Tropicamide effects on pupil size and pupillary light reflexes in Alzheimer's and Parkinson's disease
Tropicamide effects on pupil size and pupillary light reflexes in Alzheimer's and Parkinson's disease
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DOI：
10.1016/s0167-8760(02)00122-8
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发表时间：
2003-02-01
影响因子：
3
通讯作者：
Vukov, B
中科院分区：
文献类型：
--
作者：
Granholm, E;Morris, S;Vukov, B
对阿尔茨海默病(AD)患者(n=15)、帕金森病(PD)患者(n=15)和非临床对照(NC)参与者(n=15)进行了包括托吡卡胺阻断胆碱能眼动功能的阿尔茨海默病(AD)的诊断试验。双盲双眼注射0.01%托吡卡胺(0.01%)和生理盐水后，用瞳孔摄影法测量瞳孔直径和光反射。在明亮的背景光和接近黑暗的环境中测量了瞳孔大小的变化。托吡卡胺使三组受试者在光照和黑暗条件下的瞳孔直径增加程度相似。托吡卡胺对所有三组患者的瞳孔光反射的幅度和潜伏期也有相同程度的降低。因此，托吡卡胺的瞳孔反应试验不是AD的敏感或特异性诊断试验。与非临床对照组相比，AD组和PD组双眼的瞳孔光反射峰值收缩幅度均显著降低，但AD组和PD组差异无统计学意义。因此，瞳孔光反射试验对AD敏感，但缺乏足够的特异性。最后，峰值收缩幅度与痴呆的严重程度显著相关，多奈哌齐治疗可能使AD患者的瞳孔光反射异常部分正常化。因此，瞳孔光反射试验可能提示AD患者中枢胆碱能功能障碍与疾病进展相关，以及与药物治疗反应相关的胆碱能功能改善。(C)2002 Elsevier Science B.V.保留所有权利。
Diagnostic tests for Alzheimer's disease (AD) involving tropicamide blockade of cholinergic oculomotor functions were examined in AD patients (n = 15), Parkinson's disease (PD) patients (n = 15), and non-clinical control (NC) participants (n = 15). Pupillographic methods were used to measure pupil diameter and pupillary light reflexes after double-blind ocular administration of dilute tropicamide (0.01%) in one eye and saline in the other eye. Changes in pupil size were measured in bright background light and near-darkness. Tropicamide increased pupil diameter to a similar extent in all three groups in light and darkness. Tropicamide also reduced the amplitude and latency of the pupillary light reflex to a similar extent for all three groups. Tropicamide pupillary response tests, therefore, were not sensitive or specific diagnostic tests for AD. Peak constriction amplitude of the pupillary light reflex was significantly reduced in both eyes in AD and PD groups relative to non-clinical controls, but AD and PD groups did not differ significantly. The pupillary light reflex test, therefore, was sensitive to AD, but lacked adequate specificity. Finally, peak constriction amplitude correlated significantly with dementia severity and donepezil treatment may have partially normalized pupillary light reflex abnormalities in AD patients. The pupillary light reflex test, therefore, may index central cholinergic dysfunction associated with disease progression and improvement in cholinergic function associated with pharmacologic treatment response in AD. (C) 2002 Elsevier Science B.V. All rights reserved.