Pozzessere G, Rossi P, Valle E, Froio C P, Petrucci A F, Morocutti C
Istituto di Clinica delle Malattie Nervose e Mentali, Università La Sapienza, Rome, Italy.
Clin Auton Res. 1997 Dec;7(6):315-9. doi: 10.1007/BF02267724.
To study pupillary autonomic function in multiple sclerosis (MS), we examined 36 subjects with low disability, preserved visual acuity and no recent history (2 years) of optic neuritis or actual visual complaints. Compared to controls, MS patients showed a greater dilatator reaction with darkness and, for the light reflex, a lower amplitude and contraction rate and a greater recovery of pupillary diameter 5 s after the stimulus. Within the MS group, no difference was found comparing patients with or without the following characteristics: nuclear magnetic resonance imaging evidence of midbrain lesions; increased visual evoked potential P100 latency; and a previous history of optic neuritis. No correlation was found between P100 latency, duration of disease and pupillometric parameters. Our results indicate that in MS patients there is autonomic dysfunction with a reduction of parasympathetic tone and a relative increase in sympathetic dilatator tone to the pupils. We suggest that pupillary abnormalities could be due to non-specific impairment of the central pathways subserving pupil functions.
为研究多发性硬化症（MS）患者的瞳孔自主神经功能，我们对36名残疾程度较低、视力正常且无近期（2年）视神经炎病史或实际视力问题主诉的受试者进行了检查。与对照组相比，MS患者在黑暗环境中表现出更强的瞳孔扩张反应，在光反射方面，刺激后5秒瞳孔直径的振幅和收缩率更低，而瞳孔直径的恢复程度更大。在MS组内，比较有或无以下特征的患者未发现差异：中脑病变的核磁共振成像证据；视觉诱发电位P100潜伏期延长；既往视神经炎病史。未发现P100潜伏期、病程与瞳孔测量参数之间存在相关性联系。我们的结果表明，MS患者存在自主神经功能障碍，副交感神经张力降低，瞳孔的交感神经扩张张力相对增加，并提示瞳孔异常可能归因于维持瞳孔功能的中枢通路的非特异性损伤。
