视觉诱发电位评估帕金森病视幻觉视觉传导通路临床价值
The clinical value of visual evoked potential in assessing visual pathway of visual hallucinations in Parkinson disease
李向 1张琪林 1陈菲 1桂浩 1戴永萍1
作者信息
- 1. 苏州大学附属第二医院神经电生理室(苏州 215004)
- 折叠
摘要
目的 本研究旨在通过视觉诱发电位(visual evoked potential,VEP)评估帕金森病(Parkinson disease,PD)患者的视觉传导通路完整性,特别是那些伴有视幻觉的患者.方法 共纳入76例PD患者,根据是否伴有视幻觉分为两组:伴有视幻觉组24例,无视幻觉组52例.为控制变量,同时选取22例性别和年龄匹配的健康对照组.所有受试者接受VEP检测,并针对PD患者进行了统一帕金森病评分量表(UPDRS)、Hoehn&Yahr分期(H-Y分期)和简易智能精神状态检查量表(MMSE)评估.结果 伴有视幻觉的PD患者N75、P100、N135潜伏期(88.26±10.47)ms、(118.48±8.53)ms、(144.71±9.48)ms较无视幻觉组(79.00±6.96)ms、(108.60±7.01)ms、(135.95±8.21)ms显著延长(P均<0.001),而N75-P100、N135-P100峰峰波幅[4.35(2.73,7.30)μV]、[6.40(4.15,9.90)μV]则较无视幻觉组[7.10(5.28,9.98)μV]、[9.05(6.30,12.60)μV]显著降低,差异有统计学意义(P<0.001,P=0.037).相关性分析发现,PD视幻觉组中P100潜伏期与H-Y分期及UPDRS-I、UPDRS-II、UPDRS-III总分呈正相关(r=0.537,P=0.007;r=0.635,P=0.001;r=0.594,P=0.004;r=0.558,P=0.005).结论 视幻觉组PD患者的视觉传导通路完整性受损,且随着疾病进展,视觉传导通路可能遭受进一步破坏,影响可能扩展至上行通路以外的脑区.
Abstract
Objective This research was to evaluate the integrity of visual pathways in patients with Parkinson disease(PD)by visual evoked potential(VEP),especially those with visual hallucinations.Methods A total of 76 PD patients were enrolled in this study.According to the presence or absence of visual hallucinations,they were divided into two groups:24 patients with visual hallucinations and 52 patients without visual hallucinations.At the same time,22 sex-and age-matched healthy controls were selected.All subjects underwent VEP test,and Unified Parkinson's Disease Rating Scale(UPDRS),Hoehn&Yahr stage(H-Y stage)and Mini-mental State Examination(MMSE)were performed for PD patients.Results The latencies of N75,P100 and N135(88.26±10.47)ms,(118.48±8.53)ms,(144.71±9.48)ms were significantly longer in PD patients with visual hallucinations than in those without visual hallucinations[(79.00±6.96)ms,(108.60±7.01)ms,(135.95±8.21)ms](P<0.001).However,the amplitudes of N75-P100 and N135-P100[4.35(2.73,7.30)μV]、[6.40(4.15,9.90)μV]were significantly lower in PD patients with visual hallucinations than in those without visual hallucinations[7.10(5.28,9.98)μV]、[9.05(6.30,12.60)μV](P<0.001,P=0.037).Correlation analysis showed that P100 latency was positively correlated with H-Y stage,UPDRS-I,UPDRS-II,and UPDRS-III scores(r=0.537,P=0.007),(r=0.635,P=0.001),(r=0.594,P=0.004)and(r=0.558,P=0.005)in PD visual hallucinations group.Conclusion The integrity of the visual pathway is impaired in PD patients with visual hallucinations.As the progression of the disease,the impairment of visual pathway may be further deteriorated,which may extend beyond the upper pathways of visual pathway to the brain.
关键词
帕金森病/视幻觉/视觉诱发电位/视觉传导通路/上行通路Key words
Parkinson disease/Visual hallucination/Visual evoked potentials/Visual pathway/Bottom-up引用本文复制引用
基金项目
国家自然科学基金面上项目(81671270)
出版年
2024
NETL
NSTL
万方数据