NORMAL AND PATHOLOGICAL SACCADIC DYSMETRIA
NORMAL AND PATHOLOGICAL SACCADIC DYSMETRIA
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DOI：
10.1093/brain/116.2.337
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发表时间：
1993-04-01
期刊：
影响因子：
14.5
通讯作者：
BUTTNER, U
中科院分区：
文献类型：
--
作者：
BOTZEL, K;ROTTACH, K;BUTTNER, U
无论是正常人还是扫视性辨距障碍患者，对视觉目标的初始扫视通常都不精确。定量标准必须应用于明确区分正常和病理性扫视测距障碍，这是经常发现的患者小脑病变。为了建立这些标准，视觉引导水平扫视（10度和20度目标步骤）的准确性进行了研究，在一组24例病变影响小脑或其连接，并与17名正常人的数据进行比较。用红外眼电图记录眼球运动。正常受试者的眼跳平均增益为0.92 - 0.95，这取决于刺激条件。对于20度的目标步数，向心扫视明显大于离心扫视，大多数患者（n = 15）的扫视幅度明显大于正常受试者（远视），至少在一个方向上。相反方向的扫视可以是高距、高距或正常的。两名患者在两个方向上都有高度扫视。此外，对于其中一名患有远视的患者，离心性和向心性扫视之间的幅度差异显著大于正常受试者。五名患者没有显着的病理学的初始（原发性）扫视，但纠正扫视的病理模式。两名患者在所有条件下都有正常的扫视，与正常受试者的定量比较甚至可以检测到轻微的病理。根据我们的结果，当在至少一个方向上的扫视的平均增益为1.0或更大时，或者当20个扫视中的多于两个扫视之后是两个校正扫视，其中最后一个是在与初始扫视相反的方向上时（校正扫视的病理模式），可以假定病理。20度的目标步长比10度的目标步长更经常地揭示病理状况。定量标准的应用可能有助于建立病理性扫视测距障碍的诊断，即使在临床上不明显的情况下。
Initial saccades to visual targets are generally not precise in either normal subjects or patients with saccadic dysmetria. Quantitative criteria have to be applied to clearly distinguish between normal and pathological saccadic dysmetria, which is often found in patients with cerebellar lesions. To establish these criteria, the accuracy of visually guided horizontal saccades (10-degrees and 20-degrees target steps) was studied in a group of 24 patients with lesions affecting the cerebellum or its connections, and compared with data from 17 normal subjects. Eye movements were recorded with infrared oculography. Saccades of normal subjects had an average gain of 0.92 - 0.95 depending on the stimulus condition. Centripetal saccades were significantly larger than centrifugal saccades, for 20-degrees target steps.Most patients (n = 15) had significantly larger saccadic amplitudes than normal subjects (hypermetria), at least in one direction. Saccades in the opposite direction could be either hypometric, hypermetric or normal. Two patients had hypometric saccades in both directions. For one of the patients with hypermetria, in addition, the amplitude difference between centrifugal and centripetal saccades was significantly larger than in the normal subjects. Five patients had no significant pathology of the initial (primary) saccade, but a pathological pattern of corrective saccades. Two patients had normal saccades under all conditions.The quantitative comparison with normal subjects allows the detection even of mild pathology. According to our results, a pathology can be assumed when the average gain of saccades in at least one direction is 1.0 or more, or when more than two out of 20 saccades are followed by two corrective saccades of which the last is in the direction opposite to the initial saccade (pathological pattern of corrective saccades). Target steps of 20-degrees reveal a pathological condition more often than 10-degrees target steps. The application of quantitative criteria might be useful to establish a diagnosis of pathologic saccadic dysmetria even in instances in which it is clinically not obvious.