Interaction between ocular stabilization reflexes in patients with whiplash injury
Interaction between ocular stabilization reflexes in patients with whiplash injury
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DOI：
10.1167/iovs.05-1561
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发表时间：
2006-07-01
影响因子：
4.4
通讯作者：
Frens, Maarten A.
中科院分区：
文献类型：
--
作者：
Montfoort, Inger;Kelders, Willem P. A.;Frens, Maarten A.
目的.在过去的几十年里，汽车已经成为一种越来越受欢迎的交通工具，这导致了越来越多的追尾碰撞，从而导致了更多的患者与挥鞭样损伤相关的疾病（WAD）。最近，研究发现颈部挥鞭样损伤患者的眼稳定反射之一--颈眼反射（COR）的增益升高。COR对来自颈部的本体感受信号做出响应，并与前庭眼反射（VOR）和视动反射（OKR）一起起作用，以在头部运动期间保持视网膜上的稳定视觉。因此，进行了一项调查，以确定报告的WAD中COR的升高是否伴随着VOR或OKR的变化。13例患者和18名年龄匹配的健康对照者的眼球运动记录与红外线眼动跟踪装置。分析证实颈部扭伤患者的COR增加显著。与此同时，VOR和OKR的收益保持不变。在个体患者的反射增益之间没有发现相关性。这与老年受试者和谷胱甘肽缺陷受试者的早期观察结果相反，后者显示COR增益增加，VOR增益减少。颈部运动受损、颈部本体感觉改变或VOR可塑性过程中的紊乱可以解释VOR增益缺乏变化。
PURPOSE. In the past few decades, the automobile has become an increasingly more popular means of transport, which has led to an increasing number of rear-end collisions and consequently has resulted in more patients with whiplash-associated disorders (WADs). Recently, it was found that the gain of one of the ocular stabilization reflexes-the cervico-ocular reflex (COR)-is elevated in patients with whiplash injury. The COR responds to proprioceptive signals from the neck and acts in conjunction with the vestibulo-ocular reflex (VOR) and the optokinetic reflex (OKR) to preserve stable vision on the retina during head motion. Therefore, an investigation was conducted to determine whether the reported elevation of the COR in WADs is accompanied by changes in VOR or OKR.METHODS. Eye movements of 13 patients and 18 age-matched healthy controls were recorded with an infrared eye-tracking device.RESULTS. Analysis confirmed a significant increase in COR gain in whiplash patients. Meanwhile the VOR and OKR gains remained the same. No correlation was found between the gains of the reflexes in individual patients. This is in contrast to earlier observations in elderly subjects and subjects with labyrinthine defects, who showed increases in COR gain and decreases in VOR gain.CONCLUSIONS. Impaired neck motion, altered proprioception of the neck, or disorganization in the process of VOR plasticity could explain the lack of change in VOR gain.