Diagnostic potential of acoustic startle reflex, acoustic blink reflex, and electro-oculography in progressive supranuclear palsy: a prospective study.
We carried out a prospective study to analyze the diagnostic potential of acoustic startle reflex (ASR), acoustic blink reflex (ABR) and electro-oculography (EOG) in early stages of atypical parkinsonian syndrome. The study was carried out in a consecutive series of 41 patients clinically diagnosed as atypical parkinsonism (mean time from first symptoms of 38 months and follow-up of 26 months). The three procedures were carried out immediately after the first clinical evaluation. ASR and ABR were elicited by auditory stimuli while the patient was attending to a simple reaction time task. Outcome measures were: ASR (absence/presence, latency), ABR (absence/presence, latency) and EOG (suggestive/not suggestive of progressive supranuclear palsy [PSP]). Final clinical diagnosis was carried out by two neurologists blind to the neurophysiological results. A study of diagnostic sensitivity and odds ratio (OR) calculation for the PSP diagnosis was carried out. Neurophysiological examination showed the following sensitivity/specificity (%) for the diagnosis of PSP: ASR: 100/89; ABR 85/89; EOG 100/72. OR values were: ASR: 0.011; ABR: 0.037; EOG: 0.038. The three tests taken simultaneously showed a sensitivity of 100% and a specificity of 95%. The three neurophysiological tests investigated provided sensitive and specific measures with predictor value in early stages of atypical parkinsonian syndrome.
Gironell
Alexandre
A
Department of Neurology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Catalonia, Spain. agironell@correu.vilaweb.com
Kulisevsky
Jaime
J
Roig
Carles
C
Pascual-Sedano
Berta
B
Rodríguez-Fornells
Antoni
A
Otermin
Pilar
P
D000368:Aged; D001767:Blinking / Q000502:physiology*; D004585:Electrooculography / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000175:diagnosis; D017120:Nystagmus, Optokinetic; D020734:Parkinsonian Disorders / Q000175:diagnosis; D011446:Prospective Studies; D011930:Reaction Time; D012022:Reflex, Acoustic / Q000502:physiology*; D013216:Reflex, Startle / Q000502:physiology*; D012438:Saccades / Q000502:physiology; D012720:Severity of Illness Index; D013494:Supranuclear Palsy, Progressive / Q000175:diagnosis*