Arch. Neurol:眼球震颤或可作早期帕金森病的标志

2012-04-20 爱唯医学网 爱唯医学网

  4月9日,《神经病学文献》(Archives of Neurology)在线发表的一项研究报告称,在对112例患者和60例对照者进行分析之后发现,眼球震颤或眼球固定不稳是帕金森病患者普遍存在的一种特异性很高的特征。因此,采用精准的眼球追踪技术来评价眼球运动参数将有助于帕金森病的早期诊断。 美国Hunter Holmes McGuire退伍军人医疗中心的George T. Gitc

 

4月9日,《神经病学文献》(Archives of Neurology)在线发表的一项研究报告称,在对112例患者和60例对照者进行分析之后发现,眼球震颤或眼球固定不稳是帕金森病患者普遍存在的一种特异性很高的特征。因此,采用精准的眼球追踪技术来评价眼球运动参数将有助于帕金森病的早期诊断。

美国Hunter Holmes McGuire退伍军人医疗中心的George T. Gitchel博士及其同事指出,虽然之前的研究已经证实帕金森病患者大脑内的神经退行性改变会影响眼球运动控制系统,但对于患者特异性缺陷的认识仍然存在争议。“有研究者提出患者的主要特征是眼球扫视的速度减慢且持续时间延长,而其他人则认为患者方波急跳(远离目标的快速、来回、随机运动,会影响眼球固定的稳定性)的频率会增加。”虽然之前已有人对帕金森病患者的眼球固定情况进行了主观描述,但尚未对此进行系统的定量分析。

这项研究招募的帕金森病患者平均年龄为66.2岁,症状的平均持续时间为5.5年。对照者为这些患者的配偶、亲属或朋友。

视频双眼眼球跟踪器检查显示所有112例帕金森病患者均存在持续性眼球振动或固定不稳,而对照组只有2例存在这种情况,而且其中1例“显然存在帕金森病的症状前表现”。无论患者是否接受了抗帕金森病药物的治疗,均存在眼球震颤。

帕金森病患者眼球振动的平均基本频率为5.7 Hz;固定不稳的平均水平振幅为0.27度,垂直振幅为0.33度。在71例受试者中,眼球振动的最大振幅有时会达到0.5度,这被视为导致中央凹视力模糊的阈值水平。研究者还发现帕金森病组和对照组受试者的固定期平均均方根(RMS)速度(分别为每秒5.72度和3.07度)以及绝对平均速度(分别为每秒3.11度和1.80度)也存在显著差异。此外,在一个患者亚组中进行的磁性头部跟踪检查确认了患者头部移动与眼球固定不稳无关。

该研究所测量的所有眼球固定参数均与帕金森病统一评分量表第Ⅲ部分查体评分、震颤评分或疾病病程无关。94例接受了药物治疗的患者与18例没有接受药物治疗的患者在眼球震颤的基础频率、振幅或RMS速度等方面均无显著差异。帕金森病患者与对照者在对逐步移位的随机目标的扫视潜伏时间、扫视幅度、速度以及持续时间等方面亦无显著差异。

结果还显示,在帕金森病患者中观察到的眼球固定不稳有别于摆动性眼振。虽然这两种疾病在眼球固定方面的确存在一些共同特征,但主要区别在于:与摆动性眼振的一般性特征相比,帕金森病患者的振动波形更复杂,振幅更小;与典型性完全正弦波摆动性眼振相比,帕金森病患者眼球固定不稳的杂乱性更突出,存在多种正弦波频率。

研究者补充道:“该研究纳入的所有帕金森病患者都无一例外地观察到了这一特征,包括没有用药的患者,这说明眼球震颤是疾病发展过程中的一种表现,而不是因药物所致。”不过,研究者也承认该研究的局限性包括不能确定每一种药物可能对研究结果产生的影响,没有对患者视力进行正式的客观检查,因而不能评估眼球固定不稳的程度与患者实际视觉功能之间的直接关系。

该研究由美国退伍军人事务部资助。作者声明无相关利益冲突。

doi:10.1001/archneurol.2012.70
Pervasive Ocular Tremor in Patients With Parkinson Disease

George T. Gitchel, MS; Paul A. Wetzel, PhD; Mark S. Baron, MD

Objective  To further assess oculomotor control of patients with Parkinson disease (PD) during fixation and with movement.

Design  Case-control study.

Setting  A Parkinson disease research, education, and clinical center.

Patients  One hundred twelve patients with PD, including 18 de novo untreated patients, and 60 age-matched controls.

Intervention  Modern, precise eye tracking technology was used to assess oculomotor parameters. Oculomotor function was compared between groups during fixation and while tracking a randomly displaced target on a PC monitor.

