Soto Linan Victoria, Hébert Marc, Lévesque Martin
Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, Québec, QC, Canada.
Integrative Neuroscience and Experimental Therapies Axis, CERVO Brain Research Center, Québec, QC, Canada.
J Parkinsons Dis. 2025 Jun;15(4):694-709. doi: 10.1177/1877718X251331863. Epub 2025 Apr 29.
Electroretinography has emerged as a promising tool for identifying retinal functional anomalies in major psychiatric and neurodevelopmental disorders, such as schizophrenia, major depressive disorder, bipolar disorder, and autism spectrum disorder, positioning it as a potential biomarker of monoaminergic dysfunction. However, despite its potential, electroretinography studies in Parkinson's disease (PD) over the past decades have been inconsistent, largely due to variations in research methodologies. These limitations diminish its potential and hinder the association between retinal electrophysiological responses and PD neuropathology. To address this challenge, this review examines the most relevant sources of data variability and reduced reproducibility in electroretinography studies aimed at detecting a retinal functional signature characteristic of PD. We propose the consolidation of four key protocol factors and five cohort criteria to enhance the diagnostic accuracy of electroretinography in PD biomarker research. As electroretinography protocols are adapted from their clinical origins for research purposes, we argue that careful attention must be given to electrode type and placement, as well as to factors like age, sex, disease duration and severity, medication intake, psychiatric conditions, and comorbidities in cohort selection to ensure reproducible results. Suggesting that past inconsistencies in these areas may explain the variability in reported results and contribute to the lack of consensus on which electroretinography parameters comprise a disease signature in PD, we ultimately offer recommendations to improve the utility of electroretinography techniques as early biomarkers for PD.
视网膜电图已成为一种很有前景的工具，可用于识别主要精神疾病和神经发育障碍（如精神分裂症、重度抑郁症、双相情感障碍和自闭症谱系障碍）中的视网膜功能异常，使其成为单胺能功能障碍的潜在生物标志物。然而，尽管具有潜力，但过去几十年来帕金森病（PD）的视网膜电图研究结果并不一致，这在很大程度上是由于研究方法的差异。这些局限性削弱了其潜力，并阻碍了视网膜电生理反应与PD神经病理学之间的关联。为应对这一挑战，本综述考察了旨在检测PD特征性视网膜功能特征的视网膜电图研究中数据变异性和可重复性降低的最相关来源。我们提出整合四个关键方案因素和五个队列标准，以提高视网膜电图在PD生物标志物研究中的诊断准确性。由于视网膜电图方案是从其临床起源改编而来用于研究目的，我们认为在队列选择时必须仔细关注电极类型和放置，以及年龄、性别、疾病持续时间和严重程度、药物摄入、精神状况和合并症等因素，以确保结果具有可重复性。我们指出，这些领域过去的不一致可能解释了报告结果的变异性，并导致在哪些视网膜电图参数构成PD疾病特征方面缺乏共识，最终我们提供了一些建议，以提高视网膜电图技术作为PD早期生物标志物的效用。
