The use of eye-movement recording in patients with anti-Hu antibody–associated paraneoplastic neurological syndromes to objectively determine extent and course of disease
| Autor: | Malou Janssen, Peter A. E. Sillevis Smitt, Flip van Broekhoven, Jos N. van der Geest, Maarten A. Frens |
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| Přispěvatelé: | Neurology, Neurosciences |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Eye Movements genetic structures Short Communication Central nervous system Smooth pursuit 03 medical and health sciences 0302 clinical medicine Neuro‐oncology SDG 3 - Good Health and Well-being Modified Rankin Scale eye‐movement control Internal medicine Cerebellum Neoplasms medicine Humans 030212 general & internal medicine business.industry Eye movement paraneoplastic neurological syndromes saccadic eye movement Middle Aged Saccadic masking Peripheral medicine.anatomical_structure Neurology ELAV Proteins smooth pursuit Fixation (visual) Female Neurology (clinical) Brainstem sense organs business 030217 neurology & neurosurgery modified ranking scale Paraneoplastic Syndromes Nervous System |
| Zdroj: | European Journal of Neurology European Journal of Neurology, 28(6), 2126-2132. Wiley-Blackwell Publishing Ltd |
| ISSN: | 1351-5101 |
| Popis: | Background and purpose Paraneoplastic neurological syndromes with Hu‐antibodies (Hu‐PNS) are immune‐mediated disorders in patients with malignancies, most frequently small cell lung cancer, affecting both the peripheral and central nervous system (CNS). In Hu‐PNS, brainstem and cerebellar involvement are common. Here, we assessed whether eye‐movement disturbances can be used for diagnosis and monitoring of CNS involvement in Hu‐PNS. Methods Twenty‐nine patients with Hu‐PNS (17 females; mean age, 63.2 years,) and 14 healthy age‐matched controls (seven females; mean age, 60.2 years) were included. Saccadic and smooth pursuit eye movements in response to visual stimuli were recorded with video‐oculography. Eye movements were scored quantitatively (number of correction saccades, saccadic intrusions, and saccades during fixation period) and qualitatively by two eye‐movement experts. In 20 patients, up to three follow‐up measurements were made during subsequent hospital visits with fixed 4‐week intervals. Disease course was assessed using the modified Rankin Scale. Results Eye movements were disturbed in 26 of 29 Hu‐PNS patients, with horizontal eye movements being in general more impaired. Moreover, in 12 of the 14 Hu‐PNS patients without clinical CNS involvement, eye movements were disturbed. Changes in eye‐movement control over a period of up to 12 weeks were significantly correlated with the clinical response to treatment (ρ = 0.52, p = 0.02). Conclusions Hu‐PNS often affects eye‐movement control, also in the absence of CNS signs or symptoms. Eye‐movement recordings in Hu‐PNS patients might be a useful tool to objectively monitor progression and treatment efficacy in Hu‐PNS patients. Eye movements are often disturbed in patients with anti‐Hu–associated paraneoplastic neurological syndromes, including in those without clinical signs of CNS involvement. Eye‐movement recordings might contribute to determining disease progression and therapy response. |
| Databáze: | OpenAIRE |
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