Spontaneous blink rates correlate with dopamine levels in the caudate nucleus of MPTP-treated monkeys

Animal models for investigating benign essential blepharospasm

The focal dystonia benign essential blepharospasm (BEB) affects as many as 40,000 individuals in the United States. This dystonia is characterized by trigeminal hyperexcitability, photophobia, and most disabling of the symptoms, involuntary spasms of lid closure that can produce functional blindness. Like many focal dystonias, BEB appears to develop from the interaction between a predisposing condition and an environmental trigger. The primary treatment for blepharospasm is to weaken the eyelid-closing orbicularis oculi muscle to reduce lid spasms. There are several animal models of blepharospasm that recreate the spasms of lid closure in order to investigate pharmacological treatments to prevent spasms of lid closure. One animal model attempts to mimic the predisposing condition and environmental trigger that give rise to BEB. This model indicates that abnormal interactions among trigeminal blink circuits, basal ganglia, and the cerebellum are the neural basis for BEB.

Eye-blink behaviors in 71 species of primates

The present study was performed to investigate the associations between eye-blink behaviors and various other factors in primates. We video-recorded 141 individuals across 71 primate species and analyzed the blink rate, blink duration, and “isolated” blink ratio (i.e., blinks without eye or head movement) in relation to activity rhythms, habitat types, group size, and body size factors. The results showed close relationships between three types of eye-blink measures and body size factors. All of these measures increased as a function of body weight. In addition, diurnal primates showed more blinks than nocturnal species even after controlling for body size factors. The most important findings were the relationships between eye-blink behaviors and social factors, e.g., group size. Among diurnal primates, only the blink rate was significantly correlated even after controlling for body size factors. The blink rate increased as the group size increased. Enlargement of the neocortex is strongly correlated with group size in primate species and considered strong evidence for the social brain hypothesis. Our results suggest that spontaneous eye-blinks have acquired a role in social communication, similar to grooming, to adapt to complex social living during primate evolution.

Effects of subthalamic nucleus deep brain stimulation and L-DOPA on blinking in Parkinson's disease

In this study we asked whether subthalamic nucleus deep brain stimulation (STN-DBS) alone, or in combination with l-dopa, modifies voluntary, spontaneous and reflex blinking in patients with Parkinson's disease (PD). Sixteen PD patients who underwent STN-DBS were studied in four experimental conditions: without STN-DBS and without l-dopa, STN-DBS alone, l-dopa alone and STN-DBS plus l-dopa. The results were compared with those obtained in 15 healthy controls. Voluntary blinking was assessed by asking participants to blink as fast as possible; spontaneous blinking was recorded during two 60s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Blinking were recorded and analysed with the SMART motion system. STN-DBS increased the peak velocity and amplitude for both the closing and opening voluntary blink phases, but prolonged the inter-phase pause duration. l-dopa had no effects on voluntary blinking but reversed the increased inter-phase pause duration seen during STN-DBS. Spontaneous blink rate increased after either STN-DBS or l-dopa. Reflex blinking kinematics were not modified by STN-DBS or l-dopa. The STN-DBS effects on voluntary blinking kinematics and spontaneous blinking rate may occur as results of changes of cortico-basal ganglia activity. The prolonged pause duration of voluntary blinking indicates that STN-DBS has detrimental effects on the cranial region. These results also shed light on the pathophysiology of eyelids opening apraxia following STN-DBS.

Inhibition of eye blinking reveals subjective perceptions of stimulus salience

Spontaneous eye blinking serves a critical physiological function, but it also interrupts incoming visual information. This tradeoff suggests that the inhibition of eye blinks might constitute an adaptive reaction to minimize the loss of visual information, particularly information that a viewer perceives to be important. To test this hypothesis, we examined whether the timing of blink inhibition, during natural viewing, is modulated between as well as within tasks, and also whether the timing of blink inhibition varies as a function of viewer engagement and stimulus event type. While viewing video scenes, we measured the timing of blinks and blink inhibition, as well as visual scanning, in a group of typical two-year-olds, and in a group of two-year-olds known for attenuated reactivity to affective stimuli: toddlers with Autism Spectrum Disorders (ASD). Although both groups dynamically adjusted the timing of their blink inhibition at levels greater than expected by chance, they inhibited their blinking and shifted visual fixation differentially with respect to salient onscreen events. Moreover, typical toddlers inhibited their blinking earlier than toddlers with ASD, indicating active anticipation of the unfolding of those events. These findings indicate that measures of blink inhibition can serve as temporally precise markers of perceived stimulus salience and are useful quantifiers of atypical processing of social affective signals in toddlers with ASD.

Decreased spontaneous eye blink rates in chronic cannabis users: evidence for striatal cannabinoid-dopamine interactions

Chronic cannabis use has been shown to block long-term depression of GABA-glutamate synapses in the striatum, which is likely to reduce the extent to which endogenous cannabinoids modulate GABA- and glutamate-related neuronal activity. The current study aimed at investigating the effect of this process on striatal dopamine levels by studying the spontaneous eye blink rate (EBR), a clinical marker of dopamine level in the striatum. 25 adult regular cannabis users and 25 non-user controls matched for age, gender, race, and IQ were compared. Results show a significant reduction in EBR in chronic users as compared to non-users, suggesting an indirect detrimental effect of chronic cannabis use on striatal dopaminergic functioning. Additionally, EBR correlated negatively with years of cannabis exposure, monthly peak cannabis consumption, and lifetime cannabis consumption, pointing to a relationship between the degree of impairment of striatal dopaminergic transmission and cannabis consumption history.

