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Barone V, van Dijk JP, Debeij-van Hall MH, van Putten MJ. A Potential Multimodal Test for Clinical Assessment of Visual Attention in Neurological Disorders. Clin EEG Neurosci 2023; 54:512-521. [PMID: 36189613 PMCID: PMC10411032 DOI: 10.1177/15500594221129962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/05/2022] [Accepted: 09/14/2022] [Indexed: 11/17/2022]
Abstract
Attention is an important aspect of human brain function and often affected in neurological disorders. Objective assessment of attention may assist in patient care, both for diagnostics and prognostication. We present a compact test using a combination of a choice reaction time task, eye-tracking and EEG for assessment of visual attention in the clinic. The system quantifies reaction time, parameters of eye movements (i.e. saccade metrics and fixations) and event related potentials (ERPs) in a single and fast (15 min) experimental design. We present pilot data from controls, patients with mild traumatic brain injury and epilepsy, to illustrate its potential use in assessing attention in neurological patients. Reaction times and eye metrics such as fixation duration, saccade duration and latency show significant differences (p < .05) between neurological patients and controls. Late ERP components (200-800 ms) can be detected in the central line channels for all subjects, but no significant group differences could be found in the peak latencies and mean amplitudes. Our system has potential to assess key features of visual attention in the clinic. Pilot data show significant differences in reaction times and eye metrics between controls and patients, illustrating its promising use for diagnostics and prognostication.
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Affiliation(s)
- Valentina Barone
- Clinical Neurophysiology (CNPH), TechMed Centre, University of Twente, Enschede, Netherlands
- Twente Medical System International B.V. (TMSi), Oldenzaal, Netherlands
| | - Johannes P. van Dijk
- Academic Center for Epileptology Kempenhaeghe, Heeze, Netherlands
- Eindhoven University of Technology, Eindhoven, Netherlands
| | | | - Michel J.A.M. van Putten
- Clinical Neurophysiology (CNPH), TechMed Centre, University of Twente, Enschede, Netherlands
- Department of Clinical Neurophysiology, Medisch Spectrum Twente, Enschede, Netherlands
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2
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Eraslan Boz H, Koçoğlu K, Akkoyun M, Tüfekci IY, Ekin M, Özçelik P, Akdal G. The influence of stimulus eccentricity on prosaccade outcomes in patients with Alzheimer's Disease dementia at an early stage and amnestic mild cognitive impairment. J Clin Exp Neuropsychol 2022; 44:713-729. [PMID: 36856708 DOI: 10.1080/13803395.2023.2183937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Prosaccade task is a widely used objective method to evaluate reflexive saccade and visual attention. The study aimed to investigate prosaccade stimulus eccentricity, compare prosaccade parameters in patients with Alzheimer's disease dementia (AD), amnestic mild cognitive impairment (aMCI), and neurotypical adults (NA), and examine the relationship between prosaccade and neuropsychological tests. METHODS Thirty patients with AD, 34 with aMCI, and 32 NA were included in the study. Eye movements were recorded with the EyeLink 1000 Plus in the prosaccade task, and this study evaluated cognitive function with comprehensive neuropsychological tests assessing attention, memory, executive function, visuospatial function, and language domains. RESULTS The correct saccade rates of patients with AD were significantly lower than NA in the 5° and 10° stimulus eccentricities. Patients with AD had significantly longer latencies in the 10° stimulus eccentricity than those with aMCI and NA. Patients with aMCI did not differ in prosaccade performance compared to NA. Prosaccade parameters were significantly correlated with all cognitive domains. As the amplitude of the stimuli increased, the rate of correct saccades decreased, while the express saccade rate, latency, amplitude, and peak velocity increased. CONCLUSION Our findings that correct saccade rates and latency may be distinguishing parameters of early AD are promising. This study also found that stimulus eccentricity affects prosaccade measures in AD, MCI, and NA.
