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目的 探讨眼跳特征在帕金森病（Parkinson’s disease,PD）诊断及症状评估中的价值。方法 选择2024年2月至2025年7月解放军总医院运动障碍疾病门诊就诊的老年PD患者76例（PD组），同期健康对照者37例（对照组）。PD组又根据改良的Hoehn-Yahr(modified Hoehn-Yahr,mH&Y)分期分为早期PD组37例（mH&Y分期≤1.5期）和中期PD组39例（mH&Y分期≥2期）。应用视频眼动仪进行正向眼跳、反向眼跳及记忆引导眼跳（memory-guided saccade,MGS）检测。应用ROC曲线评估眼跳对PD的诊断效能，Spearman相关性分析眼跳特征与临床特征的关系。结果 与对照组比较，PD组正向眼跳误差、反向眼跳潜伏期、反向眼跳误差、MGS潜伏期及MGS眼跳误差明显升高，正向眼跳正确率、正向眼跳增益、反向眼跳峰速度、反向眼跳增益、MGS正确率、MGS峰速度及MGS眼跳增益明显降低，差异有统计学意义（P<0.05,P<0.01）。反向眼跳潜伏期延长和正向眼跳正确率下降是PD的影响因素（P<0.05,P<0.01），反向眼跳潜伏期延长是早期PD的影响因素（P<0.01）。ROC曲线分析显示，正向眼跳正确率和反向眼跳潜伏期联合区分PD组与对照组的曲线下面积为0.916，反向眼跳潜伏期区分早期PD组与对照组的曲线下面积为0.840。Spearman相关性分析显示，反向眼跳潜伏期与国际运动障碍疾病协会统一帕金森病评定量表第三部分评分及中轴评分呈正相关(ρ=0.386,95%CI:0.170～0.567,P=0.040；ρ=0.373,95%CI:0.154～0.557,P=0.047),MGS潜伏期亦与中轴评分呈正相关(ρ=0.411,95%CI:0.198～0.517,P=0.024)。结论 反向眼跳潜伏期延长可作为PD早期诊断的生物标志物，反向眼跳与MGS潜伏期均与PD运动症状（特别是中轴症状）密切相关，可用于评估PD症状及病情进展。
Abstract：Objective To investigate the value of saccadic features in the diagnosis and symptom assement of Parkinson's disease(PD). Methods A total of 76 PD patients(PD group) and 37 healthy controls(control group) admitted in the Movement Disorders Clinic of Chinese PLA General Hospital between February 2024 and July 2025 were recruited in this study. According to the results of modified Hoehn-Yahr(mH&Y) staging, the PD patients was further divided into an early PD subgroup(stage≤1.5, 37 cases) and a moderate-stage PD subgroup(stage≥2, 39 cases). All participants underwent prosaccade(PS), antisaccade(AS), and memory-guided saccade(MGS) tests using a video-based eye tracker. ROC curves were plotted to evaluate diagnostic efficacy, and Spearman correlation analysis was carried out to explore the relationships between saccadic features and clinical features. Results Compared with the control group, the PD group exhibited significantly increased incidences of PS, AS and MGS errors and longer AS and MGS latencies, while lower accuracy rates of PS and MGS, lower gains in PS, AS and MGS, and reduced peak velocities of AS and MGS(P<0.05, P<0.01). The prolonged AS latency and decreased PS accuracy rate were influencing factors for PD(P<0.05, P<0.01), and prolonged AS latency was an influencing factor for early PD(P<0.01). ROC curve analysis indicated that the AUC value of combining PS accuracy rate and AS latency in differentiating PD from control individuals was 0.916, and the value of AS latency in differentiating early PD from control individuals was 0.840. Spearman correlation analysis revealed that AS latency was positively correlated with the score of the third part and the axial subscore of Movement Disorder Society-Unified Parkinson's Disease Rating Scale(ρ=0.386, 95%CI: 0.170-0.567, P=0.040; ρ=0.373, 95%CI:0.154-0.557, P=0.047), and MGS latency was also positively correlated with the axial subscore(ρ=0.411, 95%CI:0.198-0.517, P=0.024). Conclusion Prolonged AS latency may serve as a biomarker for diagnosing early-stage PD. Both AS and MGS latencies are closely associated with motor symptoms(particularly axial symptoms) of PD patient, showing their potential application value in assessing symptom and disease progression.
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基本信息:
中图分类号:R742.5
引用信息:
[1]王淼,尹西,尹春宇,等.眼跳特征在帕金森病早期诊断及症状评估中的作用[J].中华老年心脑血管病杂志,2025,27(12):1611-1616.
基金信息:
解放军总医院青年自主创新科学基金成长项目（22QNCZ028）