Journal List > Ann Clin Neurophysiol > v.19(1) > 1099496

Kim and Park: Can pursuit eye movements reflect the efficacy of antiepileptic drugs?

초록

Background

We evaluated whether eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy.

Methods

Thirty patients with epilepsy of unknown cause as well as age- and sex-matched normal controls were enrolled in this study. We divided the patients into drug-controlled ep-ilepsy (n = 22) and drug-resistant epilepsy (n = 8) groups according to their seizure controls. We analyzed the differences in the parameters of the eye movements in these two groups compared with normal controls using video-based electro-oculography. In addition, we in-vestigated the differences in the cerebellar volumes of these two groups using whole-brain T1-weighted images.

Results

The latency and accuracy of saccade in patients with epilepsy were significantly different from normal controls, but they were not different between patients with drug-con-trolled epilepsy and drug-resistant epilepsy. However, the gain of pursuit was significantly decreased in patients with drug-resistant epilepsy compared with normal controls (p = 0.0010), whereas it was not different between patients with drug-controlled epilepsy and normal controls (p = 0.9646). In addition, the patients with drug-resistant epilepsy had lower cerebellar volumes than normal controls (p = 0.0052), whereas the cerebellar volumes in patients with drug-controlled epilepsy were not different from normal controls (p = 0.5050).

Conclusions

We demonstrated that pursuit eye movements could reflect the efficacy of antiepileptic drugs in patients with epilepsy, a finding that may be related to cerebellar dysfunction.

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Fig. 1.
Differences in the cerebellar volumes in patients with epilepsy and normal controls. The results reveal that the cerebellar volumes in patients with drug-resistant epilepsy are significantly smaller than those in normal controls (p = 0.0180), whereas the cerebellar volumes are not different between patients with drug-controlled epilepsy and normal controls (p = 0.5050).
acn-19-20f1.tif
Table 1.
Differences in the demographic and clinical characteristics between patients with drug-resistant epilepsy and drug-controlled epilepsy
Variable Patients with drug-resistant epilepsy (n = 8) Patients with drug-controlled epilepsy (n = 22) p-value
Age (years) 41.4 ± 5.3 39.9 ± 13.2 0.7569
Male 1 (12.5) 9 (40.9) 0.2103
Age of seizure onset (years) 23.8 ± 8.9 32.8 ± 14.6 0.1680
Duration of epilepsy, months (range) 184, 60-444 36, 12-252 0.0184
Partial seizure 8 (100.0) 19 (86.4) 0.5448
AED load 2.9 (2.2-4.8) 0.8 (0.4-2.8) 0.0001

Values are presented as mean ± standard deviation or n (%) unless otherwise indicated.

AED, antiepileptic drug.

Table 2.
Differences in the parameters of video-based electro-oculography between patients with drug-resistant epilepsy and drug-controlled epilepsy compared with normal controls
  Normal controls Patients with drug-resistant epilepsy p-value Patients with drug-controlled epilepsy p-value
Saccade
Fixed velocity (ms) 892.3 (658.7-1235.0) 704.3 (561.3-821.7) 0.0004 827.2 (562.3-1572.7) 0.2678
Fixed accuracy (%) 193.1 ± 12.3 181.9 ± 11.7 0.0366 179.2 ± 14.5 0.0018
Fixed latency (ms) 536.6 ± 69.2 432.9 ± 114.5 0.0065 454.5 ± 80.3 0.0011
Random velocity (ms) 970.9 (643.9-1383.2) 738.2 (636.1-859.2) 0.0008 929.0 (508.6-1614.0) 0.2172
Random accuracy (%) 192.8 (160.0-206.1) 187.2 (129.0-197.4) 0.0671 188.1 (148.2-209.3) 0.0250
Random latency (ms) 620.9 (500.9-714.3) 596.6 (266.3-704.8) 0.2855 564.2 (349.1-633.0) 0.0048
Total velocity (ms) 1932.3 ± 316.9 1436.0 ± 125.3 0.0002 1829.6 ± 483.1 0.4254
Total accuracy (%) 383.6 (322.9-417.4) 371.7 (306.1-383.1) 0.0221 370.6 (308.5-408.2) 0.0038
Total latency (ms) 1171.7 (942.5-1313.2) 1043.9 (588.4-1249.8) 0.0199 1004.9 (725.6-1224.7) 0.0011
Pursuit
0.2-Hz gain 2.0 (1.4-2.6) 1.6 (0.5-1.9) 0.0023 1.9 (1.0-3.5) 0.4729
0.4-Hz gain 1.8 (1.0-2.4) 1.3 (0.8-1.6) 0.0027 1.7 (1.0-3.2) 0.7625
Total gain 3.9 (2.6-5.1) 3.0 (1.3-3.3) 0.0027 1.7 (1.0-3.2) 0.4965
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