帕金森病患者眼球运动预测性控制与认知功能的关系

Relationship between predictable ocular motor control and cognitive function in Parkinson's disease

目的研究帕金森病(PD)患者眼球运动预测性控制能力与认知功能的关系。方法利用视频眼震电图记录24例早中期原发性PD患者(PD组)和24名健康人(对照组)的可预测性眼球扫视运动,比较两组扫视的精确度。将PD患者预见性扫视(扫视潜伏期<80 m s)的精确度与MoCA评分、UPDRS运动部分评分和Hoehn-Yahr分级进行相关性分析。结果在可预测性扫视方案中,PD组和对照组预见性扫视的精确度较非预见性扫视的精确度均显著下降(P<0.01);PD组总体扫视精确度较对照组显著下降(P=0.018);PD组预见性扫视精确度的下降幅度较对照组更为明显(P=0.000)。PD组患者预见性扫视精确度与MoCA评分相关(相关性系数为0.485,P=0.016),与UPDRS运动部分评分和Hoehn-Yahr分级无相关性(相关性系数分别为0.087和0.007,P=0.686和P=0.974)。结论PD患者预见性扫视功能较正常人明显下降,预见性扫视的精确度是反映PD患者认知功能的客观指标。

Objective To explore the relationship between predictable ocular motor control and cognitive function in Parkinson＇s disease （PD）. Methods Videonystagmography was used to examine 24 patients with idiopathic PD （PD group） and 24 healthy controls （control group） on predictable ocular motor control. The accuracies of saccade were compared between two groups. The correlation among accuracy for predictive saccade （latency 〈 80 ms） and MoCA score, score in motor portion of UPDRS and Hoehn-Yahr stage was analyzed. Results The accuracy of predictive saccade decreased significantly compared with unpredictive saccade in two groups （P 〈0.01）. The total accuracy of saccade in PD group decreased significantly compared with that in control group （P = 0. 018）. The decrease amplitude of predictive saccade in PD group was higher than that in control group（P = 0. 000）. The accuracy of predictive saccade had correlation with MoCA score （correlation coefficient was 0. 485, P = 0. 016）, while had no correlation with scores in motor portion of UPDRS and Hoehn-Yahr stage （ correlation coefficients were 0. 087 and 0. 007, P = 0. 686 and P = 0. 974, respectively）. Conclusion Patients with PD have difficulties in predictive ocular motor control. The accuracy of predictive saccade is an objective parameter reflecting cognitive function in PD.