Characterizing the spontaneous blink generator: an animal model

Although spontaneous blinking is one of the most frequent human movements, little is known about its neural basis. We developed a rat model of spontaneous blinking to identify and better characterize the spontaneous blink generator. We monitored spontaneous blinking for 55 min periods in normal conditions and after the induction of mild dry eye or dopaminergic drug challenges. The normal spontaneous blink rate was 5.3 ± 0.3 blinks/min. Dry eye or 1 mg/kg apomorphine significantly increased and 0.1 mg/kg haloperidol significantly decreased the blink rate. Additional analyses revealed a consistent temporal organization to spontaneous blinking with a median 750 s period that was independent of the spontaneous blink rate. Dry eye and dopaminergic challenges significantly modified the regularity of the normal pattern of episodes of frequent blinking interspersed with intervals having few blinks. Dry eye and apomorphine enhanced the regularity of this pattern, whereas haloperidol reduced its regularity. The simplest explanation for our data is that the spinal trigeminal complex is a critical element in the generation of spontaneous blinks, incorporating reflex blinks from dry eye and indirect basal ganglia inputs into the blink generator. Although human subjects exhibited a higher average blink rate (17.6 ± 2.4) than rats, the temporal pattern of spontaneous blinking was qualitatively similar for both species. These data demonstrate that rats are an appropriate model for investigating the neural basis of human spontaneous blinking and suggest that the spinal trigeminal complex is a major element in the spontaneous blink generator.

Spontaneous eyeblink activity

Spontaneous blinking is essential for maintaining a healthy ocular surface and clarity of vision. The spontaneous blink rate (SBR) is believed to reflect a complex interaction between peripheral influences mediated by the eye surface and the central dopaminergic activity. The SBR is thus extremely variable and dependent on a variety of psychological and medical conditions. Many different methods have been employed to measure the SBR and the upper eyelid kinematics during a blink movement. Each has its own merits and drawbacks, and the choice of a specific method should be tailored to the specific needs of the investigation. Although the sequence of muscle events that leads to a blink has been fully described, knowledge about the neural control of spontaneous blinking activity is not complete. The tear film is dynamically modified between blinks, and abnormalities of the blink rate have an obvious influence on the ocular surface.

Genetic markers of striatal dopamine predict individual differences in dysfunctional, but not functional impulsivity

Various psychiatric disorders are characterized by elevated levels of impulsivity. Although extensive evidence supports a specific role of striatal, but not frontal dopamine (DA) in human impulsivity, recent studies on genetic variability have raised some doubts on such a role. Importantly, impulsivity consists of two dissociable components that previous studies have failed to separate: functional and dysfunctional impulsivity. We compared participants with a genetic predisposition to have relatively high striatal DA levels (DAT1 9-repeat carriers, DRD2 C957T T/T homozygotes, and DRD4 7-repeat carriers) with participants with other genetic predispositions. We predicted that the first group would show high scores of dysfunctional, but not functional, self-reported impulsivity and greater difficulty in inhibiting a behavioral response to a stop-signal, a behavioral measure of impulsivity. In a sample of 130 healthy adults, we studied the relation between DAT1, DRD4, and C957T polymorphism at the DRD2 gene (polymorphisms related to striatal DA) and catechol-Omethyltransferase (COMT) Val158Met (a polymorphism related to frontal DA) on self-reported dysfunctional and functional impulsivity, assessed by the Dickman impulsivity inventory (DII), and the efficiency of inhibitory control, assessed by the stop-signal paradigm. DRD2 C957T T/T homozygotes and DRD4 7-repeat carriers indeed had significantly higher scores on self-reported dysfunctional, but not functional, impulsivity. T/T homozygotes were also less efficient in inhibiting prepotent responses. Our findings support the claim that dopaminergic variation affects dysfunctional impulsivity. This is in line with the notion that the over-supply of striatal DA might weaken inhibitory pathways, thereby enhancing the activation of, and the competition between responses.

The (b)link between creativity and dopamine: spontaneous eye blink rates predict and dissociate divergent and convergent thinking

Human creativity has been claimed to rely on the neurotransmitter dopamine, but evidence is still sparse. We studied whether individual performance (N=117) in divergent thinking (alternative uses task) and convergent thinking (remote association task) can be predicted by the individual spontaneous eye blink rate (EBR), a clinical marker of dopaminergic functioning. EBR predicted flexibility in divergent thinking and convergent thinking, but in different ways. The relationship with flexibility was independent of intelligence and followed an inverted U-shape function with medium EBR being associated with greatest flexibility. Convergent thinking was positively correlated with intelligence but negatively correlated with EBR, suggesting that higher dopamine levels impair convergent thinking. These findings support the claim that creativity and dopamine are related, but they also call for more conceptual differentiation with respect to the processes involved in creative performance.

