帕金森病患者记忆扫视的特点

目的 研究帕金森病(PD)患者记忆扫视的特点,探讨记忆扫视对PD辅助诊断的价值.方法 选取53例早、中期PD患者作为PD组,同时选取36名年龄匹配的健康受试者作为对照组.对所有受试者进行记忆扫视检查和事件相关电位P300检查,并对检查结果进行比较；同时,对29例早期PD亚组患者的记忆扫视结果进行单独分析.结果 与健康受试者相比,PD组患者记忆扫视速度、初始增益明显降低,记忆扫视潜伏期明显延长,多余扫视和多阶模式扫视的发生率明显增多(U=124.000、37.000；均P＜0.0l),这些异常在早期PD患者亚组中已经非常明显；PD患者事件相关电位P300潜伏期( 384.76±34.48) ms]较健康受试者(352.42±24.99) ms]延长(t=-4.791,P＜0.01)；多阶模式扫视的发生率对区分PD患者和健康受试者具有很好的敏感度(96.2％)和特异度(94.4％).结论 PD患者记忆扫视各项指标检查结果明显异常,可能是PD患者脑干扫视通路和额叶功能损害的反映.记忆扫视检查在PD的辅助诊断方面可能具有一定的应用价值.

Characteristics of memory-guided saccade in Parkinson' s disease

Objective To investigate characteristics of memory-guided saccade in Parkinson' s disease (PD),and to evaluate the application of memory-guided saccade in diagnosing PD.Methods Fiftythree subjects with early- or mid- stage PD were chosen as PD group,meanwhile,36 age-matched healthy subjects were chosen as control group.Memory-guided saccade test and event-related potential P300 were performed in all subjects,and results of the two groups were compared; furthermore,results of subgroups comprised of 29 patients with early-stage PD were analyzed.Results In comparison with control group,memory-guided saccade in PD group showed decreased velocity and primary gain,prolonged latency,extremely increased incidence of unwanted saccade and multi-step saccade ( U =124.000,37.000;both P ＜0.01 ),such abnormalities has already stood out even in subgroup comprised of early-stage PD patients.Meanwhile,latency of event-related potential P300 in PD group was prolonged compared with control group ((384.76 ± 34.48) ms vs (352.42 ± 24.99) ms,t =- 4.791,P ＜ 0.01 ).Multi-step saccade measurement demonstrated excellent sensitivity (96.2％ ) and specificity (94.4％) in the ability to discriminate PD patients from controls.Conclusion Memory-guided saccade in PD patients shows highly abnormal which may reflect the impairment of pontine saccade pathway and the dysfunction of frontal lobe.Memory-guided saccade test may be a useful examination in assisting the diagnosis of PD.