Rituximab improves not only back stiffness but also “stiff eyes” in stiff person syndrome: Implications for immune-mediated treatment

Satoshi Kodama; Shin-ichi Tokushige; Yusuke Sugiyama; Kazuya Sato; Juuri Otsuka; Yuichiro Shirota; Masashi Hamada; Atsushi Iwata; Tatsushi Toda; Shoji Tsuji; Yasuo Terao

doi:10.1016/j.jns.2019.116506

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Rituximab improves not only back stiffness but also “stiff eyes” in stiff person syndrome: Implications for immune-mediated treatment

Satoshi Kodama, Shin-ichi Tokushige, Yusuke Sugiyama, Kazuya Sato, Juuri Otsuka, Yuichiro Shirota, Masashi Hamada, Atsushi Iwata, Tatsushi Toda, Shoji Tsuji, …

Journal of the neurological sciences, Vol.408, p.116506

01/15/2020

DOI: 10.1016/j.jns.2019.116506

PMID: 31734550

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Abstract

Stiff person syndrome (SPS) is usually characterized by truncal muscle rigidity and episodic painful spasms, but it sometimes appears with ocular symptoms called “stiff eyes”. We recorded saccade movements in an SPS patient manifesting with “stiff eyes” conditions with slow saccade velocity and evaluated the effect of immunotherapy including rituximab on saccade parameters. We repeatedly conducted saccade eye recordings using video-based eye tracking system on a 42-year-old male SPS patient with slow saccade. The velocity and onset latency of visual guided saccades (VGS) were measured at each recording. Because VGS velocity is affected by saccade amplitude, estimated peak velocity (Vmax) was also calculated by taking the relationship between the velocity and the amplitude of saccade into account. The mean VGS velocity improved significantly after two courses of rituximab administration compared with its lowest value. The estimated Vmax decreased as the clinical manifestations worsened, but it increased after rituximab administration. Other neurological symptoms in this patient such as muscle rigidity and gait instability also improved after the treatment. Slow saccade in a “stiff eyes” patient improved after rituximab administration. Our study also indicated that the saccade eye recording is useful for evaluating the clinical condition of SPS when it is complicated with ocular symptoms. •Slow saccade in stiff person syndrome (SPS) improved after rituximab administration.•Rituximab may be effective for ocular symptoms in SPS.•Saccade eye recording can be a useful measure for evaluating ocular symptoms in SPS.

Burst neurons

Glutamic acid decarboxylase (GAD)

Latch circuit

Omnipause neuron

Slow saccade

Stiff person plus

Video-based eye tracking system

Details

Title: Subtitle: Rituximab improves not only back stiffness but also “stiff eyes” in stiff person syndrome: Implications for immune-mediated treatment
Creators: Satoshi Kodama - The University of Tokyo
Shin-ichi Tokushige - Department of Neurology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
Yusuke Sugiyama - The University of Tokyo
Kazuya Sato - The University of Tokyo
Juuri Otsuka - The University of Tokyo
Yuichiro Shirota - The University of Tokyo
Masashi Hamada - The University of Tokyo
Atsushi Iwata - The University of Tokyo
Tatsushi Toda - The University of Tokyo
Shoji Tsuji - The University of Tokyo
Yasuo Terao - Kyorin University
Resource Type: Journal article
Publication Details: Journal of the neurological sciences, Vol.408, p.116506
DOI: 10.1016/j.jns.2019.116506
PMID: 31734550
ISSN: 0022-510X
eISSN: 1878-5883
Publisher: Elsevier B.V
Language: English
Date published: 01/15/2020
Academic Unit: Neurology
Record Identifier: 9985177946402771

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