Dopaminergic functioning and preschoolers' theory of mind

Representational theory of mind (RTM) development follows a universal developmental timetable whereby major advances in reasoning about mental representations occur between the ages of 3 and 5 years old. This progression appears to be only absent in the case of specific neurodevelopmental impairments, such as autism. Taken together, this suggests that neuromaturational factors may play a role in RTM development. Recent EEG work has shown that one neuromaturational factor pacing this universal developmental timetable is the functional maturation of medial prefrontal cortex. The neurotransmitter dopamine (DA) is thought to play a crucial role in typical frontal lobe development. Therefore, the goal of the present study was to investigate the role that DA may play in RTM development. Ninety-one 48-62-month olds were given a battery of RTM tasks along with EEG measurement. EEG recordings were analyzed for eyeblinks, a reliable indicator of DA functioning, and we calculated their average eyeblinks per minute (EBR). Regression analyses showed that EBR was associated with RTM after controlling for children's performance on a Stroop-like measure, language ability, gender, and age. These findings provide evidence that DA functioning is associated with RTM in the preschool years, and are discussed with respect to how DA might provide a mechanism that helps to account for both neurobiological and experiential factors that are known to affect the timetable of preschoolers' RTM development.

Eye-blink rate predicts individual differences in pseudoneglect

Most healthy individuals display a subtle spatial attentional bias, exhibiting relative inattention for stimuli on one side of the visual field, a phenomenon known as pseudoneglect. Prior work in animals and patients has implicated dopamine in spatial attention asymmetries. The current study therefore examined - in healthy individuals - the relationship between the attentional bias and spontaneous eye-blink rate (EBR), a putative measure of central dopaminergic function. We found that those individuals, who blinked more often under resting conditions, displayed greater preference for the right side of the visual display in a subsequent attention task. This finding may support the idea that the observed attentional bias in healthy individuals reflects asymmetries in dopaminergic circuits, and corroborates previous findings implicating dopamine in spatial attention.

Spontaneous eye blinks are entrained by finger tapping

We studied the mutual cross-talk between spontaneous eye blinks and continuous, self-paced unimanual and bimanual tapping. Both types of motor activities were analyzed with regard to their time-structure in synchronization-continuation tapping tasks which involved different task instructions, namely "standard" finger tapping (Experiment 1), "strong" tapping (Experiment 2) requiring more forceful finger movements, and "impulse-like" tapping (Experiment 3) where upward-downward finger movements had to be very fast. In a further control condition (Experiment 4), tapping was omitted altogether. The results revealed a prominent entrainment of spontaneous blink behavior by the manual tapping, with bimanual tapping being more effective than unimanual tapping, and with the "strong" and "impulse-like" tapping showing the largest effects on blink timing. Conversely, we found no significant effects of the tapping on the timing of the eye blinks across all experiments. The findings suggest a functional overlap of the motor control structures responsible for voluntary, rhythmic finger movements and eye blinking behavior.

Neuronal cell replacement in Parkinson's disease

Transplantation of foetal dopamine neurons into the striatum of Parkinson's disease patients can provide restoration of the dopamine system and alleviate motor deficits. However, cellular replacement is associated with several problems. As with pharmacological treatments, cell therapy can lead to disabling abnormal involuntary movements (dyskinesias). The exclusion of serotonin and GABA neurons, and enrichment of substantia nigra (A9) dopamine neurons, may circumvent this problem. Furthermore, although grafted foetal dopamine neurons can survive in Parkinson's patients for more than a decade, the occurrence of Lewy bodies within such transplanted cells and reduced dopamine transporter and tyrosine hydroxylase expression levels indicate that grafted cells are associated with pathology. It will be important to understand if such abnormalities are host- or graft induced and to develop methods to ensure survival of functional dopamine neurons. Careful preparation of cellular suspensions to minimize graft-induced inflammatory responses might influence the longevity of transplanted cells. Finally, a number of practical and ethical issues are associated with the use of foetal tissue sources. Thus, future cell therapy is aiming towards the use of embryonic stem cell or induced pluripotent stem cell derived dopamine neurons.

Dopamine and inhibitory action control: evidence from spontaneous eye blink rates

The inhibitory control of actions has been claimed to rely on dopaminergic pathways. Given that this hypothesis is mainly based on patient and drug studies, some authors have questioned its validity and suggested that beneficial effects of dopaminergic stimulants on response inhibition may be limited to cases of suboptimal inhibitory functioning. We present evidence that, in carefully selected healthy adults, spontaneous eyeblink rate, a marker of central dopaminergic functioning, reliably predicts the efficiency in inhibiting unwanted action tendencies in a stop-signal task. These findings support the assumption of a modulatory role for dopamine in inhibitory action control.

Recreational cocaine polydrug use impairs cognitive flexibility but not working memory

RATIONALE

Chronic use of cocaine is associated with dysfunctions in frontal brain regions and dopamine D2 receptors, with poorer mental flexibility and a reduced ability to inhibit manual and attentional responses. Little is known, however, about cognitive impairments in the upcoming type of recreational cocaine polydrug user (1-4 g monthly consumption).

OBJECTIVE

We studied whether recreational cocaine polydrug users, who do not meet the criteria for abuse or dependence, showed impairments in working memory (WM) and cognitive flexibility.

METHODS

Controls and recreational cocaine polydrug users (who abstained from cocaine and other substances more than 1 week) were matched by sex, age, alcohol consumption, and IQ (Raven's Standard Progressive Matrices). Groups were tested by using two cognitive tasks measuring cognitive flexibility and three tasks investigating the maintenance and monitoring of information in WM.

RESULTS

Recreational cocaine polydrug users performed significantly worse than controls on tasks tapping cognitive flexibility, but show comparable performance in the active maintenance and monitoring of information in WM.

