Correlation of Visual Evoked Potentials with Dementia in Parkinson's Disease.
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概要
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There has been some debate regarding abnormalities in visual evoked potentials (VEP) in Parkinson's disease (PD). To elucidate the mechanism causing abnormal VEP, we investigated the relationship between VEP and mental function in PD patients. Pattern reversal VEP was recorded in PD patients (n=27) and age-matched control subjects (n=14). PD patients consisted of two subgroups; PD without dementia (nD-PD; n=17) and PD with dementia (D-PD; n=10). Dementia was evaluated according to the criteria for dementia assigned in DSM III-R, and mental faculties were estimated by using the mini-mental state examination (MMSE). In pattern VEP recordings, P100 latency and amplitude were measured for each eye stimulated. No patient or control subject had impairment of corrected visual acuity or ophthalmological disease. There was no significant difference in age among the three groups (D-PD, nD-PD and control subjects). D-PD patients showed significantly prolonged P100 latency compared to nD-PD patients and control subjects (p<0.05). With respect to P100 amplitude, no significant difference was shown among the three groups. In PD patients, there was a rough correlation between P100 latency and MMSE score. No correlation was found between P100 amplitude and MMSE score. In control subjects, P100 latency did not correlate with advancing age. In PD patients, nD-PD patients showed a significant correlation between P100 latency and age, whereas D-PD patients presented no correlation. Abnormal VEP in PD has been mostly ascribed to dopaminergic deficiency in the retina. The present study, however, suggests that dysfunction in the central visual system plays a role in abnormal pattern VEP in PD, particularly in D-PD. Since patients with Alzheimer's disease have abnormal flash VEP but normal pattern VEP, VEP seems to be valid for differential diagnosis of dementing diseases.
- 社団法人 日本老年医学会の論文