RESUMEN
AIM: To work out an optimal algorithm to identify people at the latent stage of neurodegenerative process of «parkinsonian¼ type in the Russian population. MATERIAL AND METHODS: Authors launched a two-step study aimed at identifying people at the latent stage of Parkinson's disease (PD) in the Russian population - the PARKINLAR (PARKINsonism, LAtent stage, Russia). As the first step, we formed a group of «primary risk¼ by the identification in neurologically healthy people of at least one of the following confirmed PD risk factors: a) the substantia nigra hyperechogenicity (ultrasound screening was performed in 193 people); b) mutations in «parkinsonian¼ genes (genetic screening was performed in 29 relatives of PD patients from families with LRRK2, PARK2 and GBA mutations). Thereby, 37 people comprised the «primary risk¼ group, of whom 23 agreed to continue further examination (44±10.2 years). A matched group of people without the aforementioned primary biomarkers of PD served as control. As the second step, we undertook in the prescreened groups a complex of investigations assessing the presence of secondary («minor¼) biomarkers of PD: Sniffin' Sticks olfactory testing; color visual evoked potentials; analysis of goal-directed eye-head-hand movements with the use of a special neuro-cybernetic system; assessment of motor and non-motor symptoms with the use of UPDRS and NMSS scales. RESULTS: When comparing the «primary risk¼ group with controls, maximal differences in the occurrence of symptoms were seen for goal-directed eye movements (43.5% vs. 20.0%) and color vision (39.1% vs. 26.7%). Among these individuals, we found two people with 4 secondary biomarkers and one with 3, and no such observations in controls. People with the combination of a primary biomarker with several secondary biomarkers of PD comprised a group of «high risk¼ in our study. CONCLUSION: Optimization of this algorithm of population screening of people predisposed to the development of PD may be done by expanding the spectrum of biomarkers and assessing their validity in a long-term prospective observational study.
Asunto(s)
Enfermedad de Parkinson/diagnóstico , Anciano , Algoritmos , Diagnóstico Precoz , Potenciales Evocados Visuales , Femenino , Pruebas Genéticas , Humanos , Proteína 2 Quinasa Serina-Treonina Rica en Repeticiones de Leucina , Masculino , Persona de Mediana Edad , Mutación , Examen Neurológico , Enfermedad de Parkinson/diagnóstico por imagen , Enfermedad de Parkinson/genética , Proteínas Serina-Treonina Quinasas/genética , Riesgo , Sustancia Negra/diagnóstico por imagen , Ubiquitina-Proteína Ligasas/genética , UltrasonografíaRESUMEN
Saccadic movements of the eyes were analyzed in children with the attention deficit and hyperactivity syndrome. Saccadic movements of the eyes were recorded by a special method for their isolated registration without involvement of the head and in coordination tests (eye-head, eye-hand, and eye-head-hand). Comparative analysis of saccadic movements in children with attention deficit and hyperactivity and in normal subjects was carried out. Saccades recorded in each participant in complex tests with one or two additional motor acts, such as movements of the head and hand, were compared and the changes were analyzed for the group. Children with attention deficit and hyperactivity syndrome had problem with gaze fixation on the peripheral target after the end of the saccade and these changes augmented in more complex tasks with one or two additional acts. This could be due to discrepancy between the difficulty of the task and the potentialities of the frontal cortex, more immature in these patients than in healthy children. The changes could form the objective base for disorders in the formation of reading and writing habits, often observed in children with attention deficit and hyperactivity syndrome.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/fisiopatología , Movimientos Sacádicos , Atención , Estudios de Casos y Controles , Niño , Femenino , Movimientos de la Cabeza , Humanos , Masculino , LecturaRESUMEN
Cervico-vestibulo-oculomotor interactions in patients with Parkinson disease stages III-IV and healthy subjects were studied in horizontal head movement and gaze fixation on immobile and mobile targets. Significant changes in the amplitude, head movement frequency and asymmetry, eye movement amplitude, and phase mismatch between head and eye movements were revealed in patients in comparison to the normal.
Asunto(s)
Fijación Ocular , Enfermedad de Parkinson/fisiopatología , Reflejo Vestibuloocular , Vestíbulo del Laberinto/fisiopatología , Anciano , Estudios de Casos y Controles , Femenino , Movimientos de la Cabeza , Humanos , Masculino , Persona de Mediana Edad , Desempeño Psicomotor , Movimientos Sacádicos , Índice de Severidad de la EnfermedadRESUMEN
We used tests for evaluation of latent period, duration, and accuracy of eyes, head, or hand movements and their coordinated movements. Comparative analysis of these parameters was performed in healthy subjects and in patients with early stages of Parkinson's disease. The pathology data significantly (p<0.05) differed from those in normal control subjects. These results can be used as neurophysiological markers of early neurodegenerative process. Increasing the number of tests would lead to better specificity of the markers. It will be possible to create a battery of neurophysiological tests most likely reflecting the predictive basis of early neurodegenerative process.
Asunto(s)
Degeneración Nerviosa/diagnóstico , Degeneración Nerviosa/fisiopatología , Enfermedad de Parkinson/diagnóstico , Enfermedad de Parkinson/fisiopatología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores , Movimientos Oculares/fisiología , Femenino , Humanos , Locomoción/fisiología , Masculino , Persona de Mediana EdadRESUMEN
We studied the interaction of the oculomotor, cervical, and vestibular systems using a specially developed technique. A series of two tests were performed on 26 healthy subjects and 42 patients with stages I-II Parkinson's disease receiving and not receiving treatment. In coordinated tests, all amplitude-time characteristics of patients significantly differed from those in healthy subjects. Possible mechanisms of cervico-vestibular-oculomotor disorders are discussed.
Asunto(s)
Movimientos Oculares , Movimientos de la Cabeza , Cuello/fisiopatología , Enfermedad de Parkinson/fisiopatología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/terapia , Equilibrio Postural , Desempeño Psicomotor , Estadísticas no ParamétricasRESUMEN
The study was performed with a hardware-software complex for the monitoring of human motor functions. Saccadic eye movements and vestibulo-oculomotor interactions were studied in patients with neurocirculatory asthenia and associated vertigo. No changes in saccadic eye movements were found in these patients. Abnormalities of cervico-vestibulo-oculomotor interactions were manifested in the impairment of gaze fixation and holding.
Asunto(s)
Astenia Neurocirculatoria/fisiopatología , Movimientos Sacádicos , Vértigo/fisiopatología , Adulto , Estudios de Casos y Controles , Electrooculografía , Humanos , Astenia Neurocirculatoria/complicaciones , Vértigo/complicacionesRESUMEN
Relationships between eye, head, and hand movements in patients with stages I-II Parkinson's disease were studied using an original method. The tests for individual movements in patients and healthy individuals yielded similar results, while coordination test revealed significant differences.