CONCLUSIONS

The findings suggest that recreational use of cocaine selectively impairs cognitive flexibility but not the maintenance of information in WM. The inability to adjust behavior rapidly and flexibly may have repercussions for daily life activities.

Reduced spontaneous eye blink rates in recreational cocaine users: evidence for dopaminergic hypoactivity

Chronic use of cocaine is associated with a reduced density of dopaminergic D2 receptors in the striatum, with negative consequences for cognitive control processes. Increasing evidence suggests that cognitive control is also affected in recreational cocaine consumers. This study aimed at linking these observations to dopaminergic malfunction by studying the spontaneous eyeblink rate (EBR), a marker of striatal dopaminergic functioning, in adult recreational users and a cocaine-free sample that was matched on age, race, gender, and personality traits. Correlation analyses show that EBR is significantly reduced in recreational users compared to cocaine-free controls, suggesting that cocaine use induces hypoactivity in the subcortical dopamine system.

Spontaneous eyeblink rate predicts the strength of visuomotor binding

The primate cortex represents the external world in a distributed way, which requires for a mechanism that integrates the features of a processed event. Animal and patients studies suggest that feature binding in the visual cortex is under muscarinic-cholinergic control, whereas visuomotor integration is driven by the dopaminergic system. Consistent with this picture, we present evidence that the binding of visual and action features is modulated by spontaneous eyeblink rate (EBR), which is a functional marker of central dopaminergic function. Remarkably, the impact of EBR was restricted to the task-relevant visuomotor binding, suggesting that dopamine increased the maintenance of task-relevant information.

Dopamine and cognitive control: The influence of spontaneous eyeblink rate, DRD4 exon III polymorphism and gender on flexibility in set-shifting

Converging evidence suggests a modulatory role of dopamine in cognitive control. We investigated the influence of two correlates of dopaminergic activity, the spontaneous eyeblink rate and the DRD4 exon III polymorphism, and the potential impact of gender on flexibility in an attentional set-shifting paradigm. The objective of the study was to confirm previous findings of an association between high eyeblink rates and increased cognitive flexibility. These findings were replicated in 87 healthy volunteers this time using a continuous variable for eyeblink rates instead of a dichotomized variable. The interaction between eyeblink rate and DRD4 found in the previous study was lower and failed significance. Analysis of the collapsed sample of n=150 revealed a main effect of gender and an interaction of gender and eyeblink rate on cognitive control. The complete prediction model explained 26% of the total variance. These data suggest that (1) the eyeblink rate is a reliable predictor of dopamine-mediated flexibility of cognitive control and (2) it is useful to include gender as predictor in future studies of dopaminergic modulation of cognitive control.

Nonhuman Primate Models of Parkinson's Disease

Nonhuman primate (NHP) models of Parkinson's disease (PD) play an essential role in the understanding of PD pathophysiology and the assessment of PD therapies. NHP research enabled the identification of environmental risk factors for the development of PD. Electrophysiological studies in NHP models of PD identified the neural circuit responsible for PD motor symptoms, and this knowledge led to the development of subthalamic surgical ablation and deep brain stimulation. Similar to human PD patients, parkinsonian monkeys are responsive to dopamine replacement therapies and present complications associated with their long-term use, a similarity that facilitated the assessment of new symptomatic treatments, such as dopaminergic agonists. New generations of compounds and novel therapies that use directed intracerebral delivery of drugs, cells, and viral vectors benefit from preclinical evaluation in NHP models of PD. There are several NHP models of PD, each with characteristics that make it suitable for the study of different aspects of the disease or potential new therapies. Investigators who use the models and peer scientists who evaluate their use need information about the strengths and limitations of the different PD models and their methods of evaluation. This article provides a critical review of available PD monkey models, their utilization, and how they compare to emerging views of PD as a multietiologic, multisystemic disease. The various models are particularly useful for representing different aspects of PD at selected time points. This conceptualization provides clues for the development of new NHP models and facilitates the clinical translation of findings. As ever, successful application of any model depends on matching the model to the scientific question to be answered. Adequate experimental designs, with multiple outcome measures of clinical relevance and an appropriate number of animals, are essential to minimize the limitations of models and increase their predictive clinical validity.

Spontaneous Eye Blink Rates vary according to individual differences in generalized control perception

This study tested the hypothesis that individual differences in generalized control perception for 43 undergraduate adults may be reflected in Spontaneous Eye Blink Rates during conversation in an interview. Control perception was assessed by means of Rotter's internal-external Locus of Control questionnaires, while Spontaneous Eye Blink Rates were computed from filmed videos of interviews consisting of a series of questions which could presumably have triggered different mental states. Pearson correlations and linear regression analyses indicated that the individual differences in Spontaneous Eye Blink Rates did not differ significantly across different questions, but that Spontaneous Eye Blink Rates measured over the entire interview correlated positively and significantly with an internal Locus of Control (r = .26). This could be interpreted as modest but corroborative evidence that a personality trait reflecting control perception may have a biological component. The possible roles of dopamine neurotransmission and frontal cortex involvement in higher cognition and Locus of Control are discussed.

