Ji-Hyun Choi1,2, Heejung Kim3, Jung Hwan Shin1,4, Jee-Young Lee4, Han-Joon Kim1, Jong-Min Kim2, Beomseok Jeon5. 1. Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. 2. Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. 3. Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. 4. Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. 5. Department of Neurology and Movement Disorder Center, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Korea. brain@snu.ac.kr.
Abstract
OBJECTIVE: To investigate oculomotor impairment in subtypes of progressive supranuclear palsy (PSP) and its associations with clinical features and regional brain volumes in PSP. METHODS: We compared the video-oculography (VOG) findings of 123 PSP patients, consisting of 66 PSP-Richardson syndrome (PSP-RS), 28 PSP-parkinsonism (PSP-P), and 29 PSP-progressive gait freezing (PSP-PGF), along with 80 Parkinson's disease (PD) patients. We also investigated the associations of the VOG results with clinical features (disease duration, PSP rating scales [PSPRS] scores for dysphagia and postural stability) in the subtypes of PSP patients and with regional volumes in the brainstem, including the midbrain, pons, medulla, and the superior cerebellar peduncle (SCP), among the patients who had MRI images at the time of VOG (30 PSP). RESULTS: All of the three subtypes of PSP patients showed slower vertical saccades and smooth pursuit than that of the PD patients (adjusted p < 0.05). Among the PSP subtypes, saccadic peak velocity, saccadic accuracy, and pursuit gain were significantly decreased in patients with the PSP-RS compared to those with the PSP-PGF (adjusted p < 0.05). In multiple linear regression model, vertical saccadic velocity, latency, accuracy, and pursuit gain were associated with the PSPRS score for dysphagia (adjusted p < 0.05), and a decrease in vertical saccadic speed and accuracy was associated with SCP atrophy (corrected p < 0.05). CONCLUSIONS: This study demonstrated the severity of oculomotor dysfunction in differentiating the subtypes of PSP and its significant relationships with the dysphagia symptom and SCP volume in PSP.
OBJECTIVE: To investigate oculomotor impairment in subtypes of progressive supranuclear palsy (PSP) and its associations with clinical features and regional brain volumes in PSP. METHODS: We compared the video-oculography (VOG) findings of 123 PSPpatients, consisting of 66 PSP-Richardson syndrome (PSP-RS), 28 PSP-parkinsonism (PSP-P), and 29 PSP-progressive gait freezing (PSP-PGF), along with 80 Parkinson's disease (PD) patients. We also investigated the associations of the VOG results with clinical features (disease duration, PSP rating scales [PSPRS] scores for dysphagia and postural stability) in the subtypes of PSPpatients and with regional volumes in the brainstem, including the midbrain, pons, medulla, and the superior cerebellar peduncle (SCP), among the patients who had MRI images at the time of VOG (30 PSP). RESULTS: All of the three subtypes of PSPpatients showed slower vertical saccades and smooth pursuit than that of the PDpatients (adjusted p < 0.05). Among the PSP subtypes, saccadic peak velocity, saccadic accuracy, and pursuit gain were significantly decreased in patients with the PSP-RS compared to those with the PSP-PGF (adjusted p < 0.05). In multiple linear regression model, vertical saccadic velocity, latency, accuracy, and pursuit gain were associated with the PSPRS score for dysphagia (adjusted p < 0.05), and a decrease in vertical saccadic speed and accuracy was associated with SCPatrophy (corrected p < 0.05). CONCLUSIONS: This study demonstrated the severity of oculomotor dysfunction in differentiating the subtypes of PSP and its significant relationships with the dysphagia symptom and SCP volume in PSP.
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