摘要
Neurodegeneration in Parkinson’s disease dementia (PDD) and dementia with Lew y bodies (DLB) affect cortical and subcortical networks involved in saccade gene ration. We therefore expected impairments in saccade performance in both disorde rs. In order to improve the pathophysiological understanding and to investigate the usefulness of saccades for differential diagnosis, saccades were tested in a ge-and education-matched patients with PDD (n=20) and DLB (n=20), Alzheimer’s disease (n=22) and Parkinson’s disease (n=24), and controls (n=24). Reflexive (gap, overlap) and complex saccades (prediction, decision and antisaccade) were tested with electrooculography. PDD and DLB patients had similar impairment in a ll tasks (P > 0.05, not signifi cant). Compared with controls, they were impaire d in both reflexive saccade execution (gap and overlap latencies, P < 0.0001; ga ins, P < 0.004) and complex saccade performance (target prediction, P < 0.0001; error decisions, P < 0.003; error antisaccades: P < 0.0001). Patients with Alzhe imer’s disease were only impaired in complex saccade performance (Alzheimer’s disease versus controls, target prediction P < 0.001, error decisions P < 0.0001 , error antisaccades P < 0.0001), but not reflexive saccade execution (for all, P >0.05). Patients with Parkinson’s disease had, compared with controls, similar complex saccade performance (for all, P > 0.05) and only minimal impairment in reflexive tasks, i.e. hypometric gain in the gap task (P=0.04). Impaired saccade execution in re flexive tasks allowed discrimination between DLB versus Alzheimer’s disease (se nsitivity ≥60%, specificity ≥77%)-and between PDD versus Parkinson’s disea se (sensitivity ≥60%, specificity ≥88%) when ±1.5 standard deviations was u sed for group discrimination. We conclude that impairments in reflexive saccades may be helpful for differential diagnosis and are minimal when either cortical (Alzheimer’s disease) or nigrostriatal neurodegeneration (Parkinson’s disease) exists solel
Neurodegeneration in Parkinson's disease dementia (PDD) and dementia with Lew y bodies (DLB) affect cortical and subcortical networks involved in saccade gene ration. We therefore expected impairments in saccade performance in both disorde rs. In order to improve the pathophysiological understanding and to investigate the usefulness of saccades for differential diagnosis, saccades were tested in a ge-and education-matched patients with PDD (n=20) and DLB (n=20), Alzheimer's disease (n=22) and Parkinson's disease (n=24), and controls (n=24). Reflexive (gap, overlap) and complex saccades (prediction, decision and antisaccade) were tested with electrooculography. PDD and DLB patients had similar impairment in a ll tasks (P > 0.05, not signifi cant). Compared with controls, they were impaire d in both reflexive saccade execution (gap and overlap latencies, P < 0.0001; ga ins, P < 0.004) and complex saccade performance (target prediction, P < 0.0001; error decisions, P < 0.003; error antisaccades: P < 0.0001). Patients with Alzhe imer's disease were only impaired in complex saccade performance (Alzheimer's disease versus controls, target prediction P < 0.001, error decisions P < 0.0001 , error antisaccades P < 0.0001), but not reflexive saccade execution (for all, P >0.05). Patients with Parkinson's disease had, compared with controls, similar complex saccade performance (for all, P > 0.05) and only minimal impairment in reflexive tasks, i.e. hypometric gain in the gap task (P=0.04). Impaired saccade execution in re flexive tasks allowed discrimination between DLB versus Alzheimer's disease (se nsitivity ≥60%, specificity ≥77%)-and between PDD versus Parkinson's disea se (sensitivity ≥60%, specificity ≥88%) when ±1.5 standard deviations was u sed for group discrimination. We conclude that impairments in reflexive saccades may be helpful for differential diagnosis and are minimal when either cortical (Alzheimer's disease) or nigrostriatal neurodegeneration (Parkinson's disease) exists solely; however, they bec
出处
《世界核心医学期刊文摘（眼科学分册）》
2005年第10期2-3,共2页
Digest of the World Core Medical Journals:Ophthalmology
