Diagnostic potential of acoustic startle reflex, acoustic blink reflex, and electro-oculography in progressive supranuclear palsy: A prospective study

• Published in: Movement disorders Vol. 18; no. 11; pp. 1273 - 1279
• Main Authors: Gironell, Alexandre, Kulisevsky, Jaime, Roig, Carles, Pascual-Sedano, Berta, Rodríguez-Fornells, Antoni, Otermin, Pilar
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.11.2003; Wiley
• Subjects: Aged; Biological and medical sciences; blink reflex; Blinking - physiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; electro-oculography; Electrooculography - instrumentation; Female; Follow-Up Studies; Humans; Male; Medical sciences; Middle Aged; multiple system atrophy; Multiple System Atrophy - diagnosis; Neurology; Nystagmus, Optokinetic; Parkinsonian Disorders - diagnosis; parkinsonian syndromes; progressive supranuclear palsy; Prospective Studies; Reaction Time; Reflex, Acoustic - physiology; Reflex, Startle - physiology; Saccades - physiology; Severity of Illness Index; startle reflex; Supranuclear Palsy, Progressive - diagnosis; Human; Electrooculography; Nervous system diseases; Supranuclear ophthalmoplegia; Startle reflex; Cerebral disorder; Progressive; Electrodiagnosis; Eye disease; Central nervous system disease; Degenerative disease; Diagnosis; Oculomotor syndrome; Brain stem syndrome; Blinking
• ISSN: 0885-3185; 1531-8257
• DOI: 10.1002/mds.10529

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. © 2003 Movement Disorder Society