Main Outcome Measures  Fixation stability and saccadic parameters.

Results  All patients with PD and 2 of 60 control subjects showed oscillatory fixation instability (ocular tremor), with an average fundamental frequency of 5.7 Hz and average magnitude of 0.27°. Saccadic parameters and occurrences of square wave jerks did not differ between subjects with PD and controls. The amplitude and frequency of fixation instability did not correlate with disease duration, clinical Unified Parkinson's Disease Rating Scale scores, or dopa-equivalent dosing. No differences in oculomotor parameters were found between medicated and unmedicated patients with PD.

Conclusions  All patients with PD exhibited persistent ocular tremor that prevented stability during fixation. The pervasiveness and specificity of this feature suggest that modern, precise oculomotor testing could provide a valuable early physiological biomarker for diagnosing PD.

Author Affiliations: Southeast Parkinson's Disease Research, Education, and Clinical Center, Hunter Holmes McGuire Veterans Affairs Medical Center (Mr Gitchel and Dr Baron), Department of Biomedical Engineering, Virginia Commonwealth University (Mr Gitchel and Dr Wetzel), and Department of Neurology, Virginia Commonwealth University Health System (Dr Baron), Richmond.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (4)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1649107, encodeId=099f164910efc, content=<a href='/topic/show?id=42c7e27798c' target=_blank style='color:#2F92EE;'>#眼球震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72779, encryptionId=42c7e27798c, topicName=眼球震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db4d23741776, createdName=木头人521, createdTime=Sun Jan 20 14:14:00 CST 2013, time=2013-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684036, encodeId=06d5168403685, content=<a href='/topic/show?id=a9fee2770d0' target=_blank style='color:#2F92EE;'>#眼球#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72770, encryptionId=a9fee2770d0, topicName=眼球)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a38928025675, createdName=刘阔, createdTime=Mon Mar 11 03:14:00 CST 2013, time=2013-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999198, encodeId=4ca9199919872, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 02 22:14:00 CST 2013, time=2013-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490112, encodeId=35c01490112dd, content=<a href='/topic/show?id=41d698891ef' target=_blank style='color:#2F92EE;'>#震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98891, encryptionId=41d698891ef, topicName=震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59428697908, createdName=kalseyzl, createdTime=Sun Apr 22 10:14:00 CST 2012, time=2012-04-22, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1649107, encodeId=099f164910efc, content=<a href='/topic/show?id=42c7e27798c' target=_blank style='color:#2F92EE;'>#眼球震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72779, encryptionId=42c7e27798c, topicName=眼球震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db4d23741776, createdName=木头人521, createdTime=Sun Jan 20 14:14:00 CST 2013, time=2013-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684036, encodeId=06d5168403685, content=<a href='/topic/show?id=a9fee2770d0' target=_blank style='color:#2F92EE;'>#眼球#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72770, encryptionId=a9fee2770d0, topicName=眼球)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a38928025675, createdName=刘阔, createdTime=Mon Mar 11 03:14:00 CST 2013, time=2013-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999198, encodeId=4ca9199919872, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 02 22:14:00 CST 2013, time=2013-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490112, encodeId=35c01490112dd, content=<a href='/topic/show?id=41d698891ef' target=_blank style='color:#2F92EE;'>#震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98891, encryptionId=41d698891ef, topicName=震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59428697908, createdName=kalseyzl, createdTime=Sun Apr 22 10:14:00 CST 2012, time=2012-04-22, status=1, ipAttribution=)]
    2013-03-11 刘阔
  3. [GetPortalCommentsPageByObjectIdResponse(id=1649107, encodeId=099f164910efc, content=<a href='/topic/show?id=42c7e27798c' target=_blank style='color:#2F92EE;'>#眼球震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72779, encryptionId=42c7e27798c, topicName=眼球震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db4d23741776, createdName=木头人521, createdTime=Sun Jan 20 14:14:00 CST 2013, time=2013-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684036, encodeId=06d5168403685, content=<a href='/topic/show?id=a9fee2770d0' target=_blank style='color:#2F92EE;'>#眼球#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72770, encryptionId=a9fee2770d0, topicName=眼球)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a38928025675, createdName=刘阔, createdTime=Mon Mar 11 03:14:00 CST 2013, time=2013-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999198, encodeId=4ca9199919872, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 02 22:14:00 CST 2013, time=2013-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490112, encodeId=35c01490112dd, content=<a href='/topic/show?id=41d698891ef' target=_blank style='color:#2F92EE;'>#震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98891, encryptionId=41d698891ef, topicName=震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59428697908, createdName=kalseyzl, createdTime=Sun Apr 22 10:14:00 CST 2012, time=2012-04-22, status=1, ipAttribution=)]
    2013-01-02 yinhl1978
  4. [GetPortalCommentsPageByObjectIdResponse(id=1649107, encodeId=099f164910efc, content=<a href='/topic/show?id=42c7e27798c' target=_blank style='color:#2F92EE;'>#眼球震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72779, encryptionId=42c7e27798c, topicName=眼球震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=db4d23741776, createdName=木头人521, createdTime=Sun Jan 20 14:14:00 CST 2013, time=2013-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1684036, encodeId=06d5168403685, content=<a href='/topic/show?id=a9fee2770d0' target=_blank style='color:#2F92EE;'>#眼球#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=72770, encryptionId=a9fee2770d0, topicName=眼球)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a38928025675, createdName=刘阔, createdTime=Mon Mar 11 03:14:00 CST 2013, time=2013-03-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1999198, encodeId=4ca9199919872, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Jan 02 22:14:00 CST 2013, time=2013-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1490112, encodeId=35c01490112dd, content=<a href='/topic/show?id=41d698891ef' target=_blank style='color:#2F92EE;'>#震颤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98891, encryptionId=41d698891ef, topicName=震颤)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=59428697908, createdName=kalseyzl, createdTime=Sun Apr 22 10:14:00 CST 2012, time=2012-04-22, status=1, ipAttribution=)]
    2012-04-22 kalseyzl

