帕金森病和多系统萎缩的异常眼球运动研究进展

Research progress of abnormal eye movements in Parkinson’s disease and multiple system atrophy

帕金森病(PD)是一类主要累及基底神经节的一种神经退行性疾病,其典型的临床表现有静止性震颤、运动迟缓、肌强直。多系统萎缩(MSA)的临床表现主要是帕金森症状、共济失调及自主神经症状的结合。由于临床表现重叠性强、缺乏具有特异性的检查手段及生物学标志物,PD与MSA患者在早期鉴别诊断非常困难,但如果存在眼球运动异常,它们可能有助于鉴别诊断。眼球运动检查包括床边评估和实验室记录眼球错位、不自主眼球运动,包括眼球震颤和扫视侵入、视振荡、诱发性眼球震颤、扫视、平滑跟踪和前庭眼反射。眼球运动的控制主要依赖于基底节的功能,现有研究认为PD和MSA患者均有眼球运动异常。近年来,越来越多的研究发现眼球运动异常在PD及MSA的诊断及鉴别中有重要意义。本文综述近些年来国内外学者对PD和MSA中眼球运动异常的相关研究,旨在为早期PD和MSA的鉴别提供参考。

Parkinson’s disease(PD)is a type of neurodegenerative disease that mainly affects the basal ganglia.Its typical clinical manifestations are static tremor,slow movement,and muscle rigidity.The clinical manifestations of multiple system atrophy(MSA)are mainly a combination of Parkinson’s disease,ataxia and autonomic symptoms.Due to the strong overlap of clinical manifestations and the lack of specific examination methods and biological markers,the early differential diagnosis of PD and MSA patients is very difficult,but if there are abnormal eye movements,they may help the differential diagnosis.Ocular motility examination should include bedside evaluation and laboratory recording of ocular misalignment,involuntary eye movements,triggered nystagmus,saccades,smooth pursuit(SP),the vestibulo-ocular reflex(VOR),optokinetic nystagmus(OKN),and vergence eye movements.The control of eye movement depends on the function of the basal ganglia.The current study believes that both PD and MSA patients have abnormal eye movements.In recent years,more and more have found that abnormal eye movements play an important role in the diagnosis and differentiation of Parkinson’s disease and multiple system atrophy.This article will review the research on abnormal eye movement in PD and MSA by domestic and foreign scholars in recent years,aiming to provide reference for the early identification of PD and MSA.