On feeling in control: A biological theory for individual differences in control perception

This review aims to create a cross-disciplinary framework for understanding the perception of control. Although, the personality trait locus of control, the most common measure of control perception, has traditionally been regarded as a product of social learning, it may have biological antecedents as well. It is suggested that control perception follows from the brain's capacity for self regulation, leading to flexible and goal directed behaviours. To this account, a model is presented which spans several levels of analyses. On a behavioural level, control perception may be a corollary of emotion regulation, executive functions, and social cognition. On a neural level, these self-regulatory functions are substantiated in part by the dorsolateral and ventral prefrontal cortex and the anterior cingulate cortex. In addition, a possible role of subcortical-cortical dopamine pathways underlying control perception is discussed.

Under the curve: Critical issues for elucidating D1 receptor function in working memory

It has been postulated that spatial working memory operates optimally within a limited range of dopamine transmission and D1 dopamine receptor signaling in prefrontal cortex. Insufficiency in prefrontal dopamine, as in aging, and excessive transmission, as in acute stress, lead to impairments in working memory that can be ameliorated by D1 receptor agonist and antagonist treatment, respectively. Iontophoretic investigations of dopamine's influence on the cellular mechanisms of working memory have revealed that moderate D1 blockade can enhance memory fields in primate prefrontal pyramidal neurons while strong blockade abolishes them. The combined behavioral and physiological evidence indicates that there is a normal range of dopamine function in prefrontal cortex that can be described as an "inverted-U" relationship between dopamine transmission and the integrity of working memory. Both in vivo and in vitro studies have demonstrated a role for dopamine in promoting the excitability of prefrontal pyramidal cells and facilitating their N-methyl-d-aspartate inputs, while simultaneously restraining recurrent excitation and facilitating feedforward inhibition. This evidence indicates that there is a fine balance between the synergistic mechanisms of D1 modulation in working memory. Given the critical role of prefrontal function for cognition, it is not surprising that this balancing act is perturbed by both subtle genetic influences and environmental events. Further, there is evidence for an imbalance in these dopaminergic mechanisms in multiple neuropsychiatric disorders, particularly schizophrenia, and in related nonhuman primate models. Elucidating the orchestration of dopamine signaling in key nodes within prefrontal microcircuitry is therefore pivotal for understanding the influence of dopamine transmission on the dynamics of working memory. Here, we explore the hypothesis that the window of optimal dopamine signaling changes on a behavioral time-scale, dependent upon current cognitive demands and local neuronal activity as well as long-term alterations in signaling pathways and gene expression. If we look under the bell-shaped curve of prefrontal dopamine function, it is the relationship between neuromodulation and cognitive function that promises to bridge our knowledge between molecule and mind.

Animal models of focal dystonia

Animal models indicate that the abnormal movements of focal dystonia result from disordered sensorimotor integration. Sensorimotor integration involves a comparison of sensory information resulting from a movement with the sensory information expected from the movement. Unanticipated sensory signals identified by sensorimotor processing serve as signals to modify the ongoing movement or the planning for subsequent movements. Normally, this process is an effective mechanism to modify neural commands for ongoing movement or for movement planning. Animal models of the focal dystonias spasmodic torticollis, writer's cramp, and benign essential blepharospasm reveal different dysfunctions of sensorimotor integration through which dystonia can arise. Animal models of spasmodic torticollis demonstrate that modifications in a variety of regions are capable of creating abnormal head postures. These data indicate that disruption of neural signals in one structure may mutate the activity pattern of other elements of the neural circuits for movement. The animal model of writer's cramp demonstrates the importance of abnormal sensory processing in generating dystonic movements. Animal models of blepharospasm illustrate how disrupting motor adaptation can produce dystonia. Together, these models show mechanisms by which disruptions in sensorimotor integration can create dystonic movements.

Blinking and schizotypal thinking

Spontaneous eye blink rate (SBR) is thought to be a biological marker for cerebral dopamine (DA) activity. Accordingly, positive psychotic symptoms have been found to be associated with an increased SBR and negative psychotic symptoms with a decreased SBR. However, modulations of the DA system in patient populations also result from prior neuroleptic treatment. Here, we tested the possible relationship between SBR and positive and negative schizotypal thought. To test the direct influence of DA on SBR in general and as a function of schizotypy, half of a sample of 40 healthy men received levodopa and the other half placebo in a double-blind procedure. SBR did not differ between substance groups suggesting that a pharmacologically induced DA increase in healthy individuals does not generally increase SBR. However, in the levodopa group, increasing SBR correlated with increasing negative schizotypy scores, while no relationship was found between SBR and (1) negative schizotypy in the placebo group, or (2) positive schizotypy in either substance group. We conjecture that a pre-existing hypodopaminergic state in high negative schizotypy scorers, made these individuals susceptible to an increased DA concentration, as it has been observed in Parkinson's disease. Furthermore, the absence of any relationship in the placebo group might suggest that variations in DA concentration as a function of schizotypy are too subtle to influence SBR. Finally, the lack of any association of SBR with positive schizotypy might indicate that SBR and positive schizotypy are mediated by functionally distinct neural circuits.

