早期帕金森病患者视频眼震电图分析

Video-nystagmography recording in the early stage Parkinson's disease

目的采用眼震电图检查方法对早期帕金森病眼球运动异常进行定量分析。方法选取31例H&Y分期不大于2期的帕金森病患者作为病例组,其中H&Y1期6例,1.5期16例,2期9例。同时选取31例无中枢神经系统、周围前庭系统及眼部疾病的受试者作为对照组。对病例组和对照组进行视频眼震电图检查,检查内容包括凝视检查、自发眼震检查、扫视检查、平稳跟踪检查及视动性眼震检查等。对检查结果分别进行两组间的比较。结果与对照组相比,病例组扫视速度降低,在个别扫视角度上的速度差异有统计学意义(P<0.05);左向扫视时,病例组准确度异常的发生率为21.1%,对照组为10.8%,右向扫视时,病例组、对照组准确度异常的发生率分别为18.8%和8.1%,均有极显著差异(P<0.01);病例组平稳跟踪试验速度增益明显低于对照组(P<0.05);而视动性眼震、自发及凝视性眼震在两组之间无统计学差异(P>0.05)。结论早期帕金森病患者眼球运动存在异常,主要表现在扫视和平稳跟踪运动中。眼震电图检查结果可以为帕金森病的早期诊断提供重要的依据。

Objective To quantitatively analyze eye movement abnormalities by using Video-nystagmography （VNG） recording in patients with early stage Parkinson＇s disease （ESPD）. Methods Thirty one patients with ESPD were recruited in the present study. Among them, 6 patients was at Hoehn and Yahr stage 1, 16 patients at stage 1.5 and 9 patients at stage 2. Thirty one age-and gender-matched subjects without central nervous system diseases and peripheral vestibular system diseases served as control. VNG recording which including gaze test （GT）, spontaneous nystagmus test （SN）, saccade test （ST）, smooth pursuit test （SPT） and optokinetic nystagmus test （ON） were conducted in both groups. Results Compared with controls, decreased saccadic velocity was found in ESPD patients. There were significant differences in velocity of several saccadic angles between two groups （P0.05）. The percentages of inaccurate saccades were 21.1% and 10.8% in ESPD and control groups, respectively during leftward saccades （P0.01）. The Percentages of inaccurate saccades were 18.8% and 8.1% in ESPD and control groups during rightward saccades （P0.01）. Gain of SPT test was much lower in ESPD group than in control group （P0.05）. However,, there were no significant differences in GT, SN and ON test between the two groups （P0.05）. Conclusions ESPD patients have abnormal eye movements which can be detected using ST and SPT tests. VNG test can provide the important evidence for the diagnosis for ESPD