Saccade Abnormalities in Autopsy-Confirmed Frontotemporal Lobar Degeneration and Alzheimer Disease
Saccade Abnormalities in Autopsy-Confirmed Frontotemporal Lobar Degeneration and Alzheimer Disease
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DOI：
10.1001/archneurol.2011.1021
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发表时间：
2012-04-01
影响因子：
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通讯作者：
Miller, Bruce L.
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文献类型：
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作者：
Boxer, Adam L.;Garbutt, Siobhan;Miller, Bruce L.
背景资料：在临床定义的额颞叶痴呆（FTD）和阿尔茨海默病（AD）中描述了扫视的产生和控制缺陷。目的：确定与尸检定义的额颞叶变性（FTLD）和AD病例相关的扫视异常，因为临床FTD综合征可以对应于许多不同的潜在神经病理学FTD和非FTD诊断。设计：使用红外线眼动仪记录尸检证实的FTD受试者和尸检证实的AD受试者（死亡前平均（SE）为35.6（10.0）个月）以及年龄匹配的正常对照组对10个目标的视觉引导扫视和反扫视。12例FTD受试者有FTLD-TAR DNA结合蛋白43病理学，15例有FTLD-tau病理学，1例受试者显示FTLD融合肉瘤蛋白病理学。使用受试者操作曲线统计来确定动眼变量的诊断价值。使用体素为基础的morphometry.Setting：记忆和衰老中心，神经病学系，加州大学，旧金山弗朗西斯科。Participants：共28例尸体解剖证实的FTD，10例尸体解剖证实的AD，和27个年龄匹配的正常对照组。然而，只有FTLD-tau和AD病例显示反射性视觉引导扫视异常。AD病例显示水平扫视潜伏期显著增加，这将其与FTD病例区分开来。进行性核上性麻痹患者的速度和增益受损最严重，但也存在于其他tau蛋白病中。通过使用垂直和水平扫视速度和增益作为我们的措施，我们能够区分进行性核上性麻痹患者从其他患者。垂直扫视速度与背侧中脑volume.Conclusion：视觉引导的扫视速度和增益下降提示潜在的tau病理FTD，与垂直扫视异常最诊断进行性核上性麻痹。
Background: Deficits in the generation and control of saccades have been described in clinically defined frontotemporal dementia (FTD) and Alzheimer disease (AD).Objective: To determine the saccade abnormalities associated with autopsy-defined cases of frontotemporal lobar degeneration (FTLD) and of AD, because clinical FTD syndromes can correspond to a number of different underlying neuropathologic FTD and non-FTD diagnoses.Design: An infrared eye tracker was used to record visually guided saccades to 10 targets and antisaccades in subjects with autopsy-confirmed FTD and subjects with autopsy-confirmed AD, a mean (SE) of 35.6 (10.0) months prior to death, and age-matched normal controls. Twelve subjects with FTD had an FTLD-TAR DNA-binding protein 43 pathology, 15 had an FTLD-tau pathology, and 1 subject showed an FTLD-fused in sarcoma protein pathology. Receiver operating curve statistics were used to determine the diagnostic value of the oculomotor variables. Neuroanatomical correlates of oculomotor abnormalities were investigated using voxel-based morphometry.Setting: Memory and Aging Center, Department of Neurology, University of California, San Francisco.Participants: A total of 28 subjects with autopsy-confirmed FTD, 10 subjects with autopsy-confirmed AD, and 27 age-matched normal controls.Results: All subjects with FTD or AD were impaired relative to normal controls on the antisaccade task. However, only FTLD-tau and AD cases displayed reflexive visually guided saccade abnormalities. The AD cases displayed prominent increases in horizontal saccade latency that differentiated them from the FTD cases. Impairments in velocity and gain were most severe in individuals with progressive supranuclear palsy but were also present in other tauopathies. By using vertical and horizontal saccade velocity and gain as our measures, we were able to differentiate patients with progressive supranuclear palsy from other patients. Vertical saccade velocity was strongly correlated with dorsal midbrain volume.Conclusion: Decreased visually guided saccade velocity and gain are suggestive of underlying tau pathology in FTD, with vertical saccade abnormalities most diagnostic of progressive supranuclear palsy.