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Affiliation(s)
- Hatice Eraslan Boz
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye.,Department of Neurology, Unit of Neuropsychology, Dokuz Eylül University, Izmir, Türkiye
| | - Koray Koçoğlu
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye
| | - Müge Akkoyun
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye
| | - Işıl Yağmur Tüfekci
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye
| | - Merve Ekin
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye
| | - Pınar Özçelik
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye
| | - Gülden Akdal
- Department of Neurosciences, Dokuz Eylül University, Institute of Health Sciences, Izmir, Türkiye.,Department of Neurology, Dokuz Eylül University, Izmir, Türkiye
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Comparison of Saccadic Eye Movements Among the High-tension Glaucoma, Primary Angle-closure Glaucoma, and Normal-tension Glaucoma. J Glaucoma 2021; 30:e76-e82. [PMID: 33394842 DOI: 10.1097/ijg.0000000000001757] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 11/28/2020] [Indexed: 11/25/2022]
Abstract
PRCIS Saccadic eye movements were compared between high-tension glaucoma (HTG), normal-tension glaucoma (NTG), and primary angle-closure glaucoma (PACG). Saccades were differently affected between the subtypes of primary glaucoma. AIM The aim of the study was to compare saccadic eye movements in eyes with HTG, PACG, and NTG. METHODS Saccadic eye movements were recorded using the eye tracker Eyelink-1000 in 52 participants: 15 HTG, 14 PACG, 8 NTG, and 15 normal controls. All participants underwent a complete ophthalmic and visual field examination. Prosaccades were measured using the gap paradigm. Prosaccades were measured at 3 target eccentricities (5-, 7-, and 10-degree eccentricity). All prosaccade targets were projected outside the area of visual field defect. Saccade latency, average and peak velocity, and amplitude difference of the saccades were compared between glaucoma subtypes. RESULTS The mean±SD age was lesser in controls compared with glaucoma (P=0.02). The mean age in all the glaucoma subtypes was comparable (P=0.92). The average mean deviation in PACG (-16.66±6.69 dB) was worse (P=0.01) than in HTG (-11.56±6.08 dB) and NTG (-9.55±3.96 dB). The latencies were delayed, average and peak velocities were reduced, and saccades were hypometric in glaucoma compared with controls (P<0.01). Between subtypes, the differences in latency (P<0.01), peak velocity (P=0.02), and amplitude (P=0.02) were significant. Saccadic eye movements were significantly different in NTG compared with other glaucoma subtypes (post hoc analysis; latency (HTG vs. NTG; P<0.01, HTG vs. PACG; P=0.01), peak velocity (HTG vs. NTG; P=0.02) and amplitude difference (HTG vs. NTG; P=0.02). CONCLUSIONS Saccadic eye movement parameters were differently affected among the glaucoma subtypes. Saccadic parameters were more affected in NTG.
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Opwonya J, Doan DNT, Kim SG, Kim JI, Ku B, Kim S, Park S, Kim JU. Saccadic Eye Movement in Mild Cognitive Impairment and Alzheimer's Disease: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 32:193-227. [PMID: 33959887 PMCID: PMC9090874 DOI: 10.1007/s11065-021-09495-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
Alzheimer’s disease (AD) is the leading cause of dementia, and mild cognitive impairment (MCI) is considered the transitional state to AD dementia (ADD) and other types of dementia, whose symptoms are accompanied by altered eye movement. In this work, we reviewed the existing literature and conducted a meta-analysis to extract relevant eye movement parameters that are significantly altered owing to ADD and MCI. We conducted a systematic review of 35 eligible original publications in saccade paradigms and a meta-analysis of 27 articles with specified task conditions, which used mainly gap and overlap conditions in both prosaccade and antisaccade paradigms. The meta-analysis revealed that prosaccade and antisaccade latencies and frequency of antisaccade errors showed significant alterations for both MCI and ADD. First, both prosaccade and antisaccade paradigms differentiated patients with ADD and MCI from controls, however, antisaccade paradigms was more effective than prosaccade paradigms in distinguishing patients from controls. Second, during prosaccade in the gap and overlap conditions, patients with ADD had significantly longer latencies than patients with MCI, and the trend was similar during antisaccade in the gap condition as patients with ADD had significantly more errors than patients with MCI. The anti-effect magnitude was similar between controls and patients, and the magnitude of the latency of the gap effect varied among healthy controls and MCI and ADD subjects, but the effect size of the latency remained large in both patients. These findings suggest that, using gap effect, anti-effect, and specific choices of saccade paradigms and conditions, distinctions could be made between MCI and ADD patients as well as between patients and controls.
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Affiliation(s)
- Julius Opwonya
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | - Dieu Ni Thi Doan
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | - Seul Gee Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Joong Il Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Boncho Ku
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Soochan Kim
- Department of Electrical and Electronic Engineering, Hankyong National University, Anseong, Republic of Korea
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea.
| | - Jaeuk U Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea.
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Beltrán J, García-Vázquez MS, Benois-Pineau J, Gutierrez-Robledo LM, Dartigues JF. Computational Techniques for Eye Movements Analysis towards Supporting Early Diagnosis of Alzheimer's Disease: A Review. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2018; 2018:2676409. [PMID: 29887912 PMCID: PMC5985110 DOI: 10.1155/2018/2676409] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 04/03/2018] [Indexed: 12/21/2022]
Abstract
An opportune early diagnosis of Alzheimer's disease (AD) would help to overcome symptoms and improve the quality of life for AD patients. Research studies have identified early manifestations of AD that occur years before the diagnosis. For instance, eye movements of people with AD in different tasks differ from eye movements of control subjects. In this review, we present a summary and evolution of research approaches that use eye tracking technology and computational analysis to measure and compare eye movements under different tasks and experiments. Furthermore, this review is targeted to the feasibility of pioneer work on developing computational tools and techniques to analyze eye movements under naturalistic scenarios. We describe the progress in technology that can enhance the analysis of eye movements everywhere while subjects perform their daily activities and give future research directions to develop tools to support early AD diagnosis through analysis of eye movements.
