Visuo-Oculomotor Deficiency at Early-Stage Idiopathic Scoliosis in Adolescent Girls
Visuo-Oculomotor Deficiency at Early-Stage Idiopathic Scoliosis in Adolescent Girls
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DOI：
10.1097/brs.0b013e31826a3b05
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发表时间：
2013-02-01
期刊：
影响因子：
3
通讯作者：
Perrin, Philippe P.
中科院分区：
文献类型：
--
作者：
Lion, Alexis;Haumont, Thierry;Perrin, Philippe P.
研究设计.横截面研究。确定青少年特发性脊柱侧凸（AIS）发病时是否与眼功能障碍有关，以及这些眼功能异常是否与脊柱变形幅度有关。AIS与姿势控制异常有关。到目前为止，很少有研究集中在早期AIS的视觉和前庭眼功能。根据临床和放射学标准（平均Cobb角：14.8度+/- 5.0度），53名青春期女孩被诊断为AIS（平均年龄：11.6 +/- 2.1岁）。用视频眼电图研究视眼和前庭眼功能，包括扫视、平滑追踪、冷热试验和摆动旋转，以及视觉前庭眼反射和前庭眼反射序列。根据平均Cobb角定义两个患者组：第1组29例，Cobb角5 ° ~ 14 °;第2组24例，Cobb角15 ° ~ 25 °。第2组表现出不同的眼跳特征比第1组：较高的lavian为特征的时间不确定性和预测方向的眼跳序列，较低的速度，无论类型的眼跳。扫视准确度和平滑追踪增益没有观察到差异。对于视觉前庭眼反射，第2组显示出低于第1组的总最大慢相速度，而前庭眼反射（在黑暗中测试）没有组间差异。冷热前庭试验无差异。Cobb角大于等于15的患者前庭眼反应正常，但视眼功能改变，尤其是扫视潜伏期和速度。这可能是小脑和/或脑干水平的眼神经通路功能障碍的结果。这些中枢性疾病可能与AIS的发生有关。
Study Design. Cross-sectional study.Objective. To determine whether adolescent idiopathic scoliosis (AIS) at onset is associated with oculomotor dysfunction and whether these oculomotor anomalies are correlated to the amplitude of the spine deformation.Summary of Background Data. AIS is related to abnormalities of postural control. To date, few studies have focused on visuo-oculomotor and vestibulo-ocular functions at early-stage AIS.Methods. Fifty-three adolescent girls were diagnosed with AIS (mean age: 11.6 +/- 2.1 yr) on clinical and radiological criteria (mean Cobb angle: 14.8 degrees +/- 5.0 degrees). Visuo-oculomotor and vestibulo-ocular functions were studied with video-oculography, including saccades, smooth pursuit, caloric test, and pendular rotation, with visual vestibular ocular reflex and vestibulo-ocular reflex sequences. Two patient groups were defined according to the mean Cobb angle:. group 1 included 29 patients with a Cobb angle from 5 degrees to 14 degrees and group 2 included 24 patients with a Cobb angle from 15 degrees to 25 degrees.Results. The group 2 showed different saccade characteristics than group 1: higher latencies for saccade sequences characterized by temporal uncertainty and predictive direction; lower velocity regardless of the type of the saccades. No difference was observed for saccadic accuracy and smooth-pursuit gain. For the visual vestibular ocular reflex, group 2 showed lower total maximal slow-phase velocity than group 1, whereas the vestibulo-ocular reflex (tested in dark) did not differ between groups. No difference was observed concerning the caloric vestibular test.Conclusion. Patients with a Cobb angle of 15 or more presented normal vestibulo-ocular responses but altered visuo-oculomotor functions, especially for the saccadic latency and velocity. This could be the result of a dysfunction of oculomotor pathways at cerebellar and/or brainstem level. These central disorders may be incriminated in the development of AIS.