帕金森病患者眼球运动预测性控制的临床观察

目的 研究帕金森病(PD)患者眼球运动预测性控制能力,探讨其临床意义.方法 利用视频眼震电图(VNG)对早中期原发性PD患者和年龄、性别相匹配的正常人做可预测性眼球扫视运动,比较两组的扫视潜伏期.结果 在随机性扫视方案中,PD组和对照组扫视潜伏期分别为284ms±58 ms和236 ms±37 ms,两者比较差异有统计学意义(P=0.003);在可预测性扫视方案中,PD组和对照组的扫视潜伏期分别为150 ms±138 ms和59 ms±102 ms,两组差异有统计学意义(P=0.002);在可预测扫视方案中,PD组出现预见性扫视的次数占21%,对照组则占31%,两者相比,差异有统计学意义(P=0.003).结论 PD患者存在眼球运动预见性机制缺陷,表明PD在疾病早期可能出现部分认知功能障碍.

Predictive ocular motor control in Parkinson's disease

OBJECTIVE: To investigate the changes of predictive ocular motor function in the patients with Parkinson's disease (PD), and to discuss its clinical value. METHODS: Videonystagmography (VNG) was used to examine 24 patients with idiopathic Parkinson's disease, 15 males and 9 females, aged 61 +/- 6 (50-69), and 24 sex and age-matched healthy control subjects on random ocular saccade (with the target moving at random intervals to random positions) and predictive ocular saccade (with the 1.25-second light target moving 10 degrees right or left from the center). RESULT: In the random ocular saccade program, the latency of saccade of the PD patients was 284 ms +/- 58 ms, significantly longer than that of the healthy controls (236 ms +/- 37 ms, P = 0.003). In the predictive ocular saccade pattern, the latency of saccades the PD patients was 150 ms +/- 138 ms, significantly longer than that of the healthy controls (59 ms +/- 102 ms, P = 0.002). The appearance rate of predictive saccades (with the latency of saccade <80 ms) in the PD group was 21%, significantly lower than that in the control group (31%, P = 0.003). CONCLUSION: There is dysfunction of predictive ocular motor control in the PD patients, and the cognitive function may be impaired at the early stage of PD.