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Affiliation(s)
- Jessica Beltrán
- Instituto Politécnico Nacional-CITEDI, Tijuana, BC, Mexico
- CONACYT, Ciudad de México, Mexico
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Kahana Levy N, Lavidor M, Vakil E. Prosaccade and Antisaccade Paradigms in Persons with Alzheimer’s Disease: A Meta-Analytic Review. Neuropsychol Rev 2017; 28:16-31. [DOI: 10.1007/s11065-017-9362-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 10/06/2017] [Indexed: 01/04/2023]
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7
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Noiret N, Carvalho N, Laurent É, Chopard G, Binetruy M, Nicolier M, Monnin J, Magnin E, Vandel P. Saccadic Eye Movements and Attentional Control in Alzheimer's Disease. Arch Clin Neuropsychol 2017; 33:1-13. [DOI: 10.1093/arclin/acx044] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 05/09/2017] [Indexed: 11/14/2022] Open
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8
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Coubard OA. What do we know about eye movements in Alzheimer's disease? The past 37 years and future directions. Biomark Med 2016; 10:677-80. [DOI: 10.2217/bmm-2016-0095] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Olivier A Coubard
- The Neuropsychological Laboratory, CNS-Fed, 14 rue du Regard, 75006 Paris, France
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9
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Nakamagoe K, Fujimiya S, Koganezawa T, Kadono K, Shimizu K, Fujizuka N, Takiguchi S, Ueno T, Monzen T, Tamaoka A. Vestibular Function Impairment in Alzheimer's Disease. J Alzheimers Dis 2016; 47:185-96. [PMID: 26402767 DOI: 10.3233/jad-142646] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Falls and fractures due to impaired balance in patients with Alzheimer's disease (AD) have an adverse effect on the clinical course of the disease. OBJECTIVE To evaluate balance impairment in AD from the viewpoint of vestibular functional impairment. METHODS The subjects were 12 patients with AD, 12 dementia-free elderly adults, and 12 younger adults. Vestibular function was assessed using a stepping test, caloric nystagmus, and a visual suppression (VS) test. RESULTS The stepping test was abnormal in 9 of the 12 patients in the AD group. An abnormal stepping test was not associated with self-reported dizziness or tendency to fall. Significant VS abnormalities were present in the AD group. The suppression rate of VS was lower in AD patients with either a tendency to fall or constructional apraxia than in AD patients without either. The velocity of the rapid phase of caloric nystagmus before the VS test was similar in the AD group and the elderly control group. Significant abnormalities of both caloric nystagmus and VS were not present in either the elderly or the younger control groups. CONCLUSION AD could involve impairments in the vestibular control of balance. The VS test is useful for assessing the tendency to fall in AD. Impairment of VS in AD might arise from cerebral vestibular cortex impairment rather than comorbid peripheral vestibular disorders.
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Affiliation(s)
- Kiyotaka Nakamagoe
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Suguru Fujimiya
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tadachika Koganezawa
- Department of Physiology, Division of Biomedical Science, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kotarou Kadono
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kotone Shimizu
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Natsu Fujizuka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Shino Takiguchi
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tomoyuki Ueno
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tatsuya Monzen
- Department of Neurology, Fuji Heavy Industries Health Insurance Society Ota Memorial Hospital, Gunma, Japan
| | - Akira Tamaoka
- Department of Neurology, Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Abel LA, Walterfang M, Stainer MJ, Bowman EA, Velakoulis D. Longitudinal assessment of reflexive and volitional saccades in Niemann-Pick Type C disease during treatment with miglustat. Orphanet J Rare Dis 2015; 10:160. [PMID: 26691656 PMCID: PMC4687063 DOI: 10.1186/s13023-015-0377-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 12/10/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Niemann-Pick Type C disease (NPC), is an autosomal recessive neurovisceral disorder of lipid metabolism. One characteristic feature of NPC is a vertical supranuclear gaze palsy particularly affecting saccades. However, horizontal saccades are also impaired and as a consequence a parameter related to horizontal peak saccadic velocity was used as an outcome measure in the clinical trial of miglustat, the first drug approved in several jurisdictions for the treatment of NPC. As NPC-related neuropathology is widespread in the brain we examined a wider range of horizontal saccade parameters and to determine whether these showed treatment-related improvement and, if so, if this was maintained over time. METHODS Nine adult NPC patients participated in the study; 8 were treated with miglustat for periods between 33 and 61 months. Data were available for 2 patients before their treatment commenced and 1 patient was untreated. Tasks included reflexive saccades, antisaccades and self-paced saccades, with eye movements recorded by an infrared reflectance eye tracker. Parameters analysed were reflexive saccade gain and latency, asymptotic peak saccadic velocity, HSEM-α (the slope of the peak duration-amplitude regression line), antisaccade error percentage, self-paced saccade count and time between refixations on the self-paced task. Data were analysed by plotting the change from baseline as a proportion of the baseline value at each test time and, where multiple data values were available at each session, by linear mixed effects (LME) analysis. RESULTS Examination of change plots suggested some modest sustained improvement in gain, no consistent changes in asymptotic peak velocity or HSEM-α, deterioration in the already poor antisaccade error rate and sustained improvement in self-paced saccade rate. LME analysis showed statistically significant improvement in gain and the interval between self-paced saccades, with differences over time between treated and untreated patients. CONCLUSIONS Both qualitative examination of change scores and statistical evaluation with LME analysis support the idea that some saccadic parameters are robust indicators of efficacy, and that the variability observed across measures may indicate locally different effects of neurodegeneration and of drug actions.
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Affiliation(s)
- Larry A Abel
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia.
| | - Mark Walterfang
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia. .,Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia.
| | - Matthew J Stainer
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia. .,Active Vision Lab, School of Psychology, The University of Aberdeen, Aberdeen, Scotland.
| | - Elizabeth A Bowman
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Australia. .,Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia.
| | - Dennis Velakoulis
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Australia. .,Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, Australia.
