Objective: To study vertical oculomotor reflexes and the state of the functional system “eyelid” in patients with PD.

Background: Parkinson’s disease (PD) is a common disorder of middle-aged and elderly people, in which there is degeneration of the extra-pyramidal motor system. In addition, the “visual-oculomotor” system is a model for studying the interaction between sensory and motor processes in PD. Of particular importance in PD is the study of vertical oculomotor reflexes (VOR), since they are in close conjugation with the gravity system, the change in the state of which makes a significant contribution to the pathophysiology of postural instability, a violation of maintaining the vertical posture and walking.

Methods: Eye and eyelid movements were evaluated with clinical examination, as well as during video-static histography on the hardware complex “Interacoustics” (Denmark). 250 patients with PD at the age of 35 to 70 years were examined.

Results: It has been established that in PD, the speed characteristics of oculomotor reactions in all the tests used are slowing down, the latency time is increased and the accuracy of saccades is reduced in performing the saccadic test, the rate of smooth tracking and the speed of the slow phase of the OKN decrease, and these violations in the vertical plane are manifested to a greater extent, than in the horizontal. There is a direct correlation between the severity of disorders of oculomotor dysfunction and the severity of the disease, regardless of its duration. A characteristic feature of all PD patients is violation suppression of vertical nystagmus in both directions by fixing the gaze on a moving object with the head already in the early stages of the disease. The study of the state of the eyelid system revealed the following patterns: the lag of the eyelid movements from the eye, the movement of the eyelid ahead of the eye, and also the nystagmus of the eyelids in the case of optokinetic stimulation in patients with severe disease stages in which there were significant violations of the vertical gaze in the absence of vertical OKN.

Conclusions: Thus, in patients with PD, violations of the vertical vision system are one of the symptoms of this disease. Registration and quantitative analysis of the parameters of the main oculomotor reflexes will allow to evaluate the adequacy of the prescribed therapy, as well as to solve some expert questions.

References: 1. Bronstein JM, et al. (2011). Deep brain stimulation for Parkinson disease. Archives of Neurology, 68(2): 165-171. 2. Deuschl G, et al. (2006). A randomized trial of deep-brain stimulation for Parkinson’s disease. New England Journal of Medicine, 355(9): 896-908.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/assessment-of-clinical-peculiarities-of-violations-of-vertical-vision-in-patients-with-parkinsons-disease/