姿势性心动过速综合征的视觉症状:位置依赖性视觉探索研究

IF 4.5 2区 医学 Q1 CLINICAL NEUROLOGY European Journal of Neurology Pub Date : 2024-10-27 DOI:10.1111/ene.16507
Belén Rodriguez, Lynn Pantano, Tobias Nef, René M Müri, Werner J Z'Graggen
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引用次数: 0

摘要

背景和目的:体位性心动过速综合征患者会出现体位依赖性视觉症状。尽管这些症状对日常生活有影响,但研究人员在很大程度上仍未对其进行探讨。本研究旨在调查体位性心动过速综合征视觉症状的性质以及可能的潜在病理生理机制:研究纳入了 15 名体位性心动过速综合征患者和 15 名健康对照者。通过一系列全面的测量,包括血液动力学、主观症状评估、眼球运动跟踪和瞳孔直径分析,对参与者在仰卧位和 60° 抬头倾斜位的自由图像探索过程进行了评估:结果:与仰卧位和对照组相比,患者在仰头倾斜时的固定次数和持续时间减少,眼球移动的次数、峰值速度和幅度也有所下降。这种视觉探索的减少主要发生在周边视野,与主观视觉症状的出现同时发生。两组患者在任一体位下的囊回主序列均无明显差异:结论:体位性心动过速综合征患者在直立体位时对周边视野的探索减少,有可能导致隧道视。由于患者的囊回主序列正常,加上视野中心集中和囊回振幅较低,这表明患者的脑干功能完好,因此外围视野探索的减少可归因于与位置相关的额叶眼视野功能障碍。
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Visual symptoms in postural tachycardia syndrome: An investigation of position-dependent visual exploration.

Background and purpose: Patients with postural tachycardia syndrome report position-dependent visual symptoms. Despite their impact on daily life, these symptoms have remained largely unexplored in research. The aim of this study was to investigate the nature of visual symptoms in postural tachycardia syndrome and possible underlying pathophysiological mechanisms.

Methods: Fifteen patients with postural tachycardia syndrome and 15 healthy controls were included in the study. Through a comprehensive array of measurements, including haemodynamics, subjective symptom assessments, eye movement tracking and pupil diameter analysis, participants were assessed during free image exploration in both supine and 60° head-up tilt positions.

Results: During head-up tilt, patients showed a decreased number and duration of fixations, as well as a decreased number, peak velocity and amplitude of saccades compared to the supine position and the control group. This reduction in visual exploration occurred primarily in the peripheral field of view and coincided with the occurrence of subjective visual symptoms. No significant differences in the saccade main sequence were observed between the two groups in either body position.

Conclusions: Patients with postural tachycardia syndrome have a reduced exploration of the peripheral field of view when in an upright body position, potentially leading to tunnel vision. Since the normality of the saccade main sequence in patients combined with the focus on the centre of the field of view and the lower saccade amplitudes points to an intact brainstem function, the decrease in peripheral visual exploration may be attributed to a position-dependent dysfunction of the frontal eye field.

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来源期刊
European Journal of Neurology
European Journal of Neurology 医学-临床神经学
CiteScore
9.70
自引率
2.00%
发文量
418
审稿时长
1 months
期刊介绍: The European Journal of Neurology is the official journal of the European Academy of Neurology and covers all areas of clinical and basic research in neurology, including pre-clinical research of immediate translational value for new potential treatments. Emphasis is placed on major diseases of large clinical and socio-economic importance (dementia, stroke, epilepsy, headache, multiple sclerosis, movement disorders, and infectious diseases).
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