相关资讯

MHPA:英研究称散步有助缓解抑郁

是否感到有些抑郁?试试散步吧。这是许多医学专家推荐的治疗轻度抑郁的方法。英国一项最新研究再次支持了散步在缓解抑郁方面的有效性。相关论文发表在《精神健康与身体运动》(Mental Health and Physical Activity )杂志上。 英国斯特林大学等机构的研究人员报告说,他们对过去有关抑郁和散步的大量研究进行综合整理和分析,从中挑选出300多名适合对比分析的抑郁患者的数据,最终得出

PLoS ONE:欧洲科学家首次发现提高大脑认知功能的机理

欧盟第七研发框架计划(FP7)资助290万欧元,由丹麦、西班牙和瑞士科学家组成的研究团队,在分子和细胞学研究方面取得重要进展,首次发现提高大脑认知功能的机理。该发现对治疗老年痴呆症、孤独症和各种精神失调疾病具有潜力,研究结果在最新一期的《公共科学图书馆生物学》PLoS Biology杂志上发表。 大脑中连接神经元的突融,对人类的认知功能起着举足轻重的关键作用,尤其是控制大脑认知功能活力的突融模式

Nat Genet:新基因HMGA2关联大脑尺寸及智力

在全世界最大规模的脑研究中,由来自全世界100个研究机构的200多个研究人员组成的研究小组,共同绘制出一些人类基因,这些基因有的促进大脑抵抗各种精神疾病与阿尔茨海默病,有的破坏大脑对那些疾病的抵抗。相关研究结果发表在4月15日在线版Nature Genetics上,揭示了用来解释大脑大小与智力个体差异的新基因。 研究人员不仅探讨增加单一疾病遗传风险的基因,也对导致组织萎缩和大脑尺寸减小的因素进行

Nat Neuro:研究揭示焦虑情绪与大脑前扣带皮层有关

4月8日,国际著名杂志《自然—神经科学》Nature Neuroscience在线刊登了国外研究人员的最新研究成果“Localized microstimulation of primate pregenual cingulate cortex induces negative decision-making,”,文章中,研究者揭示了焦虑情绪与大脑前扣带皮层有关。 杂志上的一项研究表明,对猴子大

Nat Genet: 4个基因的翻译影响成人记忆

据报道,已经有一项研究对阿尔茨海默疾病与大脑发育的遗传组分进行了深入了解,该研究是由8个国家71所研究机构80多个科学家共同完成的。在4月15日的Nature Genetics上发表了3篇相关的研究论文。 第一篇论文,以9000多人的遗传分析为基础,报道了4个基因的某些翻译可能加速一个涉及新记忆形成的大脑区域的皱缩。研究表明,名为海马的大脑区域,通常随着年龄增长而皱缩,但如果此过程加速,就可能增

Neuron:大脑AKT3基因突变易致侧巨脑症

近日,哈佛医学院儿童医院的研究者发现仅仅大脑组织的突变可引起侧巨脑症(HMG),这种侧巨脑症也就是一半大脑增大以及功能失调,最终导致智障以及严重癫痫症。研究者的这项研究刊登在了4月12日的国际杂志Neuron上,对于精神疾病的治疗提供了很好的线索和模板。大脑组织的突变可以由遗传产生也可以后天自发产生,遗传突变遍布于人体的全部细胞之中,但是一些自发的突变是在机体发育的过程中产生的,而且仅仅发生在某些