Diagnostic potential of saccadometry in progressive supranuclear palsy.
BACKGROUND
Progressive supranuclear palsy (PSP), an atypical parkinsonian syndrome characterized by extrapyramidal features, imbalance, supranuclear gaze paresis and dementia, can be difficult to diagnose, especially in the early stages. From the clinician's point of view, the main difficulty with this disorder is the inability to provide an accurate diagnosis, at least for the initial stages of the disease, where symptoms are often confused with other parkinsonian disorders. This inability complicates the recruitment of patients with early-stage parkinsonism to trials of disease-modifying therapy.


OBJECTIVE
To determine whether quantitative, objective examination of saccadic latency distributions can help to distinguish PSP patients from other groups of parkinsonian patients.


METHODS
We used a newly developed portable saccadometer to compare saccadic latency distributions of a group of PSP patients with two other groups in whom the initial differential diagnosis included PSP: one of these groups had Parkinson's disease and the other had developed a range of parkinsonian conditions (multiple system atrophy, dementia with Lewy bodies and corticobasal degeneration).


RESULTS
The use of a combination of saccadic parameters provided a greater discriminative power than the use of only one parameter, such as median latency. Statistical analysis and parameterization of the distributions robustly distinguished the three groups.


CONCLUSIONS
This approach appears to have considerable diagnostic potential in allowing a more accurate diagnosis of PSP, and may help particularly to eliminate misdiagnosis with other parkinsonian conditions.
Antoniades
Chrystalina A
CA
University of Cambridge, Cambridge Centre for Brain Repair, Department of Clinical Neurosciences, Forvie Site, Cambridge, CB2 2PY, UK. ca314@cam.ac.uk
Bak
Thomas H
TH
Carpenter
R H S
RH
Hodges
John R
JR
Barker
Roger A
RA