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Background <p>Various oculomotor abnormalities have been reported among Parkinson’s disease (PD) patients. However, their direction- and frequency-specific alterations, developmental trajectory, as well as associations with levodopa responsiveness, remain poorly understood and controversial.</p> Methods <p>We studied eye movements via video nystagmography (VNG) in 45 PD patients and 22 HCs. PD patients underwent saccadic accuracy, saccadic latency, and smooth pursuit eye movement (SPEM) gain tests in the OFF and ON medication states (meds) via a levodopa challenge test (LCT).</p> Results <p>Compared with HCs, PD patients had lower saccadic accuracy, longer saccadic latency, and lower SPEM gain. Among them, a reduction of 10°/s horizontal SPEM gain was present in the Hoehn and Yahr (H&amp;Y) 1–2 stage [rightward: 85.000 (83.000, 90.500)% vs. 93.882 ± 5.159%, <i>P</i> = 0.016; leftward: 82.545 ± 12.652% vs. 94.316 ± 3.215%, <i>P</i> = 0.027], which could differentiate between early PD patients and HCs with an AUC of 0.807. Levodopa treatment improved the 10°/s horizontal SPEM gain [rightward: 89.500 (81.000, 95.000)% vs. 85.000 (77.000, 91.000)%, <i>Z</i> = −2.422, <i>P</i> = 0.015; leftward: 89.000 (82.000, 93.500)% vs. 81.607 ± 13.634%, <i>Z</i> = −2.134, <i>P</i> = 0.033] and 40°/s downward SPEM gain [63.268 ± 22.778% vs. 55.452 ± 24.515%, <i>t</i> = −3.106, <i>P</i> = 0.004]. Motor symptoms were independent risk factors for reduced upward saccadic accuracy and 40°/s vertical SPEM gain, while an improvement in 40°/s downward SPEM gain was positively correlated with a decrease in the MDS–UPDRS III score (<i>r</i> = 0.331, <i>P</i> = 0.037).</p> Conclusions <p>VNG-based multidimensional SPEM analysis holds promise as biomarkers to enable early PD detection, monitor disease progression, and optimize early precision interventions.</p> <p><i>Trial registration</i>: The study was registered with the Chinese Clinical Trial Registry (Clinical Trial Registration No. ChiCTR1900022655, Date: April 20, 2019).</p>

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Smooth pursuit eye movements in different directions and frequencies as biomarkers for detecting early stage Parkinson's disease and assessing levodopa responsiveness: a cross-sectional study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年11月21日

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  • Bo Zhao,
  • Changshen Yu,
  • Yue Zhang,
  • Miaomiao Yin,
  • Xuan Yang,
  • Change Wang,
  • Peipei Liu,
  • Yang Yu,
  • Yuanyuan Cheng,
  • Zhizhong Zhu,
  • Xiyue Jing,
  • Jialing Wu

摘要

Background

Various oculomotor abnormalities have been reported among Parkinson’s disease (PD) patients. However, their direction- and frequency-specific alterations, developmental trajectory, as well as associations with levodopa responsiveness, remain poorly understood and controversial.

Methods

We studied eye movements via video nystagmography (VNG) in 45 PD patients and 22 HCs. PD patients underwent saccadic accuracy, saccadic latency, and smooth pursuit eye movement (SPEM) gain tests in the OFF and ON medication states (meds) via a levodopa challenge test (LCT).

Results

Compared with HCs, PD patients had lower saccadic accuracy, longer saccadic latency, and lower SPEM gain. Among them, a reduction of 10°/s horizontal SPEM gain was present in the Hoehn and Yahr (H&Y) 1–2 stage [rightward: 85.000 (83.000, 90.500)% vs. 93.882 ± 5.159%, P = 0.016; leftward: 82.545 ± 12.652% vs. 94.316 ± 3.215%, P = 0.027], which could differentiate between early PD patients and HCs with an AUC of 0.807. Levodopa treatment improved the 10°/s horizontal SPEM gain [rightward: 89.500 (81.000, 95.000)% vs. 85.000 (77.000, 91.000)%, Z = −2.422, P = 0.015; leftward: 89.000 (82.000, 93.500)% vs. 81.607 ± 13.634%, Z = −2.134, P = 0.033] and 40°/s downward SPEM gain [63.268 ± 22.778% vs. 55.452 ± 24.515%, t = −3.106, P = 0.004]. Motor symptoms were independent risk factors for reduced upward saccadic accuracy and 40°/s vertical SPEM gain, while an improvement in 40°/s downward SPEM gain was positively correlated with a decrease in the MDS–UPDRS III score (r = 0.331, P = 0.037).

Conclusions

VNG-based multidimensional SPEM analysis holds promise as biomarkers to enable early PD detection, monitor disease progression, and optimize early precision interventions.

Trial registration: The study was registered with the Chinese Clinical Trial Registry (Clinical Trial Registration No. ChiCTR1900022655, Date: April 20, 2019).