Tear-film lipid layer morphology and corneal sensation in the development of blinking in neonates and infants

The aim of the study was to evaluate the role of lipid layer thickness and corneal sensation in the development of blinking in neonates. The study group comprised sixty-four neonates and infants (mean age 27.5 +/- 15 (sd) weeks, range 3.4-52) whose mothers were attending a general practice healthy baby clinic. Spontaneous eye-blink activity was determined from digital videographic recordings; tear film lipid layer morphology wasexamined using interference patterns produced by the Keeler Tearscopetrade mark Plus over a five-point grading scale (higher grades are associated with thick and stable lipid films); corneal sensation threshold was assessed with the Non-Contact Corneal Aesthesiometer (NCCA), using the eye-blink response as an objective indication that the cooling stimulus had been felt; palpebral aperture dimensions were measured using calibrated digital still images of the eye in the primary position. The overall mean spontaneous blink-rate was found to be 3.6 (+/- 0.3) blinks min(-1), and the mean interblink time was 21.6 (+/- 2.8) s. The lowest blink-rates were observed in the 0-17-week age group (average 2 blinks min(-1)). The blink-rate showed a highly significant correlation with age (r = 0.46, P < 0.01). The overall mean lipid layer grading was 3.6 (+/- 0.2 SE) arbitrary units. Higher grades were found in the newborn and the mean grading score reduced with age (P < 0.01). The mean sensation threshold to blink (TTB) was 0.69 (0.04 SE) mbar, which did not differ from a control group of older subjects (P > 0.05). There was a rapid increase in palpebral aperture length and width from birth to 1 year old, with surface area increasing by 50% over the same period. We concluded that the low rate of spontaneous eye blink activity in neonates is associated with a thick stable lipid layer that may be a function of a small palpebral aperture. Furthermore, neonates appear to have the capacity to detect ocular surface cooling, which is a major trigger for spontaneous blinking.

Dopamine D4 receptor exon III genotype influence on the auditory evoked novelty P3

The functional implications of the dopamine D4 receptor gene (DRD4) exon III polymorphism and its role in the modulation of temperament and in the pathophysiology of psychiatric disorders are still a matter of debate. Based on evidence from animal studies, we hypothesised that this polymorphism is involved in the modulation of the cortical response to novelty as reflected by the auditory evoked novelty P3 event-related potential. In a sample of 46 healthy volunteers, we observed an interactive effect of DRD4 exon III genotype and the eye-blink rate, a measure of central dopaminergic activity, on the novelty P3. These findings suggest that the DRD4 exon III polymorphism influences the processing of novelty and that this influence depends on tonic dopaminergic activity.

The spontaneous eye-blink as sleepiness indicator in patients with obstructive sleep apnoea syndrome-a pilot study

BACKGROUND AND PURPOSE

To evaluate the spontaneous eye-blink as drowsiness/sleepiness indicator in patients with obstructive sleep apnoea (OSA) syndrome.

PATIENTS AND METHODS

Using a contact-free sensor for the recording of spontaneous eye-blinks, we investigated the diagnostic value of spontaneous blink parameters in 21 OSA patients. Before the study, all patients underwent a night of polysomnography. Eye-blinks were studied the following morning before therapy, and again after the first therapy night with nasal continuous positive airway pressure (nCPAP), to investigate whether blink parameters reflected changes of alertness pre- and post-nCPAP treatment. General daytime sleepiness was assessed using the Epworth Sleepiness Scale (ESS). The current subjective state was determined by means of standardised questionnaires directly before recording the eye-blinks. Studies were conducted in two sleep laboratories in hospitals.

RESULTS

In OSA patients with excessive daytime sleepiness (EDS; ESS >10, respiratory disturbance index [RDI]=42.4) several parameters proved informative for sleepiness diagnostics. Reduction of blink duration and reopening time as well as increase in blink frequency were significant; furthermore, proportion of long-closure duration blinks indicated reduced sleepiness. OSA patients without EDS (ESS < or =10, RDI=33.5) did not reveal systematic changes of the blink parameters registered after one night of nCPAP intervention.

CONCLUSIONS

Specific parameters of the spontaneous eye-blink may be applied as a sleepiness index for diagnostics in OSA patients. Further studies are needed to prove the diagnostic value of blink parameters and their advantages in comparison to subjective measures commonly used in clinical studies.

Why your "head is in the clouds" during thinking: the relationship between cognition and upper space

Higher-order cognition in humans has not generally been viewed as closely entwined with the brain mechanisms mediating more basic perceptual-motor interactions in 3-D space. However, recent findings suggest that perceptual and oculomotor mechanisms that are biased toward the upper field (which disproportionately represents radially distant space) are activated during complex mental operations, ranging from semantic processing to mental arithmetic and memory search. The particularly close affinity with upward conjugate eye deviations--further confirmed in a study of 24 schoolchildren who responded to various mental questions and demands--suggests that active, abstract thinking in humans may have expropriated the focal-extrapersonal brain systems involved in saccadic exploration of the distant environment in other primates.

Dopamine and Cognitive Control: The Influence of Spontaneous Eyeblink Rate and Dopamine Gene Polymorphisms on Perseveration and Distractibility

One fundamental problem of intelligent organisms pursuing goal-directed behavior is how to dynamically regulate the balance between maintenance and flexibility. The authors show that central dopaminergic activity, as indicated by spontaneous eyeblink rate and dopamine gene polymorphisms, plays an important role in the modulation of this balance. Seventy-two young adults were examined. Participants with high blink rates showed increased cognitive flexibility but decreased cognitive stability compared with participants with low blink rates. This pattern of results was even more pronounced for carriers of the DRD4 exon III 4/7 genotype, even though no main effects were found for DRD4 and COMT polymorphisms. Results converge with neuropsychological models that suggest a modulatory role of prefrontal dopaminergic activity for processes of cognitive control.