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Abstract
A growing body of literature has investigated changes in eye movements as a result of Alzheimer's disease (AD). When compared to healthy, age-matched controls, patients display a number of remarkable alterations to oculomotor function and viewing behavior. In this article, we review AD-related changes to fundamental eye movements, such as saccades and smooth pursuit motion, in addition to changes to eye movement patterns during more complex tasks like visual search and scene exploration. We discuss the cognitive mechanisms that underlie these changes and consider the clinical significance of eye movement behavior, with a focus on eye movements in mild cognitive impairment. We conclude with directions for future research.
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Affiliation(s)
- Robert J Molitor
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Philip C Ko
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brandon A Ally
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA Department of Psychology, Vanderbilt University, Nashville, TN, USA Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
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12
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Ocular motor abnormalities in neurodegenerative disorders. Eye (Lond) 2014; 29:200-7. [PMID: 25412716 DOI: 10.1038/eye.2014.276] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Accepted: 10/10/2014] [Indexed: 12/11/2022] Open
Abstract
Eye movements are a source of valuable information to both clinicians and scientists as abnormalities of them frequently act as clues to the localization of a disease process. Classically, they are divided into two main types: those that hold the gaze, keeping images steady on the retina (vestibulo-ocular and optokinetic reflexes) and those that shift gaze and redirect the line of sight to a new object of interest (saccades, vergence, and smooth pursuit). Here we will review some of the major ocular motor abnormalities present in neurodegenerative disorders.
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13
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Kapoula Z, Yang Q, Otero-Millan J, Xiao S, Macknik SL, Lang A, Verny M, Martinez-Conde S. Distinctive features of microsaccades in Alzheimer's disease and in mild cognitive impairment. AGE (DORDRECHT, NETHERLANDS) 2014; 36:535-43. [PMID: 24037325 PMCID: PMC4039256 DOI: 10.1007/s11357-013-9582-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 08/22/2013] [Indexed: 05/11/2023]
Abstract
During visual fixation, the eyes are never completely still, but produce small involuntary movements, called "fixational eye movements," including microsaccades, drift, and tremor. In certain neurological disorders, attempted fixation results in abnormal fixational eye movements with distinctive characteristics. Thus, determining how normal fixation differs from pathological fixation has the potential to aid early and differential noninvasive diagnosis of neurological disease as well as the quantification of its progression and response to treatment. Here, we recorded the eye movements produced by patients with Alzheimer's disease, patients with mild cognitive impairment, and healthy age-matched individuals during attempted fixation. We found that microsaccade magnitudes, velocities, durations, and intersaccadic intervals were comparable in the three subject groups, but microsaccade direction differed in patients versus healthy subjects. Our results indicate that microsaccades are more prevalently oblique in patients with Alzheimer's disease or mild cognitive impairment than in healthy subjects. These findings extended to those microsaccades paired in square-wave jerks, supporting the hypothesis that microsaccades and square-wave jerks form a continuum, both in healthy subjects and in neurological patients.
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Affiliation(s)
- Zoi Kapoula
- />CeSeM, UMR 8194, CNRS University Paris V IRIS group, Ophthalmology service European Hospital Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Qing Yang
- />CeSeM, UMR 8194, CNRS University Paris V IRIS group, Ophthalmology service European Hospital Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Jorge Otero-Millan
- />Department of Neurobiology, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ 85013 USA
- />University of Vigo, Vigo, Spain
| | - Shifu Xiao
- />Geriatric Psychiatry Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, 600 Wan Ping Nan Road, 200030 Shanghai, China
| | - Stephen L. Macknik
- />Department of Neurobiology, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ 85013 USA
- />Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ 85013 USA
| | - Alexandre Lang
- />CeSeM, UMR 8194, CNRS University Paris V IRIS group, Ophthalmology service European Hospital Georges Pompidou, 20 rue Leblanc, 75015 Paris, France
| | - Marc Verny
- />Department of Geriatric Neurology, Salpetrière Hospital, Paris, France
| | - Susana Martinez-Conde
- />Department of Neurobiology, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ 85013 USA
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14
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Yang Q, Wang T, Su N, Xiao S, Kapoula Z. Specific saccade deficits in patients with Alzheimer's disease at mild to moderate stage and in patients with amnestic mild cognitive impairment. AGE (DORDRECHT, NETHERLANDS) 2013; 35:1287-98. [PMID: 22576337 PMCID: PMC3705110 DOI: 10.1007/s11357-012-9420-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 04/24/2012] [Indexed: 05/05/2023]
Abstract
Saccadic impairment in Alzheimer's disease (AD) was found in horizontal saccades. The present study extends investigation to vertical saccades in a large number of subjects, including AD and amnestic mild cognitive impairment (aMCI). We examined both horizontal and vertical saccades in 30 healthy elderly, 18 aMCI, and 25 AD. Two tasks were used: gap (fixation target extinguishes prior to target onset) and overlap (fixation stays on after target onset). Eye movements were recorded with the Eyeseecam system. (1) Robust gap effect (shorter latencies in gap than in overlap) exists for AD and aMCI patients as for healthy elderly; (2) abnormal long latency of saccades in gap and overlap tasks for AD relative to healthy elderly and aMCI patients; (3) longer latency for aMCI patients than for healthy elderly for the overlap task; (4) significant correlation between scores of Mini-Mental State Examination (MMSE) and latencies of saccades considering the AD group only; (5) higher coefficient of variation in latency for AD patients than for healthy elderly and for aMCI patients; (6) variability of accuracy and speed is abnormally higher in AD patients than in aMCI and healthy elderly. Abnormalities of latency and latency-accuracy-speed variability reflect deficits of cerebral areas involved in the triggering and execution of saccades; latency of saccades can be used as follow-up test for aMCI and AD patients with its significant correlation with the changes of MMSE scores.
