Deficits in ocular and manual tracking due to episodic ataxia type 2

Conventional MRI findings in hereditary degenerative ataxias: a pictorial review

Purpose

Cerebellar ataxias are a large and heterogeneous group of disorders. The evaluation of brain parenchyma via MRI plays a central role in the diagnostic assessment of these conditions, being mandatory to exclude the presence of other underlying causes in determining the clinical phenotype. Once these possible causes are ruled out, the diagnosis is usually researched in the wide range of hereditary or sporadic ataxias.

Methods

We here propose a review of the main clinical and conventional imaging findings of the most common hereditary degenerative ataxias, to help neuroradiologists in the evaluation of these patients.

Results

Hereditary degenerative ataxias are all usually characterized from a neuroimaging standpoint by the presence, in almost all cases, of cerebellar atrophy. Nevertheless, a proper assessment of imaging data, extending beyond the mere evaluation of cerebellar atrophy, evaluating also the pattern of volume loss as well as concomitant MRI signs, is crucial to achieve a proper diagnosis.

Conclusion

The integration of typical neuroradiological characteristics, along with patient’s clinical history and laboratory data, could allow the neuroradiologist to identify some conditions and exclude others, addressing the neurologist to the more appropriate genetic testing.

Pursuit disorder and saccade dysmetria after caudal fastigial inactivation in the monkey

The caudal fastigial nuclei (cFN) are the output nuclei by which the medio-posterior cerebellum influences the production of saccadic and pursuit eye movements. We investigated the consequences of unilateral inactivation on the pursuit eye movement made immediately after an interceptive saccade toward a centrifugal target. We describe here the effects when the target moved along the horizontal meridian with a 10 or 20°/s speed. After muscimol injection, the monkeys were unable to track the present location of the moving target. During contralesional tracking, the velocity of postsaccadic pursuit was reduced. This slowing was associated with a hypometria of interceptive saccades such that gaze direction always lagged behind the moving target. No correlation was found between the sizes of saccade undershoot and the decreases in pursuit speed. During ipsilesional tracking, the effects on postsaccadic pursuit were variable across the injection sessions, whereas the interceptive saccades were consistently hypermetric. Here also, the ipsilesional pursuit disorder was not correlated with the saccade hypermetria either. The lack of correlation between the sizes of saccade dysmetria and changes of postsaccadic pursuit speed suggests that cFN activity exerts independent influences on the neural processes generating the saccadic and slow eye movements. It also suggests that the cFN is one locus where the synergy between the two motor categories develops in the context of tracking a moving visual target. We explain how the different fastigial output channels can account for these oculomotor tracking disorders. NEW & NOTEWORTHY Inactivation of the caudal fastigial nucleus impairs the ability to track a moving target. The accuracy of interceptive saccades and the velocity of postsaccadic pursuit movements are both altered, but these changes are not correlated. This absence of correlation is not compatible with an impaired common command feeding the circuits producing saccadic and pursuit eye movements. However, it suggests an involvement of caudal fastigial nuclei in their synergy to accurately track a moving target.

Learning the trajectory of a moving visual target and evolution of its tracking in the monkey

An object moving in the visual field triggers a saccade that brings its image onto the fovea. It is followed by a combination of slow eye movements and catch-up saccades that try to keep the target image on the fovea as long as possible. The accuracy of this ability to track the "here-and-now" location of a visual target contrasts with the spatiotemporally distributed nature of its encoding in the brain. We show in six experimentally naive monkeys how this performance is acquired and gradually evolves during successive daily sessions. During the early exposure, the tracking is mostly saltatory, made of relatively large saccades separated by low eye velocity episodes, demonstrating that accurate (here and now) pursuit is not spontaneous and that gaze direction lags behind its location most of the time. Over the sessions, while the pursuit velocity is enhanced, the gaze is more frequently directed toward the current target location as a consequence of a 25% reduction in the number of catch-up saccades and a 37% reduction in size (for the first saccade). This smoothing is observed at several scales: during the course of single trials, across the set of trials within a session, and over successive sessions. We explain the neurophysiological processes responsible for this combined evolution of saccades and pursuit in the absence of stringent training constraints. More generally, our study shows that the oculomotor system can be used to discover the neural mechanisms underlying the ability to synchronize a motor effector with a dynamic external event.

Neuronal P/Q-type calcium channel dysfunction in inherited disorders of the CNS

The past two decades have witnessed the emergence of a new and expanding field of neurological diseases--the genetic ion channelopathies. These disorders arise from mutations in genes that encode ion channel subunits, and manifest as paroxysmal attacks involving the brain or spinal cord, and/or muscle. The voltage-gated P/Q-type calcium channel (P/Q channel) is highly expressed in the cerebellum, hippocampus and cortex of the mammalian brain. The P/Q channel has a fundamental role in mediating fast synaptic transmission at central and peripheral nerve terminals. Autosomal dominant mutations in the CACNA1A gene, which encodes voltage-gated P/Q-type calcium channel subunit α(1) (the principal pore-forming subunit of the P/Q channel) are associated with episodic and progressive forms of cerebellar ataxia, familial hemiplegic migraine, vertigo and epilepsy. This Review considers, from both a clinical and genetic perspective, the various neurological phenotypes arising from inherited P/Q channel dysfunction, with a focus on recent advances in the understanding of the pathogenetic mechanisms underlying these disorders.

Allocentric cues do not always improve whole body reaching performance

The aim of this investigation was to gain further insight into control strategies used for whole body reaching tasks. Subjects were requested to step and reach to remembered target locations in normal room lighting (LIGHT) and complete darkness (DARK) with their gaze directed toward or eccentric to the remembered target location. Targets were located centrally at three different heights. Eccentric anchors for gaze direction were located at target height and initial target distance, either 30 degrees to the right or 20 degrees to the left of target location. Control trials, where targets remained in place, and remembered target trials were randomly presented. We recorded movements of the hand, eye and head, while subjects stepped and reached to real or remembered target locations. Lateral, vertical and anterior-posterior (AP) hand errors and eye location, and gaze direction deviations were determined relative to control trials. Final hand location errors varied by target height, lighting condition and gaze eccentricity. Lower reaches in the DARK compared to the LIGHT condition were common, and when matched with a tendency to reach above the low target, help explain more accurate reaches for this target in darkness. Anchoring the gaze eccentrically reduced hand errors in the AP direction and increased errors in the lateral direction. These results could be explained by deviations in eye locations and gaze directions, which were deemed significant predictors of final reach errors, accounting for a 17-47% of final hand error variance. Results also confirmed a link between gaze deviations and hand and head displacements, suggesting that gaze direction is used as a common input for movement of the hand and body. Additional links between constant and variable eye deviations and hand errors were common for the AP direction but not for lateral or vertical directions. When combined with data regarding hand error predictions, we found that subjects' alterations in body movement in the AP direction were associated with AP adjustments in their reach, but final hand position adjustments were associated with gaze direction alterations for movements in the vertical and horizontal directions. These results support the hypothesis that gaze direction provides a control signal for hand and body movement and that this control signal is used for movement direction and not amplitude.