Evaluation of animal models of Parkinson's disease for neuroprotective strategies

Parkinson's disease (PD) is a common neurodegenerative disorder characterized by the progressive loss of dopaminergic nigral neurons and striatal dopamine. Despite the advances of modern therapy to treat the symptoms of PD, most of the patients will eventually experience debilitating disability. The need for neuroprotective strategies that will slow or stop the progression of the disease is clear. The progress in the understanding of the cause and pathogenesis of PD is providing clues for the development of disease-modifying strategies. In that regard, animal models of PD and non-human primate models in particular, are essential for the preclinical evaluation and testing of candidate therapies. However, the diversity of models and different outcome measures used by investigators make it challenging to compare results between neuroprotective agents. In this review we will discuss methods for the selection, development and assessment of animal models of PD, the role of non-human primates and the concept of "multiple models/multiple endpoints" to predict the success in the clinic of neuroprotective strategies.

Hyperexcitable Blink Reflex Preceding the Diagnosis of Neuroblastoma

The diagnosis of neuroblastoma is sometimes preceded by development of a paraneoplastic syndrome, most commonly opsoclonus-myoclonus-ataxia (OMA). The authors describe a patient who developed a hyperexcitable blink reflex, without symptoms of OMA, prior to his oncologic diagnosis. The authors believe this may represent a distinct paraneoplastic process caused by increased dopaminergic stimulation of the blink reflex and suggest that children manifesting an unexplained hyperexcitable blink reflex should be screened for occult neuroblastoma.

Spontaneous eye blinking in human infants: a review

Spontaneous eye blinking has been studied in clinical and neuropharmacological research in adult humans and nonhuman primates as a putative index of central dopamine system activity. One purpose of this review is to provide a general overview of the research on spontaneous eye blinking with an emphasis on the relationship between spontaneous eye blinking and central dopamine systems. We suggest that the body of research from human (adults, children, and infants) and nonhuman primates supports the continued empirical investigation of spontaneous eye blinking in human infants. A second purpose is to present approaches for empirical work to further investigate the development, correlates, and mechanisms of spontaneous eye blinking in human infants. The results of further investigation may reveal new insights into relationships between the central nervous system activity and behavior in early human development.

Positron emission tomography scanning in essential blepharospasm

PURPOSE

To localize in the brain using positron emission tomography neuroimaging with (18)fluorodeoxyglucose [PET ((18)FDG)] differences in glucose metabolism between patients with essential blepharospasm (EB) and controls.

DESIGN

Prospective case-control study.

METHODS

Positron emission tomography neuroimaging with (18)fluorodeoxyglucose was performed in 11 patients with EB and 11 controls matched for age and gender. Global analysis of images was used to localize differences in glucose metabolism between groups.

RESULTS

Multiple cortical and subcortical abnormalities were observed in EB patients in comparison with controls. Cortical areas with the largest and most significant clusters of increased glucose uptake were the inferior frontal gyri, right posterior cingulate gyrus, left middle occipital gyrus, fusiform gyrus of the right temporal lobe, and left anterior cingulate gyrus. Cortical areas with the largest and most significant clusters of decreased glucose uptake were the inferior frontal gyri, ventral to the area of increased glucose metabolism. Subcortical abnormalities, consisting of increased glucose uptake, involved the right caudate and consisting of decreased glucose uptake, involved the left inferior cerebellar hemisphere and thalamus.

CONCLUSIONS

Global analysis of positron emission tomography neuroimaging with (18)fluorodeoxyglucose neuroimaging in EB patients in comparison with controls demonstrates a pattern of abnormalities involving several cortical and subcortical areas that control blinking, including the inferior frontal lobe, caudate, thalamus, and cerebellum.

Pharmacodynamics of ziprasidone in children and adolescents: impact on dopamine transmission

OBJECTIVE

Ziprasidone is an atypical antipsychotic with a high ratio of 5-HT(2A) to D(2) receptor antagonism. It is also an agonist at 5-HT(1A), which has been shown in rats to increase dopamine in prefrontal cortex. The objective of this study was to probe the dopamine agonist and antagonist pharmacodynamic properties of ziprasidone in youth.

METHOD

A single-dose, open-label study was conducted in 24 youths, 7 to 16 years of age, with Tourette syndrome or chronic tic disorder. Ziprasidone oral suspension (40 mg/mL) was given to achieve 0.2 to 0.3 mg/kg. Patients were subsequently assessed for serum ziprasidone, serum prolactin, and eye blink rates.

RESULTS

Serum ziprasidone peaked 4 hours postdose. Prolactin (baseline mean 7.2 ng/mL, 95% confidence interval [CI] 5.2-9.2) peaked at 4 hours (mean 27.5 ng/mL, 95% CI 22.6-32.3). Eyeblink rates per 5 minutes (baseline mean 60, 95% CI 42-79) peaked at 6 hours (mean 74, 95% CI 52-96).

CONCLUSIONS

Ziprasidone acutely blocks dopamine transmission, as indicated by increased prolactin levels, and, in a delayed fashion, appears to stimulate dopaminergic transmission, as indicated by the increase in spontaneous eye blinks. The mechanism of dopaminergic stimulation is presumed to be indirect, via 5-HT(1A) agonism.

