The potential value of saccades and antisaccades to identify tremor dominant and postural instability/gait difficulty subtypes in Parkinson′s disease
10.3760/cma.j.cn113694-20240111-00028
- VernacularTitle:眼球扫视在鉴别帕金森病运动亚型中的潜在价值
- Author:
Qi QI
1
;
Yan LI
;
Chentao HE
;
Piao ZHANG
;
Mengfei CAI
;
Kun NIE
;
Limin WANG
;
Lijuan WANG
;
Yuhu ZHANG
Author Information
1. 广东省心血管病研究所 广东省人民医院（广东省医学科学院）神经内科，广州 510080
- Keywords:
Parkinson disease;
Eye movements;
Saccade;
Antisaccade;
Motor subtypes
- From:
Chinese Journal of Neurology
2024;57(11):1190-1198
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the potential value of saccade and antisaccade parameters in early identification of Parkinson′s disease (PD) and its motor subtypes.Methods:A total of 111 PD patients [tremor dominant (TD) type in 45, postural instability/gait difficulty (PIGD) type in 54 and indeterminate type in 12)] and 54 healthy controls were recruited from Department of Neurology, Guangdong Provincial People′s Hospital from July 2022 to July 2023. All subjects underwent oculomotor test including visually guided saccades and volitional antisaccades by the Eyeknow-M10-B Eye tracker. For PD patients, TD and PIGD scores were measured using the Movement Disorder Society Unified Parkinson′s Disease Rating Scale (MDS-UPDRS) Part Ⅱ and Part Ⅲ. Oculomotor parameters among TD, PIGD patients and healthy controls were firstly compared. Multiple linear regression analyses were performed to assess the relationship between ocular parameters with differences and TD/PIGD score. Then receiver operating characteristic (ROC) curve analysis was made between PD patients and healthy controls, as well as between PIGD and TD subtypes.Results:Compared to healthy controls, PD patients showed significantly decreased saccadic accuracy [100.0%(90.0%, 100.0%) vs 100.0%(100.0%, 100.0%), U=1 732.500, P<0.001], prolonged latency [252.2(228.5, 300.1) ms vs 227.7(214.2, 241.8) ms, U=1 401.000, P<0.001], minimum duration [233.6(211.2, 278.8) ms vs 211.0(200.0, 222.5) ms, U=1 534.500, P<0.001], average duration [356.6(313.8, 427.8) ms vs 279.4(267.4, 312.9) ms, U=881.000, P<0.001],as well as decreased peak [444.4(335.0, 593.7) °/s vs 526.7(412.6, 696.2) °/s, U=1 971.000, P=0.007] and average velocity [196.3(144.4, 240.5) °/s vs 256.7(226.7, 312.0) °/s, U=1 330.000, P<0.001] in saccades. And in antisaccades, PD patients also showed prolonged latency [432.0(362.9, 599.8) ms vs 352.9(309.8, 407.6) ms, U=1 553.000, P<0.001], minimum duration [333.4(299.8, 377.6) ms vs 290.1(263.9, 332.9) ms, U=1 608.000, P<0.001], average duration [518.2(462.7, 603.5) ms vs 424.2(377.1, 473.5) ms, U=1 181.000, P<0.001], decreased peak [458.5(327.9, 604.3) °/s vs 560.4(440.3, 698.5) °/s, U=1 838.500, P=0.001] and average velocity [186.6(143.1, 228.1) °/s vs 263.2(217.2, 301.5) °/s, U=1 131.000, P<0.001]. There was no statistically significant difference in antisaccadic accuracy [55.0%(15.0%, 80.0%) vs 66.7%(39.4%, 86.9%), U=2 167.500, P=0.053]. Compared with TD subtype, PIGD patients showed significantly decreased antisaccadic peak velocity [416.2(300.3, 534.3) °/s vs 527.1(402.3, 636.4) °/s, U=-26.474, P=0.009]. After adjusting for age, gender and education, antisaccadic peak velocity was negatively correlated with PIGD score in PD patients (β=-0.296, P=0.001), and no correlation with TD score was found. The ROC analysis was performed on combined saccadic and antisaccade metrics between PD patients and healthy controls, with area under the curve (AUC) as 0.918. For antisaccadic peak velocity between PIGD and TD subtypes, the AUC was 0.690. Conclusions:Eye movement metrics have potential value in distinguishing PD patients from healthy controls. The antisaccadic peak velocity is related to the severity of motor symptoms in PIGD patients, which is helpful for distinguishing the motor subtypes of PD patients.