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Affiliation(s)
- Qing Yang
- />IRIS group, UMR 8194, CNRS, Hôpital Européen Georges Pompidou, University Paris V, 20 rue Leblanc, 75015 Paris, France
| | - Tao Wang
- />Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine; Alzheimer’s Disease and Related Disorders Center,, Shanghai Jiaotong University, 600 Wan Ping Nan Road, 200030 Shanghai, China
| | - Ning Su
- />Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine; Alzheimer’s Disease and Related Disorders Center,, Shanghai Jiaotong University, 600 Wan Ping Nan Road, 200030 Shanghai, China
| | - Shifu Xiao
- />Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine; Alzheimer’s Disease and Related Disorders Center,, Shanghai Jiaotong University, 600 Wan Ping Nan Road, 200030 Shanghai, China
| | - Zoi Kapoula
- />IRIS group, UMR 8194, CNRS, Hôpital Européen Georges Pompidou, University Paris V, 20 rue Leblanc, 75015 Paris, France
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15
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Abstract
The neural centers in the cerebral hemispheres, both cortex and basal ganglia, involved in the generation of saccadic and smooth pursuit eye movements have been well delineated in terms of their location and function. For the generation of saccades these include the frontal eye fields, the supplementary eye field, and the intraparietal sulcus, and in the basal ganglia the caudate nucleus and the substantia nigra, pars compacta. The generation of pursuit eye movements involves the middle temporal (area V5) and medial superior temporal areas and the frontal eye field. These centers and their connections are disturbed not only in acute and chronic lesions such as cerebral infarction, but also in a wide variety of neurodegenerative diseases. In certain of these conditions, such as patients with cortical dementias and basal ganglia disorders, correct interpretation of the resulting eye movement abnormalities can contribute to differentiating between a range of differential diagnoses.
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Affiliation(s)
- Christopher Kennard
- Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Headington, Oxford, UK.
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Yang Q, Wang T, Su N, Liu Y, Xiao S, Kapoula Z. Long latency and high variability in accuracy-speed of prosaccades in Alzheimer's disease at mild to moderate stage. Dement Geriatr Cogn Dis Extra 2011; 1:318-29. [PMID: 22203824 PMCID: PMC3246280 DOI: 10.1159/000333080] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Studying saccades is a useful tool to investigate brain function. There is still controversy regarding deficits in prosaccades in Alzheimer's disease (AD), and a study of saccades in subjects with mild cognitive impairment (MCI) has not been published to date. METHODS We examined horizontal saccades in 10 healthy elderly, and 9 MCI and 9 AD patients. Two tasks were used: gap (fixation target extinguishes prior to target onset) and overlap (fixation stays on after target onset). Eye movements were recorded with the Skalar IRIS system. RESULTS (1) Latencies were shorter in the gap than in the overlap task (a gap effect) in all three groups of subjects: healthy elderly, MCI and AD; (2) for both tasks, latency of saccades was longer for AD patients than for healthy and MCI subjects, and (3) accuracy and mean velocity were normal in MCI and AD subjects, however, variability in accuracy-speed was higher for AD patients than for healthy and MCI subjects in the overlap task. CONCLUSIONS Abnormalities in reaction time and accuracy-speed variability reflect deficits in cerebral areas involved in the triggering and execution of saccades; a saccade test can be useful to follow up the evolution of MCI subjects as some of them may develop AD disease.
