EPV 3. Regional microstructural impairment is associated with characteristic altered oculomotor performance in Parkinsonian syndromes

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• 作者：M. Gorges ; M. Maier ; H.- P. Mü ; ller ; A.C. Ludolph ; E.H. Pinkhardt ; J. Kassubek
• 刊名：Clinical Neurophysiology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：127
• 期：9
• 页码：e223-e224
• 全文大小：47 K

文摘

A common feature of Parkinsonism – including idiopathic Parkinson’s disease (PD), Multisystem Atrophy (MSA) and Progressive Supranuclear Palsy (PSP) – are characteristic alterations of eye movement control (Gorges et al., 2014). Regional microstructural alterations assessed by diffusion tensor imaging (DTI) have been reported in PD (Agosta et al., 2014), MSA (Prakash et al., 2009) and PSP (Rosskopf et al., 2015).

Objective

To investigate the association between eye movement disturbances and microstructural impairment in patients with PD, MSA and PSP.

Methods

Video-oculographic recordings (EyeSeeCam®) of smooth pursuit and visually guided reactive saccades as well as whole-brain based fractional anisotropy (FA) maps computed from diffusion tensor imaging (1.5T) data were analyzed for 37 IPS, 31 PSP, 19 MSA and 36 matched healthy control subjects.

Results

The prevalence of saccadic intrusions as a measure for inhibitory control was significantly increased in PD patients compared with controls (p < 0.001) and negatively correlated with the fractional anisotropy (FA) in the capsula interna (p < 0.001, FDR corrected). As a cardinal oculomotor feature in MSA, smooth pursuit was disturbed by characteristic ‘catch-up’ saccades (p < 0.001) and was significantly correlated with a FA reduction in the middle cerebral peduncle (p < 0.001, FDR corrected). The hallmark of PSP are pathologically slowed vertical peak eye velocities compared with controls (p < 0.001); the lower the peak eye velocity the more marked microstructural impairment in midbrain (p < 0.001, FDR corrected).

Conclusions

Eye movements alterations are predominantly the result of executive dysfunction in PD and reflect impaired infratentorial oculomotor control pathways in MSA and PSP. The worse the performance of the characteristic oculomotor parameter the more impaired was the associated regional microstructure.