Pupil Light Reflex in Parkinson's Disease: Evaluation With Pupillometry
Pupil Light Reflex in Parkinson's Disease: Evaluation With Pupillometry
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DOI：
10.3109/00207454.2010.526730
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发表时间：
2011-01-01
影响因子：
2.2
通讯作者：
Karlovasitou, Anna
中科院分区：
文献类型：
--
作者：
Giza, Evangelia;Fotiou, Dimitrios;Karlovasitou, Anna
本文采用瞳孔测量法对帕金森病患者和正常人的瞳孔光反射（PLR）进行测定，探讨其与帕金森病患者临床特征的关系。采用瞳孔测量法对66例无自主神经功能障碍临床证据的PD患者和44例健康对照进行PLR评估。采用24.6 candela /m(2)强度、持续时间为20 ms的单次闪光刺激触发PLR，在充分记录瞳孔运动后研究6个参数。帕金森患者潜伏期（T1）明显增加，幅度（R1-R2）、最大收缩速度（Vmax）和最大加速度（ACmax）显著降低。初始半径（R1）和最小半径（R2）值无显著差异。在研究的参数中，ACmax成为区分PD患者和对照组的重要预测因子。瞳孔测量参数与患者的临床特征（病程、分期和统一帕金森病评定运动量表）无显著相关性。该研究表明，即使没有明显的临床自主神经功能障碍，PD患者也存在PLR障碍。瞳孔测量似乎是一种有用的、无创的方法来探索PD的PLR改变，并可能被证明对亚临床自主神经系统功能障碍的早期检测有用。
We evaluated pupil light reflex (PLR) in patients with Parkinson's disease (PD) and normal controls by means of pupillometry and explored its possible relation to clinical characteristics in parkinsonian patients. PLR was evaluated using pupillometry in 66 patients with PD without clinical evidence of autonomic dysfunction and 44 healthy matched controls. PLR was elicited by single flash stimuli of 24.6 candelas/m(2) intensity and 20 ms duration, and six parameters were studied after full recording of pupil's movement. A significant increase in latency (T1) and significant decrease in amplitude (R1-R2), maximum constriction velocity (Vmax), as well as maximum acceleration (ACmax) was found in parkinsonian patients. There was no significant difference in initial radius (R1) and minimum radius (R2) values. Of the parameters studied, ACmax emerged as a significant predictor for discrimination between PD patients and controls. There was no significant correlation between pupillometry parameters and clinical characteristic of patients (disease duration, stage, and the Unified Parkinson's Disease Rating motor scale). The study demonstrates PLR disorder in PD patients even without overt clinical autonomic dysfunction. Pupillometry appears to be a useful and noninvasive method for exploration of PLR alterations in PD and may prove to be useful for the early detection of subclinical autonomic nervous system dysfunction.