Neurophysiological study of facial chorea in patients with Huntington's disease

OBJECTIVE

Choreic movements of patients with Huntington's disease (HD) may result from an abnormal control of sensory inputs. In order to further examine the pathophysiology of facial choreic movements (FCM), we carried out a neurophysiological study, including prepulse inhibition of the blink reflex (BR), in HD patients with and without FCM.

METHODS

The study was conducted in 20 genetically proven HD patients with Unified Huntington Disease Rating Scale (UHDRS) scores of FCM ranging between 0 and 3, and in 12 age-matched healthy volunteers who served as control subjects. We counted the number of spontaneous blinks, recorded the electromyographic activity underlying FCM, and analyzed latency, amplitude, and duration of the BR responses to electrical and auditory stimuli. Prepulse inhibition was studied by comparing the responses to test trials with those to control trials. In control trials BRs were obtained to either a single supraorbital nerve electrical stimulus (EBR) or to a 90dB auditory stimulus (ABR). In test trials, the same stimuli were preceded by the prepulse, which was either a weak acoustic tone or a weak electrical stimulus to the third finger, delivered 30-150 ms before.

RESULTS

Spontaneous blinking rate was abnormally low in 3 patients, and abnormally high in 9 patients. Mean duration of the BR was longer in patients than in control subjects. In prepulse trials, the percentage inhibition of the BR was abnormally reduced in 15 patients to at least one sensory modality, and significantly correlated with the score of FCM.

CONCLUSIONS

Our results suggest that the severity of FCM in patients with HD might be an expression of a disturbance in motor control partly related to an abnormal processing of sensory inputs. Such abnormality involves circuits used in prepulse inhibition of the BR.

Effects of catecholamine depletion on D2 receptor binding, mood, and attentiveness in humans: a replication study

The effect of catecholamine depletion, achieved by per-oral administration of 5250 mg alpha-methyl-para-tyrosine (AMPT) given in the 29 h prior to [11C]raclopride positron emission tomography (PET) was studied on measures of dopamine (DA) release, mood, and attention. Neostriatal DA levels in vivo were estimated by comparing the neostriatal DA D(2) receptor binding potential (D(2)RBP) before and after catecholamine depletion using PET and the radiotracer [11C]raclopride. Six healthy subjects completed the protocol. The AMPT treatment increased D(2)RBP significantly by 13.3+/-5.9% (average+/-standard deviation) and decreased plasma levels of the DA metabolite homovanillic acid (HVA) by 62+/-17%, and levels of the norepinephrine (NE) metabolite 3-methoxy-4-hydroxyphenethyleneglycol (MHPG) by 66+/-5%. Catecholamine depletion resulted in decreased happiness, euphoria, energy, talkativeness, vigor, and attentiveness, and in increased sleepiness, fatigue, sedation, and eye blink rate (EBR). These changes were not correlated with the D(2)RBP increments. The results of this study are overall consistent with previous findings by our group using the same methodology in a different cohort of six healthy subjects.

Prestimulus modification of the startle reflex: relationship to personality and physiological markers of dopamine function

Prepulse inhibition (PPI), a measure of sensorimotor gating, is regulated by dopamine (DA) in rodents. We examined the relationship of PPI in humans to putative markers of brain DA function: (1) novelty seeking (NS; Cloninger's Tridimensional Personality Questionnaire (TPQ)), which is associated with specific DA receptor subtypes, and is reduced in Parkinson's Disease; (2) blink rate, which is increased in primates by DA agonists, and is reduced in Parkinson's Disease. PPI, TPQ and blink rate were measured in 79 normal adult males. A significant negative correlation was observed between resting blink rate and mean PPI, but not between NS and PPI. Blink rate correlated positively with resting EMG level, but this did not account for the relationship between blink rate and PPI. In normal male humans, PPI is inversely related to a physiological marker of resting DA tone (blink rate), but not to a putatively DA-linked personality trait (high NS).

The effects of exercise on children with attention-deficit hyperactivity disorder

PURPOSE

The effects of exercise on children with attention-deficit hyperactivity disorder (ADHD) were evaluated by studying the rate of spontaneous eye blinks, the acoustic startle eye blink response (ASER), and motor impersistence among 8- to 12-yr-old children (10 boys and 8 girls) meeting DSM-III-R criteria for ADHD.

METHODS

Children ceased methylphenidate medication 24 h before and during each of three daily conditions separated by 24-48 h. After a maximal treadmill walking test to determine cardiorespiratory fitness (VO(2peak)), each child was randomly assigned to counterbalanced conditions of treadmill walking at an intensity of 65-75% VO(2peak) or quiet rest. Responses were compared with a group of control participants (11 boys and 14 girls) equated with the ADHD group on several key variables.

RESULTS

Boys with ADHD had increased spontaneous blink rate, decreased ASER latency, and decreased motor impersistence after maximal exercise. Girls with ADHD had increased ASER amplitude and decreased ASER latency after submaximal exercise.

CONCLUSIONS

The findings suggest an interaction between sex and exercise intensity that is not explained by physical fitness, activity history, or selected personality attributes. The clinical meaning of the eye blink results is not clear, as improvements in motor impersistence occurred only for boys after maximal exercise. Nonetheless, these preliminary findings are sufficiently positive to encourage additional study to determine whether a session of vigorous exercise has efficacy as a dopaminergic adjuvant in the management of behavioral features of ADHD.