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Progressive Worsening of Spatial and Chromatic Processing Deficits in Parkinson Disease
Nico J. Diederich, MD;
Rema Raman, MS;
Sue Leurgans, PhD;
Christopher G. Goetz, MD
Arch Neurol. 2002;59:1249-1252.
Context Impairments of color discrimination (CD) and contrast sensitivity are
established signs of Parkinson disease (PD), but their temporal evolution
has not been studied.
Objective To determine whether there is progressive, longitudinal deterioration
of color discrimination (CD) and contrast sensitivity (CS) in PD.
Design A prospective study.
Setting Tertiary care center–based sample of PD patients without dementia
with normal visual acuity (Snellen fraction >0.6 in the best eye).
Main Outcome Measures With a mean ± SD interval of 19.8 ± 2.8 months, the following
tests were applied twice in 28 patients: the Lanthony D15 test and the Farnsworth
Munsell 100 Hue test as tests of CD and the monocular and binocular Pelli-Robson
test and the binocular Vistech tables as tests of CS.
Results There was deterioration of both CD (Farnsworth Munsell 100 hue test: P = .002) and CS (binocular Vistech test at a spatial frequency
of 6 cycles per degree, P<.001). Both deficits
correlated with age, and the chromatic deficit additionally correlated with
higher impairment of motor function (Unified Parkinson's Disease Rating Scale
motor section, P = .04) and activities of daily life
(Unified Parkinson's Disease Rating Scale activities of daily living section, P = .006). Patients with the highest pathologic psychiatric
rating score (Brief Psychiatric Rating Scale) performed worse on both CS (P = .02) and CD (P = .01) at the
second examination.
Conclusions Impairments of CD and CS in PD are progressive over time. Visual deficits
may influence overall motor function and lead to enhanced motor impairment.
From the Departments of Neurological Sciences (Drs Diederich, Leurgans,
and Goetz) and Preventive Medicine (Dr Leurgans and Ms Raman), Rush-Presbyterian-St
Luke's Medical Center, Chicago, Ill; and Department of Neuroscience, Centre
Hospitalier de Luxembourg, Luxembourg (Dr Diederich).
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