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Affiliation(s)
- Qing Yang
- IRIS Group, UMR 8194, CNRS, Hôpital Européen Georges Pompidou, Paris, France
| | - Tao Wang
- Geriatric Psychiatry Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ning Su
- Geriatric Psychiatry Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuanyuan Liu
- Geriatric Psychiatry Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Geriatric Psychiatry Department, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zoi Kapoula
- IRIS Group, UMR 8194, CNRS, Hôpital Européen Georges Pompidou, Paris, France
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17
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Hutton JT, Albrecht JW, Shapiro I, Johnston C. Visual information processing and dementia. Neuroophthalmology 2009. [DOI: 10.3109/01658108709007437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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18
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Hotson JR, Steinke GW. Vertical and Horizontal Saccades in Aging and Dementia: Failure to Inhibit Anticipatory Saccades. Neuroophthalmology 2009. [DOI: 10.3109/01658108808996053] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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19
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Crawford TJ, Higham S, Renvoize T, Patel J, Dale M, Suriya A, Tetley S. Inhibitory control of saccadic eye movements and cognitive impairment in Alzheimer's disease. Biol Psychiatry 2005; 57:1052-60. [PMID: 15860346 DOI: 10.1016/j.biopsych.2005.01.017] [Citation(s) in RCA: 113] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2004] [Revised: 10/25/2004] [Accepted: 01/11/2005] [Indexed: 11/30/2022]
Abstract
BACKGROUND This study examined the relationship of inhibitory control and measures of neuropsychological impairment in patients with early Alzheimer's disease (AD). Four specific questions were addressed: 1) Which error parameters of saccadic inhibition are sensitive to AD? 2) Which inhibitory deficits are related to cognitive measures of impairment? 3) Is the inhibitory impairment in AD dependent on the initiation of a volitional eye movement? 4) How do the effects of saccadic inhibitory control in AD relate to the normal effects of aging? METHODS Eighteen patients with probable AD and two control groups (seventeen young, and eighteen old participants) completed a battery of neuropsychological tests and four saccadic eye movement paradigms: pro-saccade, NO-GO, GO/NO-GO and anti-saccade. RESULTS Old controls generated increased inhibition errors in comparison to young controls in the GO/NO-GO paradigm. In comparison to old controls, AD generated normal saccades in the pro-saccade paradigm, but showed a higher proportion of inhibition errors in the NO-GO, GO/NO-GO and anti-paradigms. The frequency of uncorrected errors in the anti-saccade paradigm was positively correlated with cognitive measures of dementia. CONCLUSIONS AD patients have an impairment of inhibitory control and error-correction that exceeds the effects of normal aging and is related to the severity of dementia. However, the inhibitory impairment is not contingent on the interaction with a volitional saccade.
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Affiliation(s)
- Trevor J Crawford
- Mental Health and Neural Systems Research Unit, Lancaster University, Lancaster, United Kingdom.
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20
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Versino M, Romani A, Beltrami G, Cosi V. Saccadic and smooth pursuit eye movements in memory-impaired elderly people. Acta Neurol Scand 1996; 93:39-43. [PMID: 8825271 DOI: 10.1111/j.1600-0404.1996.tb00168.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The aim of the study was to compare eye movements recorded in 14 non-demented memory impaired elderly subjects with those of 36 sex- and education-matched controls. Eye movements were recorded with the bitemporal electrooculographic technique, and analyzed with a personal computer. Saccades were elicited in accordance with reflexive, predictive and antisaccade paradigms. Smooth pursuit eye movements were elicited with a triangular ramp paradigm. The memory-impaired subjects showed a higher prevalence of increased reflexive saccade latency and a lower smooth pursuit performance index. In addition, we detected a correlation between antisaccade and reflexive saccade latencies. Our results showed very slight differences in eye movement parameters. However, our findings are in keeping with the hypothesis of a subtle involvement of differing cortical areas in memory impaired subjects.
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Affiliation(s)
- M Versino
- Istituto Neurologico Fondazione C. Mondino, Università di Pavia, Italy
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21
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Abstract
A countermanding paradigm was utilized to investigate the regulation of saccade initiation. Two rhesus monkeys were instructed to generate a saccade to a peripheral target; however, on a fraction of trials after a delay, the monkeys were signaled to inhibit saccade initiation. With short delays between the presentation of the target and the signal to inhibit saccade generation, monkeys withheld saccades to the peripheral target. As the delay of the stop signal increased, monkeys increasingly failed to withhold the saccade. The hypothesis that the generation of the saccade is determined by a race between a go and a stop process provides three explicit means of estimating the covert latency of response to the stop signal. This latency, known as stop signal reaction time, was estimated to be on average 82 ms for both monkeys. Because the stop signal latency represents the time required to exert inhibitory control over saccade production, the countermanding paradigm will be useful for studying neural mechanisms that regulate saccade initiation.
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Affiliation(s)
- D P Hanes
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA
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22
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Bylsma FW, Rasmusson DX, Rebok GW, Keyl PM, Tune L, Brandt J. Changes in visual fixation and saccadic eye movements in Alzheimer's disease. Int J Psychophysiol 1995; 19:33-40. [PMID: 7790287 DOI: 10.1016/0167-8760(94)00060-r] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Visual fixation and saccadic eye movements were assessed in 31 mild to moderately demented patients with probable Alzheimer's disease (AD) and 31 age- and education-matched nondemented elderly control subjects. Seventeen AD and 17 matched control subjects were reassessed after a 9-month interval. On a fixation task, duration of fixation and number of intrusive saccades were not different between groups at baseline or follow-up. Both AD patients and control subjects showed more intrusive saccades at follow-up than at baseline. AD patients showed increased latency to initiation of saccades at baseline and on follow-up. Amplitude and velocity of saccades were not different between groups at any visit. Changes in measures of fixation, but no saccade measure, correlated with changes in MMSE scores over testing sessions. These data suggest that fixation is more sensitive than are saccades to the progession of AD.
