Clinical Neurophysiology最新文献_第8页

Effect of resting motor threshold availability on preoperative motor cortex localization using navigated-TMS in glioma surgery 脑胶质瘤手术中静息运动阈值可用性对术前运动皮质定位的影响。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-09 DOI: 10.1016/j.clinph.2025.2111429

Buntou Ro , Manabu Tamura , Atsushi Kuwano , Tomokazu Takakura , Sachiko Kodera , Akimasa Hirata , Takakazu Kawamata , Ken Masamune , Yoshihiro Muragaki

Objective

To assess the concordance between preoperative motor cortex mapping using navigated transcranial magnetic stimulation (nTMS) and intraoperative direct electrical stimulation (DES), and to determine whether the ability to obtain the resting motor threshold (RMT) affects mapping accuracy.

Methods

Seventeen patients with motor or premotor cortical gliomas underwent preoperative nTMS and intraoperative DES. Motor mapping was performed using the RMT or, if unobtainable, the active motor threshold (AMT). Concordance between nTMS and DES was analyzed using Fisher’s exact test.

Results

Spatial concordance between nTMS and DES was observed in 9 of 12 patients (75 %) with measurable RMT. None of the five AMT-only cases demonstrated concordance. The difference in concordance rates between RMT and AMT-only cases was statistically significant (p = 0.026). Representative cases illustrate the relationship between RMT availability and mapping accuracy.

Conclusions

Preoperative nTMS mapping showed high concordance with DES when the RMT was obtainable. The lack of an RMT may predict reduced intraoperative mapping reliability.

Significance

RMT preoperative assessment can guide surgical planning, including the need for subcortical mapping or adjusted resection margins. These findings highlight the utility of nTMS for motor localization and emphasize the value of the RMT for predicting intraoperative mapping success.

目的：评估术前经颅磁刺激（nTMS）和术中直接电刺激（DES）运动皮质映射的一致性，并确定获得静息运动阈值（RMT）的能力是否影响映射精度。方法：17例运动或运动前皮质胶质瘤患者术前接受nTMS和术中DES。运动映射使用RMT，如果无法获得，则使用活动运动阈值（AMT）。采用Fisher精确检验分析nTMS与DES的一致性。结果：在12例可测量RMT的患者中，有9例（75%）观察到nTMS和DES的空间一致性。5例仅amt的病例均未显示一致性。RMT与amt的一致性率差异有统计学意义（p = 0.026）。代表性的案例说明了RMT可用性和映射准确性之间的关系。结论：术前行RMT时，nTMS图谱与DES高度一致。缺乏RMT可能预示术中测图可靠性降低。意义：RMT术前评估可以指导手术计划，包括需要皮质下作图或调整切除边缘。这些发现强调了nTMS在运动定位中的应用，并强调了RMT在预测术中定位成功方面的价值。

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引用次数: 0

Identifying the epileptogenic zone by 18F-FDG PET/MRI in drug-resistant epilepsy with focal cortical dysplasia type IIIa 18F-FDG PET/MRI在伴有局灶性皮质发育不良的IIIa型耐药癫痫中确定致痫区。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-08 DOI: 10.1016/j.clinph.2025.2111412

Lingling Zhang , Hailing Zhou , Yongjin Tang , Jiefeng Gan , Xiangshu Hu , Hainan Li , Xueying Ling , Qiang Guo , Hao Xu

Objective

Focal cortical dysplasia (FCD) type IIIa, distinct from isolated FCD in drug-resistant epilepsy, is typically confirmed via postoperative histopathology. This study aimed to evaluate the diagnostic utility of preoperative noninvasive ¹⁸F-fludeoxyglucose (FDG) PET/MRI co-registration in localizing the epileptogenic zone (EZ) in FCD type IIIa.

Methods

We performed a retrospective study that included 60 patients with FCD type IIIa who underwent resection for drug-resistant epilepsy. The sensitivity of each modality for localizing the EZ was calculated, with invasive stereoelectroencephalography (SEEG) as a reference. Diagnostic accuracy and value of each modality were further assessed with respect to SEEG and postoperative outcomes for all patients and MRI negative/doubtful patients.

