Previous studies provide partly contradictory results about the characteristics of saccades in PD and the possible effects of levodopa, which may be attributed to different study design regarding disease stages, medication state or cognitive functioning. We studied horizontal and vertical visually guided saccades (VGS) and antisaccades (AS) in 40 patients with PD with and without postural instability in On and Off medication state as well as in 20 healthy controls (HC). Motor and cognitive performance were assessed using UPDRS, Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB). The PD group showed decreased VGS amplitudes and increased vertical VGS and AS latencies. Only relatively few studies had assessed vertical saccades in PD so far. However, our results indicate that vertical saccadic amplitude may be a supportive marker in diagnosing PD since upwards gain demonstrated an AUC of 0.85 for the discrimination of PD and HC. Only more advanced patients in Hoehn & Yahr stage 3 executed higher numbers of AS errors than HC. Since the AS error rate correlated with FAB and MoCA scores, AS performance seems to reflect cognitive ability in PD. Furthermore, the correlation of AS latency with the UPDRS axial subscore promotes the recently highlighted connection between postural control and executive function in PD. Levodopa did not alter saccade amplitudes and had opposing effects on the initiation of VGS and AS: Levodopa intake prolonged VGS latency, but decreased AS latency. Possible mechanisms by which levodopa may be capable of partially reversing the impaired balance between voluntary and reflexive cortical saccade initiation of PD are discussed.

先前的研究在PD扫视的特征和左旋多巴的可能作用方面提供了部分矛盾的结果，这可能归因于关于疾病阶段，用药状态或认知功能的不同研究设计。我们研究了40例PD伴有和不伴有姿势不稳的PD患者的水平和垂直视觉引导扫视（VGS）和抗扫视（AS），以及20名健康对照（HC）的体位状态。使用UPDRS，蒙特利尔认知评估（MoCA）和额叶评估电池（FAB）评估运动和认知表现。PD组显示VGS振幅降低，垂直VGS和AS潜伏期增加。到目前为止，仅有相对较少的研究评估了PD的垂直扫视。然而，我们的结果表明，垂直声波振幅可能是诊断PD的支持性标志，因为向上的增益显示0.85的AUC可以区分PD和HC。在Hoehn＆Yahr第3期中，只有更高级的患者比HC发生了更多的AS错误。由于AS错误率与FAB和MoCA分数相关，因此AS表现似乎反映了PD的认知能力。此外，AS潜伏期与UPDRS轴向子评分的相关性促进了PD中姿势控制与执行功能之间最近突出的联系。左旋多巴不会改变扫视幅度，并且对VGS和AS的发作有相反的影响：左旋多巴的摄入延长了VGS潜伏期，但降低了AS潜伏期。