Background

In clinical practice, eye movements can provide an early diagnostic marker for early onset ataxia (EOA). However, quantitative oculomotor assessment is not included in the most frequently used and age-validated ataxia rating scale in children, the Scale for the Assessment and Rating of Ataxia (SARA). We aimed to investigate the applicability of semi-quantitative eye movement assessment by the International Cooperative Ataxia Rating Scale (ICARS_OCM) and Ocular Motion Score (OMS_7-10) complementary to SARA measurements in children.

Methods

In 52 typically developing children (aged 4–16 years; n = 4 per year of age), three independent assessors scored saccadic eye movements and ocular pursuit according to the ICARS_OCM and matching parameters from the OMS_7-10. For ICARS_OCM, we determined 1) construct validity for coordinated eye movements by correlation with OMS_7-10, ICARS_{EYE-HAND-COORDINATION} and SARA subscale scores, 2) agreement percentage and inter-rater agreement (Fleiss Kappa) and 3) age-dependency.

Results

Spearman's rank correlations of ICARS_OCM with OMS_7-10 and ICARS- and SARA subscales were moderate to fair (all p < .001). Inter-rater agreement of ICARS-_OCM was 80.8%; (Fleiss Kappa: 0.411). ICARS_OCM scores revealed a similar exponentially decreasing association with age as the other SARA (sub)scores, reaching a plateau at 10 years of age.

Interpretation

ICARS_OCM has a valid construct for the measurement of coordinated eye movement performance and is reliably assessable in children. ICARS_OCM reveals a similar age-dependent relationship as the other ataxia subscales, reflecting the physiological maturation of the cerebellum. In children, these data may implicate that ICARS_OCM can reliably contribute to coordination assessment, complementary to the SARA subscales.

中文翻译：

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定量动眼神经和 SARA 评估在儿童中的适用性

背景

在临床实践中，眼球运动可以为早发性共济失调 (EOA) 提供早期诊断标志物。但是，最常用和经过年龄验证的儿童共济失调评分量表，即共济失调评估和评定量表 (SARA) 中不包括定量动眼神经评估。我们旨在研究通过国际合作共济失调评定量表 (ICARS _OCM ) 和眼动评分 (OMS _7-10 ) 对儿童进行 SARA 测量的半定量眼动评估的适用性。

方法

在 52 名典型发育儿童（4-16 岁；n = 4 每岁）中，三位独立评估员根据 ICARS _OCM和来自 OMS _{7-10 的}匹配参数对扫视眼球运动和眼球追踪进行评分。对于 ICARS _OCM，我们确定了 1) 通过与 OMS _7-10、ICARS_眼手协调和 SARA 分量表分数的相关性来确定协调眼球运动的构造有效性，2) 一致性百分比和评估者间一致性 (Fleiss Kappa) 和 3) 年龄-依赖性。

结果

ICARS _OCM与 OMS _7-10以及 ICARS- 和 SARA 分量表的Spearman 等级相关性为中等至一般（所有p  < .001）。ICARS- _OCM的评分者间一致性为80.8%；（弗莱斯卡帕：0.411）。ICARS _OCM分数与其他 SARA（子）分数显示出与年龄类似的指数下降关联，在 10 岁时达到平台期。

解释

ICARS _OCM具有测量协调性眼球运动性能的有效结构，并且可在儿童中可靠地进行评估。ICARS _OCM显示出与其他共济失调分量表类似的年龄依赖性关系，反映了小脑的生理成熟。在儿童中，这些数据可能暗示 ICARS _OCM可以可靠地促进协调评估，补充 SARA 分量表。