Results

We analyzed the diagnostic value of the different non-invasive diagnostic techniques with respect to concordance with SEEG findings and postsurgical seizure outcomes. For all included patients, ¹⁸F-FDG PET/MRI showed the highest sensitivity (75.7 %) for localizing the EZ across all modalities. We also found that ¹⁸F-FDG PET/MRI demonstrated the best accuracy and diagnostic value for localizing the EZ (60.0 %). Among MRI-doubtful/negative patients, ¹⁸F-FDG PET/MRI not only showed the highest sensitivity (79.3 %) but also achieved most promising accuracy and diagnostic value for identifying the EZ (61.7 % accuracy) across all modalities.

Significance

¹⁸F-FDG PET/MRI coregistration appears to be overwhelmingly rewarding in affording localization of EZ for patients with FCD type IIIa. This technique is potentially valuable as a noninvasive method to identify the EZ in patients with drug-resistant epilepsy due to FCD type IIIa, especially for MRI-negative/doubtful patients.

目的：局灶性皮质发育不良（FCD） IIIa型不同于耐药性癫痫的孤立性FCD，通常通过术后组织病理学确诊。本研究旨在评估术前无创18f -氟脱氧葡萄糖（FDG） PET/MRI联合登记在定位IIIa型FCD的致痫区（EZ）中的诊断价值。方法：我们进行了一项回顾性研究，包括60例IIIa型FCD患者，他们因耐药癫痫而接受了手术切除。以有创立体脑电图（SEEG）为参考，计算各模式定位EZ的灵敏度。对所有患者和MRI阴性/可疑患者的SEEG和术后结果进一步评估每种模式的诊断准确性和价值。结果：我们分析了不同的非侵入性诊断技术在与SEEG结果和术后癫痫发作结果的一致性方面的诊断价值。对于所有纳入的患者，18F-FDG PET/MRI在所有模式下对EZ的定位显示出最高的灵敏度（75.7%）。我们还发现18F-FDG PET/MRI对EZ的定位具有最佳的准确性和诊断价值（60.0%）。在MRI可疑/阴性患者中，18F-FDG PET/MRI不仅显示出最高的灵敏度（79.3%），而且在所有模式下识别EZ（61.7%）的准确性和诊断价值也最有希望。意义：18F-FDG PET/MRI共登记在为IIIa型FCD患者提供EZ定位方面似乎是非常有益的。该技术作为一种非侵入性方法，在IIIa型FCD致耐药癫痫患者中识别EZ具有潜在价值，特别是对于mri阴性/可疑患者。

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引用次数: 0

Feasibility and prognostic utility of laryngeal adductor reflex monitoring in anterior cervical spine surgery 喉内收肌反射监测在颈椎前路手术中的可行性及预后价值

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-08 DOI: 10.1016/j.clinph.2025.2111430

Jongsuk Choi , Ki Eob Kim , Min Jun Song , Joo Hyeong Lee , Byung Hoon Yoon , Kyung Seok Park

Objective

To evaluate the feasibility and clinical relevance of intraoperative laryngeal adductor reflex (LAR) monitoring for detecting recurrent laryngeal nerve (RLN) dysfunction during anterior cervical discectomy and fusion (ACDF).

Methods

LAR monitoring was performed in 104 patients undergoing ACDF using an electromyographic endotracheal tube. R1 amplitudes were recorded, and significant reductions were classified as transient or permanent. Swallowing and voice outcomes were assessed on postoperative day 7 (POD7), and at 3 and 6 months (POM3, POM6). Receiver operating characteristic (ROC) analysis was used to identify amplitude-reduction thresholds associated with RLN dysfunction.

Results

LAR signals were successfully obtained in 89.4 % of patients. Transient amplitude reductions occurred in 55 patients and were associated with short-term symptoms at POD7 (sensitivity 100 %, specificity 46.6 %, area under the curve [AUC] = 0.88), which resolved by POM6. Permanent reductions (n = 4) corresponded to persistent RLN dysfunction, with 100 % specificity and positive predictive value. Sensitivity increased over time, reaching 100 % at POM6. Post hoc ROC analysis identified an 81 % amplitude-reduction threshold that accurately predicted persistent RLN dysfunction at final follow-up (AUC = 1.000).

Conclusions

Intraoperative LAR monitoring was feasible and demonstrated strong predictive value for RLN dysfunction during ACDF.

Significance

LAR monitoring may enhance intraoperative neurophysiological monitoring by enabling real-time assessment of vagus nerve function in cervical spine surgery.

