帕金森病患者记忆扫视的特点

Characteristics of memory-guided saccade in Parkinson＇ s disease

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〈0．01），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19300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。

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 Fifty- three 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 saeeade in PD patients shows highly abnormal which may reflect the impairment of pontine saceade pathway and the dysfunction of frontal lobe. Memory-guided saccade test may be a useful examination in assisting the diagnosis of PD.