Panagiota Tsitsi, Mattias Nilsson, Josefine Waldthaler, Gustaf Öqvist Seimyr, Olof Larsson, Per Svenningsson, Ioanna Markaki
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引用次数: 0
Abstract
Introduction: Visual disturbance is common symptom in Parkinson's disease (PD), and defective pupil light reflex (PLR) is an anticipated contributing factor that may be associated to the presence of autonomic dysfunction, which is a common non-motor feature of PD. Studies investigating the intercorrelation between PLR and dysautonomia in PD are limited.
Methods: The aim of this study was to investigate differences of PLR parameters, measured by eye-tracker, between patients with PD, with and without signs of dysautonomia, and healthy controls (HC). In total, 43 HC and 50 patients with PD were recruited and PLR parameters were measured with Tobii Pro Spectrum, during a long (1,000 ms) and a short (100 ms) light stimulus. Presence of orthostatic hypotension (OH) was used as proxy marker of dysautonomia. Linear mixed-effects model and non-parametric comparative statistics were applied to investigate differences among groups.
Results: Peak constriction velocity was slower in PD compared with HC, after adjustment for age and sex in the mixed model, and the difference was greater in the subgroup of PD with OH (unadjusted). Dilation amplitude and velocity were also gradually slower in HC vs. PD without OH vs. PD with OH (unadjusted for confounders). In the mixed model, age was significant predictor of dilation response.
Discussion: Our results support previous observations on defective PLR in PD, evaluated with eye-tracker, and show a possible association with autonomic dysfunction. Further studies with more patients and rigorous evaluation of autonomic dysfunction are needed to validate these findings.
引言：视觉障碍是帕金森病（PD）的常见症状，瞳孔光反射缺陷（PLR）是一个预期的促成因素，可能与自主神经功能障碍的存在有关，自主神经功能障碍是帕金森病的一个常见非运动特征。研究PLR与帕金森病自主神经功能障碍之间相互关系的研究有限。方法：本研究的目的是研究有和无自主神经功能障碍症状的帕金森病患者与健康对照组（HC）之间通过眼动仪测量的PLR参数的差异。总共招募了43名HC和50名PD患者，并在长（1000ms）和短（100ms）光刺激期间使用Tobii Pro Spectrum测量PLR参数。直立性低血压（OH）的存在被用作自主神经功能障碍的替代标志。采用线性混合效应模型和非参数比较统计学方法研究各组间的差异。结果：在混合模型中调整了年龄和性别后，PD的峰值收缩速度比HC慢，并且在伴有OH的PD亚组中差异更大（未调整）。HC组的扩张幅度和扩张速度也逐渐变慢，而无OH组的扩张振幅和扩张速度则逐渐变慢。在混合模型中，年龄是扩张反应的重要预测因素。讨论：我们的研究结果支持了之前用眼动仪评估的PD患者PLR缺陷的观察结果，并显示了与自主神经功能障碍的可能关联。需要对更多患者进行进一步研究，并对自主神经功能障碍进行严格评估，以验证这些发现。
期刊介绍：
Frontiers in Integrative Neuroscience publishes rigorously peer-reviewed research that synthesizes multiple facets of brain structure and function, to better understand how multiple diverse functions are integrated to produce complex behaviors. Led by an outstanding Editorial Board of international experts, this multidisciplinary open-access journal is at the forefront of disseminating and communicating scientific knowledge and impactful discoveries to researchers, academics, clinicians and the public worldwide.
Our goal is to publish research related to furthering the understanding of the integrative mechanisms underlying brain functioning across one or more interacting levels of neural organization. In most real life experiences, sensory inputs from several modalities converge and interact in a manner that influences perception and actions generating purposeful and social behaviors. The journal is therefore focused on the primary questions of how multiple sensory, cognitive and emotional processes merge to produce coordinated complex behavior. It is questions such as this that cannot be answered at a single level – an ion channel, a neuron or a synapse – that we wish to focus on. In Frontiers in Integrative Neuroscience we welcome in vitro or in vivo investigations across the molecular, cellular, and systems and behavioral level. Research in any species and at any stage of development and aging that are focused at understanding integration mechanisms underlying emergent properties of the brain and behavior are welcome.
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