目的评价术中喉内收反射（LAR）监测在颈前椎间盘切除术融合术（ACDF）中检测喉返神经（RLN）功能障碍的可行性及临床意义。方法采用肌电图气管内管对104例ACDF患者进行slar监测。R1振幅被记录下来，显著的减少被分类为短暂或永久的。在术后第7天（POD7）、第3个月和第6个月（POM3、POM6）评估吞咽和语音结果。受试者工作特征（ROC）分析用于识别与RLN功能障碍相关的降幅阈值。结果89.4%的患者成功获得slar信号。55例患者出现短暂的波幅降低，并伴有短期症状（敏感性100%，特异性46.6%，曲线下面积[AUC] = 0.88），经POM6缓解。永久性减少（n = 4）对应于持续性RLN功能障碍，具有100%的特异性和阳性预测值。灵敏度随时间增加，在POM6时达到100%。事后ROC分析发现81%的幅度降低阈值可以准确预测最终随访时持续的RLN功能障碍（AUC = 1.000）。结论术中LAR监测是可行的，对ACDF中RLN功能障碍具有较强的预测价值。通过实时评估颈椎手术中迷走神经功能，ar监测可增强术中神经生理监测。

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引用次数: 0

Classic midline versus lateral scalp montages in lower limb somatosensory evoked potentials during intra-operative neuromonitoring 术中神经监测中下肢躯体感觉诱发电位的经典中线与外侧头皮蒙太奇。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-08 DOI: 10.1016/j.clinph.2025.2111428

Danilo E. Lopez-Garcia , Luis A. Marin-Castaneda , Huguette Heredia Martínez , Daniel Murra-Talamas , Fabiola M. López-Castellanos , Antonio de León , Gerson Ángel Alavez , Daniel San-Juan , Geronimo Pacheco-Aispuro

引用次数: 0

Perioperative quantification of clinical bradykinesia measurements in patients with Parkinson’s disease using accelerometry 应用加速计量化帕金森病患者临床运动迟缓围手术期测量。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-07 DOI: 10.1016/j.clinph.2025.2111424

Annemarie Smid , Teus van Laar , Amber E. Pinkster , Jolien M. ten Kate , Naomi I. Kremer , D. L. Marinus Oterdoom , Katalin Tamasi , J. Marc C. van Dijk , Gea Drost

Objective

The gold standard for assessing bradykinesia in Parkinson’s disease (PD) is the Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS), although it is inherently subjective and relies on experienced raters. Therefore, we translated MDS-UPDRS upper limb bradykinesia assessments into an objective scoring method with 3D-accelerometry.

Methods

In this study, 44 PD-patients and 44 healthy controls (sex and age matched) were included. Two raters assessed MDS-UPDRS criteria for bradykinesia, while accelerometric measurements were conducted at the index fingers. Measurements were performed in an off-medication state. The 3D-acceleration data produced quantitative measures, like frequency and amplitude of hand movement. The algorithm for calculating accelerometric scores was based on MDS-UPDRS criteria with thresholds from healthy controls. Agreement between MDS-UPDRS bradykinesia scores and accelerometric scores was estimated with Cohen’s kappa-coefficient (κ).

Results

The accelerometric scores showed moderate agreement (κ ≥ 0.548) with MDS-UPDRS ratings. The inter-rater agreement between the two MDS-UPDRS raters was moderate for all tests (κ ≥ 0.595). Accelerometric test–retest reliability was good to excellent (ICC ≥ 0.764, p < 0.001).

Conclusions

This study introduces an accelerometric algorithm to classify upper extremity bradykinesia according to MDS-UPDRS criteria, yielding high test–retest reliability.

Significance

Given its consistency, this method could reduce MDS-UPDRS rater-dependency and improve objective monitoring of upper limb bradykinesia.

目的：评估帕金森病（PD）运动迟缓的金标准是运动障碍协会统一PD评定量表（MDS-UPDRS），尽管它本身是主观的，依赖于经验丰富的评分者。因此，我们将MDS-UPDRS上肢运动迟缓评估转化为一种带有3d加速度计的客观评分方法。方法：本研究纳入44例pd患者和44例健康对照（性别和年龄相匹配）。两名评分员评估运动迟缓的MDS-UPDRS标准，同时在食指进行加速度测量。在停药状态下进行测量。3d加速数据产生了定量测量，比如手部运动的频率和幅度。计算加速度计评分的算法基于MDS-UPDRS标准和健康对照的阈值。用Cohen's kappa系数（κ）估计MDS-UPDRS慢动评分和加速评分之间的一致性。结果：加速度计评分与MDS-UPDRS评分具有中等一致性（κ≥0.548）。两个MDS-UPDRS评分者之间的一致性在所有测试中均为中等（κ≥0.595）。结论：本研究根据MDS-UPDRS标准，引入加速度计算法对上肢运动迟缓进行分类，获得较高的重测信度。意义：该方法具有一致性，可降低MDS-UPDRS评分依赖性，改善上肢运动迟缓的客观监测。

