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The effect of levodopa on saccades – Oxford Quantification in Parkinsonism study. Parkinsonism Relat Disord 2019; 68:49-56. [DOI: 10.1016/j.parkreldis.2019.09.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/25/2019] [Accepted: 09/27/2019] [Indexed: 11/18/2022]
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Lal V, Truong D. Eye movement abnormalities in movement disorders. Clin Park Relat Disord 2019; 1:54-63. [PMID: 34316601 PMCID: PMC8288550 DOI: 10.1016/j.prdoa.2019.08.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/12/2022] Open
Abstract
The visual system represents the most well-developed sensory system in humans, who are highly dependent on vision for organized response to their environment. The region of eye that is responsible for sharp central vision is the fovea. Thus, to see the world, images of objects of interest should fall on fovea. This is achieved through various sets of eye movements, all of which work together to keep the image of the target object on the fovea. It is therefore not surprising that a large part of the human brain is devoted to eye movements (e.g., several cortical and subcortical areas, including the brainstem, cerebellum and basal ganglia). Given that a large area of brain is devoted to eye movements, it is not surprising to find eye movement abnormalities in various brain disorders, including movement disorders. In fact, many of the movement disorders commonly encountered in clinical practice are associated with characteristic eye movement abnormalities that not only help in specific diagnosis, but also contribute to morbidity associated with these disorders. In this article, we review the pathophysiology, clinical characteristics, and significance of various eye movement abnormalities in patients with various movement disorders.
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Affiliation(s)
- Vivek Lal
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Daniel Truong
- The Truong Neuroscience Institute, Orange Coast Memorial Medical Center, Fountain Valley, CA 92708, USA
- Department of Psychiatry and Neuroscience, University of California Riverside, Riverside, CA, USA
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Stuart S, Lawson RA, Yarnall AJ, Nell J, Alcock L, Duncan GW, Khoo TK, Barker RA, Rochester L, Burn DJ. Pro-Saccades Predict Cognitive Decline in Parkinson's Disease: ICICLE-PD. Mov Disord 2019; 34:1690-1698. [PMID: 31442355 DOI: 10.1002/mds.27813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cumulative dementia incidence in Parkinson's disease (PD) is significant, with major personal and socioeconomic impacts on individuals with PD and their carers. Early identification of dementia risk is vital to ensuring optimal intervention. Saccadic deficits often distinguish neurodegenerative disorders and cognitive impairment, but their ability to predict cognitive decline in PD has yet to be determined. The aims of this study were to (1) evaluate baseline (6.4 ± 6.1 months since PD diagnosis) differences in pro-saccadic metrics between those with early PD and healthy age-matched adults; and (2) assess the ability of baseline pro-saccades to predict subsequent cognitive decline over 4.5 years. METHODS One hundred and forty-one PD and 90 age-matched participants recruited at diagnosis underwent saccadometric assessment of pro-saccades at baseline and had cognition assessed at baseline, 18, 36, and 54 months. Pro-saccadic characteristics included latency, duration, amplitude, peak, and average velocity. Cognitive assessment included executive function, attention, fluctuating attention, and memory. Linear mixed-effects models examined pro-saccadic metrics as predictors of cognitive decline over 54 months. RESULTS Pro-saccades were significantly impaired at baseline in PD compared with controls. Pro-saccadic characteristics of latency, duration, peak, and average velocity predicted decline in global cognition, executive function, attention, and memory over 54 months in PD. In addition, only reduction in global cognition and attention were predicted by pro-saccadic metrics in age-matched adults, indicating that PD findings were not purely age related. CONCLUSIONS Saccadic characteristics are impaired in early PD and are predictive of cognitive decline in several domains. Assessment of saccades may provide a useful non-invasive biomarker for long-term PD cognitive decline in early disease. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Samuel Stuart
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, Oregon, USA
| | - Rachael A Lawson
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Alison J Yarnall
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Jeremy Nell
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Lisa Alcock
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Gordon W Duncan