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Affiliation(s)
- F W Bylsma
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287-7218, USA
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23
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Zaccara G, Gangemi PF, Muscas GC, Paganini M, Pallanti S, Parigi A, Messori A, Arnetoli G. Smooth-pursuit eye movements: alterations in Alzheimer's disease. J Neurol Sci 1992; 112:81-9. [PMID: 1469444 DOI: 10.1016/0022-510x(92)90136-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Smooth-pursuit eye movements induced by targets moving at constant velocities (from 5 to 100 deg/sec) were recorded from 13 patients with Alzheimer's disease (AD) and from 11 healthy subjects. Four variables were evaluated to quantify the patients' response to the eye movement tests: (1) average peak velocity of smooth-pursuit; (2) percent target matching index after saccade removal (percent ratio between the area of the velocity curve of smooth-pursuit eye movement after saccade removal and the area of target velocity) which is related to the eye performance for each value of target velocity; (3) total amplitude of anticipatory saccades; (4) total number of anticipatory saccades. Compared to the controls, AD patients were found to have significantly lower values of average peak velocity of smooth pursuit and of percent target matching index and a significantly increased number and amplitude of anticipatory saccades. A discriminant stepwise analysis indicated that 5 oculographic variables were significantly associated with the patient's clinical condition (healthy volunteer or AD patient). These statistics yielded an equation for predicting the patient's status according to which the percentage of cases classified correctly was 82.6% in the overall group (n = 23). The predictive performance was similar between the healthy volunteers subgroup (81.8%, n = 11) and the AD subgroup (83.3%, n = 12). The discriminant score was significantly correlated with the score resulting from the MiniMental test (r = 0.67). A significant correlation was also found between the MiniMental score and the number of anticipatory saccades (r = -0.61). No significant correlation was present between the gain of smooth pursuit and the patients' cognitive decline.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- G Zaccara
- Department of Neurological and Psychiatric Sciences, University of Florence, Italy
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24
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Merrill PT, Paige GD, Abrams RA, Jacoby RG, Clifford DB. Ocular motor abnormalities in human immunodeficiency virus infection. Ann Neurol 1991; 30:130-8. [PMID: 1680302 DOI: 10.1002/ana.410300203] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We studied ocular motor performance in 47 subjects with human immunodeficiency virus (HIV) infection and 25 normal control subjects. Saccade accuracy was the most sensitive measure, being significantly poorer for all four HIV-positive groups (asymptomatic, acquired immunodeficiency syndrome [AIDS] without dementia, and AIDS with dementia, and AIDS-related complex) than for control subjects. While saccade duration and peak velocity were not significantly different across groups, the scatter of saccade duration was increased in all HIV-positive groups. Saccade latency was not significantly affected. In both simple and complex antisaccade tasks, the asymptomatic, AIDS, and AIDS dementia groups made significantly fewer correct-way antisaccades than did control subjects. Latencies of correct-way antisaccades were increased for AIDS and AIDS dementia groups in the simple antisaccade trials, and for all HIV-positive groups in the complex trials. Fixation stability was significantly worse in the AIDS dementia group than in control subjects. Smooth pursuit gain was decreased in the asymptomatic, AIDS, and AIDS dementia groups for the least demanding trial. One or more ocular motor abnormalities were present in 15 (88%) asymptomatic subjects, 11 (69%) with AIDS-related complex, and 14 (100%) AIDS patients without or with dementia.
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Affiliation(s)
- P T Merrill
- Department of Neurology, Washington University School of Medicine, St Louis, MO
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25
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Tedeschi G, Allocca S, Di Costanzo A, Carlomagno S, Merla F, Petretta V, Toriello A, Tranchino G, Ambrosio G, Bonavita V. Multisystem involvement of the central nervous system in Strümpell's disease. A neurophysiological and neuropsychological study. J Neurol Sci 1991; 103:55-60. [PMID: 1865233 DOI: 10.1016/0022-510x(91)90284-e] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The multisystem involvement of the central nervous system (CNS) in familial spastic paraplegia (FSP) has not been fully investigated by means of complete neurophysiological and neuropsychological examinations. The classification which distinguishes pure and complicated forms of FSP, is based on clinical features and does not take into account the possibility that clinically silent lesions of the CNS can be identified by means of adequate tests. The study was intended to assess the subclinical and multisystem involvement of the CNS in a group of 11 patients affected by FSP, clinically distinguished in 7 pure forms and 4 complicated forms. Neurophysiological tests included saccadic eye movements analysis, visual and auditory brain stem evoked responses. Neuropsychological examination was devised by means of a special purpose mental deterioration battery. Our results, showing a high incidence of multisystemic subclinical involvement of the CNS, confirm and extend the concept that FSP is a multisystemic degenerative disease of the CNS, and that the existence of "pure" forms should be reconsidered.
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Affiliation(s)
- G Tedeschi
- Institute of Neurological Sciences, First School of Medicine, University of Naples, Italy
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26
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Abstract
Alzheimer's disease is a progressive neurologic disorder which may present with visual disturbance before the diagnosis is clearly established. Central acuity and visual field are initially normal. Alzheimer patients may show anomalies of color vision, spatial contrast sensitivity, susceptibility to visual masks, fundus examination, ocular motility, higher cortical visual function, visual evoked potential, and pattern electroretinogram. Pathologic analysis has shown abnormalities at all levels of the visual axis from retinal ganglion cell to associative visual cortex. Correlations between the visual abnormalities of Alzheimer's disease and corresponding neuroanatomic substrates are discussed.