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引用次数: 0

C3-C4 transcranial direct current stimulation montage stimulates lower limb region better than C1-C2 montage C3-C4经颅直流电刺激蒙太奇对下肢区域的刺激优于C1-C2蒙太奇

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-05 DOI: 10.1016/j.clinph.2025.2111416

Ziping Huang , Riki Shimizu , Saurabh R. Sinha , Derek Southwell , Charalambos C. Charalambous , Angel V. Peterchev , Wuwei Feng , Pratik Y. Chhatbar , Taewon Kim

引用次数: 0

Minimal social co-presence modulates heartbeat evoked potentials and EEG dynamics during a parallel crafting task 在并行制作任务中，最小的社会共同存在调节心跳诱发电位和脑电图动态。

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-05 DOI: 10.1016/j.clinph.2025.2111414

Junya Orui , Keigo Shiraiwa , Fumie Tazaki , Masaya Ueda , Keita Ueno , Yasuo Naito , Ryouhei Ishii

Objective

To investigate the neurophysiological effects of minimal social co-presence on the Heartbeat Evoked Potential (HEP) and EEG dynamics, providing a normative baseline for altered interoception in clinical disorders.

Methods

Thirty healthy adults performed a repetitive crafting task in “alone” and “parallel social presence” conditions. EEG and ECG were recorded, and HEPs plus time–frequency dynamics were compared using permutation testing. Changes in cardiac vagal activity and subjective stress were also assessed.

Results

Parallel co-presence significantly altered HEP morphology (reduced frontal negativity, central-parietal positivity) and EEG power (beta, theta, alpha bands). Only under parallel condition, frontal HEP amplitude correlated with increased cardiac vagal activity (r = 0.39) and reduced subjective stress (rS = -0.55).

Conclusion

Minimal social context alters the brain’s processing of cardiac signals and its autonomic relationship in healthy young adults, establishing a neurophysiological benchmark for brain-body-society interactions. As this study used a non-clinical sample, the findings are not direct evidence of HEP’s clinical utility. This work provides a foundational baseline for future comparative studies needed to determine its potential as a clinical biomarker.

Significance

This study is the first to demonstrate normative neurophysiological effects of minimal social presence on HEP, providing critical evidence and guidance for future clinical research.

目的：探讨最小社会共存在对心电诱发电位（HEP）和脑电图动态的神经生理影响，为临床障碍中内感受的改变提供规范的基线。方法：30名健康成人在“单独”和“平行社会存在”条件下进行重复性制作任务。记录脑电图和心电图，采用排列试验比较HEPs和时频动态。还评估了心脏迷走神经活动和主观应激的变化。结果：平行共存显著改变了HEP形态学（额叶负性、中央-顶叶正性减弱）和脑电图功率（β、θ、α波段）。只有在平行条件下，额部HEP振幅与心脏迷走神经活动增加（r = 0.39）和主观应激减少（r = -0.55）相关。结论：最小的社会环境改变了健康年轻人大脑对心脏信号的处理及其自主关系，为脑-体-社会相互作用建立了神经生理学基准。由于本研究使用的是非临床样本，因此研究结果并不是HEP临床应用的直接证据。这项工作为未来的比较研究奠定了基础，以确定其作为临床生物标志物的潜力。意义：本研究首次证明了最小社会存在对HEP的规范性神经生理影响，为今后的临床研究提供了重要的证据和指导。

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引用次数: 0

Fiber recruitment in intra-epidermal electrical stimulation: Assessing the likelihood of Aδ- and Aβ-fiber activation 表皮内电刺激中的纤维募集：评估Aδ-和a β-纤维激活的可能性

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-05 DOI: 10.1016/j.clinph.2025.2111415

Sara U. Júlio , Jana Vaterlaus , Robin Lütolf , Markus Kofler , Michèle Hubli , Martin Schubert

Objective

To compare intra-epidermal (IES) and transcutaneous (TES) electrical stimulation with regard to nociceptive Aδ-fiber activation and Aβ-fiber co-activation. Cutaneous silent periods (CSPs) were assessed as a proxy for Aδ-fiber activation, and cortical vertex potentials (VPs) in the absence of somatosensory evoked cortical potentials (SSEPs) were assessed to exclude Aβ-fiber activation.