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tien K Khoo
- School of Medicine & Menzies Health Institute Queensland, Griffith University, Australia.,School of Medicine, University of Wollongong, Wallongong, New South Wales, Australia
| | - Roger A Barker
- Cambridge University, John van Geest Centre for Brain Repair and Department of Neurology, E.D. Adrian Building, Cambridge, UK
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - David J Burn
- Faculty of Medical Science, Newcastle University, Newcastle Upon Tyne, UK
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Barbosa P, Kaski D, Castro P, Lees AJ, Warner TT, Djamshidian A. Saccadic Direction Errors are Associated with Impulsive Compulsive Behaviours in Parkinson’s Disease Patients. JOURNAL OF PARKINSONS DISEASE 2019; 9:625-630. [DOI: 10.3233/jpd-181460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pedro Barbosa
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
- The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Diego Kaski
- Department of Clinical and Movement Neurosciences, University College London, London, UK
- Department of Neuro-Otology, Charing Cross Hospital, Imperial College London, London, UK
| | - Patricia Castro
- Escuela de Fonoaudiologia, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Andrew J. Lees
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas T. Warner
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
- The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Atbin Djamshidian
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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Oculomotor effects of medical and surgical treatments of Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2019; 249:297-305. [PMID: 31325988 DOI: 10.1016/bs.pbr.2019.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Oculomotor abnormalities are fast becoming a proxy for disease diagnosis and progression. Saccades-ballistic eye movements-are known to be affected by dopaminergic cell loss in the basal ganglia, caused by Parkinson's disease. Pharmaceutical and neurosurgical interventions such as deep brain stimulation and functional neurosurgery have both been noted to have an effect on saccades. Comparing and contrasting these effects may yield insights into Parkinson's disease pathophysiology, and the mechanisms of pharmacological and neurosurgical treatments. Computational models of saccadic control, such as the LATER model, can help to interpret the distribution of saccadic latencies, providing a framework for objectively comparing the effects of pharmaceutical interventions and deep brain stimulation.
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Larrazabal A, García Cena C, Martínez C. Video-oculography eye tracking towards clinical applications: A review. Comput Biol Med 2019; 108:57-66. [DOI: 10.1016/j.compbiomed.2019.03.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/20/2019] [Accepted: 03/26/2019] [Indexed: 10/27/2022]
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Impedovo D, Pirlo G. Dynamic Handwriting Analysis for the Assessment of Neurodegenerative Diseases: A Pattern Recognition Perspective. IEEE Rev Biomed Eng 2019; 12:209-220. [DOI: 10.1109/rbme.2018.2840679] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Zhang Y, Yan A, Liu B, Wan Y, Zhao Y, Liu Y, Tan J, Song L, Gu Y, Liu Z. Oculomotor Performances Are Associated With Motor and Non-motor Symptoms in Parkinson's Disease. Front Neurol 2018; 9:960. [PMID: 30546341 PMCID: PMC6280559 DOI: 10.3389/fneur.2018.00960] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/25/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Parkinson's disease (PD) patients exhibit deficits in oculomotor behavior, yet the results are inconsistent across studies. In addition, how these results are associated with clinical symptoms is unclear, especially in China. Methods: We designed a case-control study in China including 37 PD patients and 39 controls. Clinical manifestations in PD patients were recorded. Oculomotor performance was measured by a video-based eye tracker system. Results: We found that six oculomotor parameters, including fixation stability, saccadic latency, smooth pursuit gain, saccade frequency, viewing range, and saccade frequency during free-viewing context, were significantly different in PD patients and control group. Combining application of these six parameters could improve diagnostic accuracy to over 90%. Moreover, pursuit gain was significantly associated with PD duration, UPDRS III, in PD patients. Saccade latency was significantly associated with PD duration, Berg balance score, RBD score, and Total LEDD in PD patients. Conclusions: PD patients commonly exhibit oculomotor deficits in multiple behavioral contexts, which are associated with both motor and non-motor symptoms. Oculomotor test may provide a valuable tool for the clinical assessment of PD.
