Ohki M, Nakamura T, Aoyagi M
Department of Otolaryngology, Yamagata University School of Medicine.
Nihon Jibiinkoka Gakkai Kaiho. 1997 Jan;100(1):27-35. doi: 10.3950/jibiinkoka.100.27.
We studied the relationship between MRI findings and ocular abnormalities in 46 patients with spinocerebellar degeneration. MRI was performed for all patients. In order to evaluate the severity of atrophy in the brainstem and cerebellum, we delineated the region of the pons, mesencephalic tegmentum, medulla oblongata, cerebellar hemisphere, and vermis on a typical section of their T1 weighted image. Each area or the longest diameter of each regions were measured by using a computed graphic analyzer. The data were compared with those of 10 normal subjects and the severity of atrophy in each region was quantitatively estimated. In all of the patients, electro-oculographic tests including gaze nystagmus, positional and positioning nystagmus, smooth pursuit eye movements (smooth pursuit), optokinetic nystagmus test (OKN), horizontal saccade test, and visual suppression of the caloric nystagmus test (VS test) were examined. Eight patients with rebound nystagmus showed more severe atrophy than those of 38 patients without rebound nystagmus in the cerebellar hemisphere and vermis. Nine patients with apogeotrophic derection changing nystagmus indicates more severe atrophy than those of 35 patients without it in the cerevellar hemisphere, pons, mesencephalic tegmentum, medulla oblongata. Twenty three patients who showed severe impairments of OKN, 11 patients with a burst phenomenon on VS test and 19 patients with significantly reduced saccade velocity showed particularly severe pontine atrophy. A significant atrophic change in the pons and medulla oblongata was seen in 4 patients with severely impaired pursuit eye movements. Our finding that there is good correlation between ocular abnormalities and markedly atrophic regions on MRI support the neurophysiological findings which had been reported concerning the generation of ocular abnormalities in humans and animals.
我们研究了46例脊髓小脑变性患者的MRI表现与眼部异常之间的关系。对所有患者均进行了MRI检查。为了评估脑干和小脑萎缩的严重程度，我们在T1加权像的典型层面上勾勒出脑桥、中脑被盖、延髓、小脑半球和蚓部的区域。使用计算机图像分析仪测量每个区域的面积或各区域的最长直径。将数据与10名正常受试者的数据进行比较，并对每个区域萎缩的严重程度进行定量评估。对所有患者均进行了包括凝视性眼球震颤、位置性和定位性眼球震颤、平稳跟踪眼动（平稳跟踪）、视动性眼球震颤试验（OKN）、水平扫视试验以及冷热性眼球震颤试验的视抑制（VS试验）在内的眼电图检查。8例有反弹性眼球震颤的患者在小脑半球和蚓部的萎缩比38例无反弹性眼球震颤的患者更严重。9例有地倾性方向改变性眼球震颤的患者在小脑半球、脑桥、中脑被盖、延髓的萎缩比35例无此症状的患者更严重。23例OKN严重受损的患者、11例VS试验出现爆发现象的患者以及19例扫视速度明显降低的患者表现出特别严重的脑桥萎缩。4例追踪眼动严重受损的患者脑桥和延髓出现明显萎缩性改变。我们发现眼部异常与MRI上明显萎缩区域之间存在良好相关性，这支持了此前关于人类和动物眼部异常发生的神经生理学研究结果。