Methods

IES and TES were applied at increasing intensities (multiples of electrical detection threshold, EDT). In Experiment 1, psychophysical assessments, i.e., pain intensity and quality, and CSPs were compared for IES and TES at the index finger in 29 participants (10 m, 26.6 ± 3.5 years). In Experiment 2, SSEPs and VPs were compared for IES and TES over the superficial radial nerve in 28 participants (11 m, 26.6 ± 3.4 years).

Results

IES, irrespective of stimulation intensity, was mainly perceived as noxious and significantly more painful than TES (p < 0.001). Significant EMG suppression (p = 0.002) indicated robust CSPs following IES, suggesting efficient Aδ-fiber activation compared to TES at 4x EDT. Moreover, SSEPs were absent in response to IES at 4x EDT, suggesting low Aβ-fiber co-activation, while VPs were consistently detected.

Conclusions

IES at 4x EDT produces efficient Aδ-fiber activation with minimal Aβ-fiber co-activation, accompanied by consistently detected VPs.

Significance

IES at 4x EDT is suggested for efficient electrical nociceptive testing.

目的比较表皮内电刺激（IES）和经皮电刺激（TES）对痛觉性a δ-纤维激活和a β-纤维共激活的影响。评估皮肤沉默期（CSPs）作为a - β纤维激活的替代指标，评估体感诱发皮层电位（ssep）缺失时的皮质顶点电位（vp）以排除a - β纤维激活。方法以增加的强度（电检测阈值的倍数，EDT）应用sies和TES。在实验1中，比较29名参与者（10 m, 26.6±3.5岁）的IES和TES在食指的心理物理评估，即疼痛强度和质量，以及csp。实验2比较28例（11 m, 26.6±3.4岁）患者桡浅神经上IES和TES的ssep和VPs。结果，无论刺激强度如何，主要被认为是有害的，明显比TES更痛苦（p < 0.001）。显著的肌电抑制（p = 0.002）表明，IES后csp强健，表明在4倍EDT时，与TES相比，a - δ纤维激活更有效。此外，在4倍EDT时，ssep对IES的反应缺失，表明a β-纤维共激活较低，而VPs一直被检测到。结论在4倍EDT下，a - δ-纤维有效活化，a - β-纤维协同活化最小，并伴有持续检测到的VPs。建议在4倍EDT时进行有效的电伤害性测试。

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引用次数: 0

Does the ability to stop ongoing movement differentiate cervical dystonia from functional cervical dystonia? 停止正在进行的运动的能力能否区分颈张力障碍和功能性颈张力障碍？

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-04 DOI: 10.1016/j.clinph.2025.2111417

Sattwika Banerjee , Supriyo Choudhury , Asit Baran Bayen , Suchismita Majumdar , Akash Roy , Praveen Kumar , Souvik Chakroborty , Soumava Mukherjee , Jacky Ganguly , Purba Basu , Mark R Baker , Stuart N Baker , Hrishikesh Kumar

Objective

Functional Cervical Dystonia (FCD) is characterized by hyperkinetic movements resembling Cervical Dystonia (CD). Previous studies report impaired reactive inhibition in CD, reflected by prolonged optimum combination Stop Signal Reaction Time (ocSSRT). This study compared ocSSRT in FCD, CD, and healthy controls.

Methods

20 CD and 14 FCD patients were recruited along with 23 age-matched healthy controls. All participants used a battery-operated portable device that measured both median reaction time and ocSSRT. Subjects released a button following a GO (green) signal and attempted to abort the movement when a STOP (red) signal followed the GO cue after a short delay.

Results

CD patients had significantly prolonged ocSSRT compared to FCD and healthy controls (CD: 373 ± 76 ms, FCD: 285 ± 80 ms, healthy: 248 ± 64 ms; CD vs FCD, p = 0.026; CD vs healthy, p < 0.001). No significant difference was found between FCD and healthy controls (p = 0.396). Median reaction time was significantly longer in CD (563 ± 117 ms) than healthy controls (466 ± 82 ms; p = 0.015), but not FCD (500 ± 117 ms; p = 0.296). The ROC curve AUC for ocSSRT distinguishing CD from FCD was 0.775 (p = 0.002).