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Affiliation(s)
- Yu Zhang
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aijuan Yan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bingyu Liu
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Ying Wan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuchen Zhao
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Ying Liu
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Jiangxiu Tan
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Lu Song
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Gu
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Zhenguo Liu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Clonazepam improves the symptoms of two siblings with novel variants in the SYNJ1 gene. Parkinsonism Relat Disord 2018; 62:221-225. [PMID: 30473187 DOI: 10.1016/j.parkreldis.2018.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 11/15/2018] [Accepted: 11/17/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Mutations in the SYNJ1 gene have been associated with early-onset of atypical Parkinson's disease or severe neurodegeneration with intractable seizures. Due to the rarity of the disease, there were limitations in the quality of available treatment options for SYNJ1-related diseases. METHODS Two affected siblings from a non-consanguineous family were evaluated through a set of clinical and laboratory tests. The genetic screening was performed through exome next generation sequencing. SYNJ1 mutant transcripts were purified and cloned into the vectors for Sanger sequence of single-stranded DNA. Relative level of the SYNJ1 transcript was measured by quantitative PCR. RESULTS The clinical features were characterized by a triad of symptomatic progression including diplopia, dystonia, and Parkinsonism. The dystonic symptoms were outstanding in the siblings, which preceded the Parkinsonism symptoms and became the main symptoms. Clonazepam resolved the clinical symptoms, especially the severe trunk dystonia and dystonic postures of limbs. Compound heterozygous variants (c.2579-2A > G; p.A860Gfs*5 and c.3845C > A; p.P1282L) were identified in the SYNJ1 gene co-segregating in this family. The proline residue is highly conserved across species and predicted to be damaging by several in silico tools. The splice site variant caused a skip of exon 20 and a significant reduction of the SYNJ1 transcript expression. CONCLUSIONS Our study expanded the clinical and genetic spectrums of the SYNJ1-related diseases. Although our study was a preliminary observation, it indicated that clonazepam could improve the dystonic symptoms caused by mutations in the SYNJ1 gene.
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Serrano JI, del Castillo MD, Cortés V, Mendes N, Arroyo A, Andreo J, Rocon E, del Valle M, Herreros J, Romero JP. EEG Microstates Change in Response to Increase in Dopaminergic Stimulation in Typical Parkinson's Disease Patients. Front Neurosci 2018; 12:714. [PMID: 30374285 PMCID: PMC6196245 DOI: 10.3389/fnins.2018.00714] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 09/19/2018] [Indexed: 12/31/2022] Open
Abstract
Objectives: Characterizing pharmacological response in Parkinson's Disease (PD) patients may be a challenge in early stages but gives valuable clues for diagnosis. Neurotropic drugs may modulate Electroencephalography (EEG) microstates (MS). We investigated EEG-MS default-mode network changes in response to dopaminergic stimulation in PD. Methods: Fourteen PD subjects in HY stage III or less were included, and twenty-one healthy controls. All patients were receiving dopaminergic stimulation with levodopa or dopaminergic agonists. Resting EEG activity was recorded before the first daily PD medication dose and 1 h after drug intake resting EEG activity was again recorded. Time and frequency variables for each MS were calculated. Results: Parkinson's disease subjects MS A duration decreases after levodopa intake, MS B appears more often than before levodopa intake. MS E was not present, but MS G was. There were no significant differences between control subjects and patients after medication intake. Conclusion: Clinical response to dopaminergic drugs in PD is characterized by clear changes in MS profile. Significance: This work demonstrates that there are clear EEG MS markers of PD dopaminergic stimulation state. The characterization of the disease and its response to dopaminergic medication may be of help for early therapeutic diagnosis.
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Affiliation(s)
- J. Ignacio Serrano
- Neural and Cognitive Engineering Group, Centre for Automation and Robotics, Spanish National Research Council – Technical University of Madrid, Madrid, Spain
| | - María Dolores del Castillo
- Neural and Cognitive Engineering Group, Centre for Automation and Robotics, Spanish National Research Council – Technical University of Madrid, Madrid, Spain
| | - Verónica Cortés
- Faculty of Experimental Sciences, Francisco de Vitoria University, Madrid, Spain
| | - Nuno Mendes
- Faculty of Sciences, University of Lisbon, Lisbon, Portugal
| | - Aida Arroyo
- Faculty of Experimental Sciences, Francisco de Vitoria University, Madrid, Spain
| | - Jorge Andreo
- Faculty of Experimental Sciences, Francisco de Vitoria University, Madrid, Spain
| | - Eduardo Rocon
- Neural and Cognitive Engineering Group, Centre for Automation and Robotics, Spanish National Research Council – Technical University of Madrid, Madrid, Spain
| | - María del Valle
- Department of Neurology, Fuenlabrada University Hospital, Madrid, Spain
| | - Jaime Herreros
- Department of Neurology, Infanta Leonor University Hospital, Madrid, Spain
| | - Juan Pablo Romero
- Neural and Cognitive Engineering Group, Centre for Automation and Robotics, Spanish National Research Council – Technical University of Madrid, Madrid, Spain
- Brain Damage Unit, Hospital Beata Maria Ana, Madrid, Spain
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Affiliation(s)
- Olga Waln
- Department of Neurology, Houston Methodist Neurological Institute, Houston, TX, USA
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorder Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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