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Affiliation(s)
- B Katz
- Department of Ophthalmology, University of California, San Diego, La Jolla
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27
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Kiyosawa M, Bosley TM, Chawluk J, Jamieson D, Schatz NJ, Savino PJ, Sergott RC, Reivich M, Alavi A. Alzheimer's disease with prominent visual symptoms. Clinical and metabolic evaluation. Ophthalmology 1989; 96:1077-85; discussion 1085-6. [PMID: 2788851 DOI: 10.1016/s0161-6420(89)32769-2] [Citation(s) in RCA: 81] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The authors examined eight patients with dementia of the Alzheimer's type (DAT), five with prominent visual symptoms early in the illness (VS) and three with no visual symptoms (NVS). Results of neuro-ophthalmologic examinations on VS patients showed relatively consistent abnormalities in figure copying, color vision tested by isochromatic plates, and stereopsis. Cerebral glucose metabolism determined by 18F-fluoro-2-deoxyglucose positron emission tomography (PET) was unchanged in primary visual cortex of VS and NVS patients compared with 12 normal volunteers of similar age and sex. Glucose metabolism in VS patients was decreased by 45 and 34% in left and right visual association cortex (P less than 0.01 and P less than 0.05, respectively) and 34 and 37% in left and right inferior parietal cortex (P less than 0.05) compared with controls; NVS patients had no significant metabolic alteration in these areas. Symptoms, physical examination, and metabolic imaging imply that these patients are a heterogenous but distinct clinical subgroup of DAT often with mild dementia who have visual symptoms due primarily to visual agnosia.
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Affiliation(s)
- M Kiyosawa
- Department of Neurology, University of Pennsylvania, Philadelphia
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28
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Abel LA, Dell'osso LF, Rustad LC. Longitudinal saccadic changes in Huntington's disease and Alzheimer's disease. Neuroophthalmology 1988. [DOI: 10.3109/01658108808996059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Wolfson LI, Whipple R, Amerman P, Kleinberg A. Stressing the postural response. A quantitative method for testing balance. J Am Geriatr Soc 1986; 34:845-50. [PMID: 3782696 DOI: 10.1111/j.1532-5415.1986.tb07256.x] [Citation(s) in RCA: 169] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Using a series of graded destabilizing forces, we have developed a simple quantitative test of the postural response: the Postural Stress Test (PST). Suitable for widespread testing of elderly subjects, the test evaluates the subject's ability to avoid a fall as well as the appropriateness of the response. We have determined that by comparison with young subjects, the elderly controls have compromised although functionally effective balance. On the other hand, the balance response was severely compromised in half of the individuals with a history of falls. Experience with the Postural Stress Test suggests it will predict those elderly individuals with a tendency to fall as well as provide a simple mechanism for studying the balance response in the elderly.
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31
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Tyson SL, Lessell S. Resolution of optociliary shunt vessels. JOURNAL OF CLINICAL NEURO-OPHTHALMOLOGY 1986; 6:205-8. [PMID: 2947923 DOI: 10.3109/01658108609034216] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
A 40-year-old woman developed profound bilateral loss of vision from chronic atrophic papilledema. There were striking optociliary shunt vessels on the right optic disc. Within 1 month after removal of a massive intracranial meningioma, the shunt vessels had regressed markedly. This regression was evident on fluorescein angiograms. We attribute their resolution to the normalization of intracranial pressure.
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Abstract
Saccades were measured by magnetic search coil technique in 13 patients with Alzheimer's disease and compared with those of 11 age-matched control subjects. We analyzed responses to target motion of predictable and unpredictable timing or amplitude, and responses to briefly flashed targets. Latencies were significantly prolonged and peak velocities reduced only when the timing of target motion was unpredictable. Saccades to predictable amplitude targets were abnormally hypometric. In 8 patients, impersistence of gaze was manifested by large-amplitude saccadic intrusions away from the intended position of gaze. When instructed to make saccades away from a flashed target, patients made reflexive saccades toward the target. We attribute this visual grasp reflex to frontal lobe degeneration. These eye movement deficits can be used to quantify motor dysfunction in Alzheimer's disease.
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33
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Beenen N, Büttner U, Lange HW. The diagnostic value of eye movement recordings in patients with Huntington's disease and their offspring. ELECTROENCEPHALOGRAPHY AND CLINICAL NEUROPHYSIOLOGY 1986; 63:119-27. [PMID: 2417812 DOI: 10.1016/0013-4694(86)90005-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Eye movements were studied with EOG in a large number of Huntington's disease (HD) patients (N = 48) and their offspring (subjects at risk, N = 97). The following oculomotor paradigms were investigated: horizontal and vertical saccades of different sizes (10-80 degrees), smooth pursuit eye movements, optokinetic and vestibular nystagmus. It was found that 75% of the HD patients had pathologically slow saccades. This number rose to 87% if other oculomotor deficits were included. Thus a small, but definite number of HD patients had normal eye movements. This included patients with disease durations of more than 14 years. A comparison with the results of clinical and evoked potential studies on these patients showed that they were clinically only mildly affected but did not form a different group of HD patients. Subjects at risk had statistically (P less than 0.01) slower horizontal saccades (average 427 deg/sec) than the controls (455 deg/sec). For 11% of the subjects at risk horizontal saccade velocity was pathological and altogether 22% had some oculomotor deficits. Subjects with pathological slow horizontal saccades also had a high incidence (64%) of pathological evoked potentials. Thus, subjects with pathological slow horizontal saccades can be considered to have a high risk of developing the clinical symptoms of HD.
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