Conclusion and Significance

ocSSRT may serve as a useful marker to differentiate CD from FCD in clinical settings.

目的：功能性颈肌张力障碍（FCD）的特征是类似于颈肌张力障碍（CD）的过度运动。先前的研究报告了CD的反应性抑制受损，反映在最佳组合停止信号反应时间（ocSSRT）延长。本研究比较了FCD、CD和健康对照的ocSSRT。方法：招募20例乳糜泻患者和14例乳糜泻患者以及23例年龄匹配的健康对照者。所有参与者都使用了一个电池供电的便携式设备来测量中位反应时间和ocSSRT。受试者在绿灯信号发出后释放按钮，并在短暂延迟后红灯信号发出后试图中止动作。结果：与FCD和健康对照相比，CD患者的ocSSRT时间明显延长（CD: 373±76 ms, FCD: 285±80 ms，健康对照：248±64 ms； CD vs FCD, p = 0.026； CD vs健康对照，p）。结论及意义：ocSSRT可作为临床区分CD和FCD的有效标志物。

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引用次数: 0

Ocular motor dysfunction in patients with multiple system atrophy and Parkinson’s disease 多系统萎缩和帕金森病患者的眼运动功能障碍

IF 3.6 3区医学 Q1 CLINICAL NEUROLOGY

Clinical Neurophysiology

Pub Date : 2025-11-02 DOI: 10.1016/j.clinph.2025.2111413

Xia Ling , Xinyan Ma , Zhirong Wan , Yunchuang Sun , Fan Li , Luhua Wei , Kai Li , Jing Chen , Guiping Zhao , Ji-Soo Kim , Xu Yang , Zhaoxia Wang

Objective

Differentiating multiple system atrophy (MSA) from Parkinson’s disease (PD) remains challenging. This study aimed to investigate the utility of specific ocular motor features in distinguishing MSA from PD, as these dysfunctions may offer valuable diagnostic clues.

Methods

We used video-oculography to assess spontaneous nystagmus, saccadic intrusions or oscillations, gaze, saccades, head shaking, positional nystagmus, and vestibulo-ocular reflex (VOR) cancellation in 23 MSA patients and 49 PD patients.

Results

Spontaneous downbeat nystagmus, saccadic intrusions/oscillations, and perverted head shaking nystagmus (pHSN) didn’t differ between groups. Horizontal gaze-evoked nystagmus (GEN) occurred in MSA patients but not in PD (P = 0.009). MSA showed significantly more prolonged saccade latency (both horizontal and vertical) and vertical saccadic hypermetria than PD (all P < 0.05). Central positional nystagmus (CPN) was more common in MSA (P = 0.046). Impaired VOR cancellation was significantly higher in MSA than in PD (95.7 % vs. 32.7 %, P < 0.001).

Conclusion

MSA exhibits significantly more pronounced VOR cancellation deficits, horizontal GEN, CPN, saccadic hypermetria, and prolonged saccade latency than PD. These findings suggest a link to the more widespread neurodegeneration characteristic of MSA.

Significance

Impaired VOR cancellation, horizontal GEN, saccadic hypermetria, and CPN offer potential for distinguishing MSA from PD.

目的多系统萎缩（MSA）与帕金森病（PD）的鉴别仍然具有挑战性。本研究旨在探讨特异性眼运动特征在区分MSA和PD中的作用，因为这些功能障碍可能提供有价值的诊断线索。方法对23例MSA患者和49例PD患者的自发性眼球震、眼球侵犯或振荡、凝视、扫视、头摇、位置性眼球震和前庭眼反射（VOR）消除进行了观察。结果自发性下拍性眼球震颤、眼跳侵入/振荡、变态头摇型眼球震颤（pHSN）组间无明显差异。水平凝视诱发眼球震颤（GEN）发生在MSA患者中，而不发生在PD患者中（P = 0.009）。MSA显示的眼跳潜伏期（水平和垂直）和垂直眼跳高明显高于PD（均P <； 0.05）。中枢位置性眼球震颤（CPN）在MSA中更为常见（P = 0.046）。MSA中受损的VOR取消明显高于PD（95.7%比32.7%,P < 0.001）。结论msa比PD表现出更明显的VOR取消缺陷、水平GEN、CPN、跳眼高速和延长的跳眼潜伏期。这些发现表明与MSA更广泛的神经退行性变特征有关。意义：受损的VOR取消、水平GEN、跳高和CPN提供了区分MSA和PD的潜力。

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引用次数: 0