Follow-up observation of eye movements in multiple system atrophy and Parkinson's disease: a cohort study.

IF 2.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Yinglin Leng, Hong Zhou, Luhua Wei, Yanyan Jiang, Xia Wang, Yunchuang Sun, Fan Li, Jing Chen, Wei Sun, Wei Wang, Lin Zhang, Guiping Zhao, Zhaoxia Wang
{"title":"Follow-up observation of eye movements in multiple system atrophy and Parkinson's disease: a cohort study.","authors":"Yinglin Leng, Hong Zhou, Luhua Wei, Yanyan Jiang, Xia Wang, Yunchuang Sun, Fan Li, Jing Chen, Wei Sun, Wei Wang, Lin Zhang, Guiping Zhao, Zhaoxia Wang","doi":"10.1136/bmjopen-2024-094106","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to explore the changes in oculomotor deficiencies during the follow-up of patients with multiple system atrophy (MSA) and Parkinson's disease (PD), and to investigate the value of dynamic eye movement examination in their differential diagnosis.</p><p><strong>Design: </strong>This was a cohort study conducted from 2017 to 2023.</p><p><strong>Setting: </strong>The Movement Disorders Clinic at a tertiary hospital in Beijing, China.</p><p><strong>Participants: </strong>56 patients with PD and 13 patients with MSA from an initial cohort of over 1100 with parkinsonism were included in the final longitudinal analysis.</p><p><strong>Outcome measures: </strong>Multisystem evaluations were performed at baseline. Videonystagmography (VNG) was repeated to assess oculomotor dysfunction at baseline and during follow-up. Abnormalities in the fixation and gaze-holding test, without-fixation test, reflexive and memory-guided saccade tests, smooth pursuit test and optokinetic test were qualitatively and quantitatively recorded and statistically analysed.</p><p><strong>Results: </strong>The median follow-up time of MSA (16 months) was significantly shorter than that of PD (27 months). In MSA, the incidence of abnormalities in fixation and gaze-holding tests (0% vs 30.8%, p=0.030), reflexive saccade tests (46.2% vs 84.6%, p=0.039, with slow saccades increasing from 7.7% to 46.2%, p=0.027) and smooth pursuit tests (38.5% vs 76.9%, p=0.047) increased significantly from baseline to the end of follow-up. In PD, no significant changes were revealed during follow-up.</p><p><strong>Conclusions: </strong>MSA exhibited more rapid and prominent changes in fixation and gaze-holding tests, reflexive saccades and smooth pursuit tests than PD. Dynamic observation of oculomotor function may aid in the differential diagnosis of Parkinson's syndrome.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 7","pages":"e094106"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjopen-2024-094106","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: We aimed to explore the changes in oculomotor deficiencies during the follow-up of patients with multiple system atrophy (MSA) and Parkinson's disease (PD), and to investigate the value of dynamic eye movement examination in their differential diagnosis.

Design: This was a cohort study conducted from 2017 to 2023.

Setting: The Movement Disorders Clinic at a tertiary hospital in Beijing, China.

Participants: 56 patients with PD and 13 patients with MSA from an initial cohort of over 1100 with parkinsonism were included in the final longitudinal analysis.

Outcome measures: Multisystem evaluations were performed at baseline. Videonystagmography (VNG) was repeated to assess oculomotor dysfunction at baseline and during follow-up. Abnormalities in the fixation and gaze-holding test, without-fixation test, reflexive and memory-guided saccade tests, smooth pursuit test and optokinetic test were qualitatively and quantitatively recorded and statistically analysed.

Results: The median follow-up time of MSA (16 months) was significantly shorter than that of PD (27 months). In MSA, the incidence of abnormalities in fixation and gaze-holding tests (0% vs 30.8%, p=0.030), reflexive saccade tests (46.2% vs 84.6%, p=0.039, with slow saccades increasing from 7.7% to 46.2%, p=0.027) and smooth pursuit tests (38.5% vs 76.9%, p=0.047) increased significantly from baseline to the end of follow-up. In PD, no significant changes were revealed during follow-up.

Conclusions: MSA exhibited more rapid and prominent changes in fixation and gaze-holding tests, reflexive saccades and smooth pursuit tests than PD. Dynamic observation of oculomotor function may aid in the differential diagnosis of Parkinson's syndrome.

多系统萎缩和帕金森病眼动的随访观察:一项队列研究。
目的:探讨多系统萎缩(MSA)和帕金森病(PD)患者随访期间眼球运动缺陷的变化,探讨动态眼动检查在其鉴别诊断中的价值。设计:这是一项从2017年到2023年进行的队列研究。地点:中国北京某三级医院运动障碍门诊。参与者:从1100多名帕金森患者的初始队列中,56名PD患者和13名MSA患者被纳入最终的纵向分析。结果测量:在基线进行多系统评估。在基线和随访期间,反复进行视震成像(VNG)以评估动眼肌功能障碍。定性、定量记录注视注视试验、无注视注视试验、反射性和记忆引导扫视试验、平滑追踪试验和光动力学试验的异常情况,并进行统计学分析。结果:MSA的中位随访时间(16个月)明显短于PD(27个月)。在MSA中,从基线到随访结束,注视和凝视试验(0%对30.8%,p=0.030)、反射性扫视试验(46.2%对84.6%,p=0.039,慢扫视从7.7%增加到46.2%,p=0.027)和平滑追踪试验(38.5%对76.9%,p=0.047)的异常发生率显著增加。PD随访无明显变化。结论:MSA在注视和凝视测试、反射性扫视和平滑追踪测试中表现出比PD更快和更显著的变化。动态观察动眼肌功能有助于帕金森综合征的鉴别诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BMJ Open
BMJ Open MEDICINE, GENERAL & INTERNAL-
CiteScore
4.40
自引率
3.40%
发文量
4510
审稿时长
2-3 weeks
期刊介绍: BMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around fully open peer review and continuous publication, publishing research online as soon as the article is ready.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信