia University, Catanzaro, Italy.
Neuroscience Research Center, Magna Graecia University, Viale Europa, Germaneto, 88100, Catanzaro, Italy.
Neurol Sci. 2025 Apr 21. doi: 10.1007/s10072-025-08184-w.
Eye movement dysfunction has been described in Parkinson's disease (PD), but differences between tremor-dominant (TD) and postural instability/gait difficulty (PIGD) PD motor subtypes remain poorly understood. The aim of this study was thus to compare video-oculographic (VOG) features between PD motor subtypes.
Two hundred and four PD patients and 55 age-matched healthy control subjects (HC) were enrolled in this study. PD patients were stratified into PIGD and TD motor subtype groups. VOG amplitude, peak velocity of upward, downward, and vertical saccades, and square wave jerks (SWJ) number and amplitude were compared across groups. Multivariate linear models also investigated associations between VOG parameters and motor severity, gait/balance disturbances, dopaminergic treatment, and cognitive function.
The final cohort included 180 PD patients classified as PIGD (n = 121) or TD subtype (n = 59) and 55 HC. Both PD subtypes showed reduced upward and downward amplitude compared to HC, with normal peak velocity. PIGD patients exhibited significantly decreased upward saccadic amplitude compared to TD patients, with no differences in other VOG parameters. Moreover, the upward saccadic amplitude was associated with motor severity, particularly slowness of gait and bradykinesia/rigidity scores, as well as with levodopa equivalent daily dose (LEDD) in the PIGD group.
This study provides evidence of greater saccadic hypometria in PIGD than in TD patients in upward gaze, contributing to a better understanding of oculomotor impairment in PD. The association of saccadic amplitude with bradykinesia/rigidity severity and LEDD may suggest a role of underlying dopaminergic deficits in ocular dysfunction in PD patients.
帕金森病（PD）患者存在眼球运动功能障碍，但震颤为主型（TD）和姿势不稳/步态障碍型（PIGD）这两种PD运动亚型之间的差异仍知之甚少。因此，本研究旨在比较PD运动亚型之间的视频眼动图（VOG）特征。
本研究纳入了204例PD患者和55例年龄匹配的健康对照者（HC）。将PD患者分为PIGD和TD运动亚型组。比较各组之间的VOG幅度、向上、向下和垂直扫视的峰值速度以及方波急跳（SWJ）的数量和幅度。多变量线性模型还研究了VOG参数与运动严重程度、步态/平衡障碍、多巴胺能治疗和认知功能之间的关联。
最终队列包括180例分为PIGD（n = 121）或TD亚型（n = 59）的PD患者和55例HC。与HC相比，两种PD亚型的向上和向下幅度均降低，峰值速度正常。与TD患者相比，PIGD患者的向上扫视幅度显著降低，其他VOG参数无差异。此外，在PIGD组中，向上扫视幅度与运动严重程度相关，特别是步态迟缓以及运动徐缓/强直评分，还与左旋多巴等效日剂量（LEDD）相关。
本研究提供了证据，表明在向上注视时，PIGD患者的扫视减退比TD患者更严重，这有助于更好地理解PD患者的眼动障碍。扫视幅度与运动徐缓/强直严重程度和LEDD之间的关联可能提示潜在的多巴胺能缺陷在PD患者眼部功能障碍中起作用。
