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Ticku H, Fotedar N, Juncos J, Factor SA, Shaikh AG. Pseudonystagmus in progressive supranuclear palsy. J Neurol Sci 2022; 434:120157. [DOI: 10.1016/j.jns.2022.120157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/30/2021] [Accepted: 01/13/2022] [Indexed: 10/19/2022]
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Mathis T, Rauber H, Sautivet L, Chambard C, Denis P, Danaila T, Kodjikian L. [Screening for reading difficulties in Parkinson's disease: An evaluation of the Alouette test]. J Fr Ophtalmol 2018; 41:718-724. [PMID: 30150017 DOI: 10.1016/j.jfo.2018.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 01/24/2018] [Accepted: 01/26/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Reading disorders in Parkinson's disease (PD) are poorly evaluated due to the lack of validated tests to screen for them. They are often attributed to hand tremors associated with the disease. In this study, we evaluated the "alouette test" validated for dyslexia screening, in PD by comparing the results to healthy patients. METHODS The "alouette test" was conducted on a fixed surface to avoid errors related to tremor. A fixation and tracking test were then performed. All the tests were filmed to be analyzed later by 2 examiners blinded to the neurological diagnosis. RESULTS Thirty-eight patients were included, 19 with PD, and 19 healthy age-matched patients. PD patients read on average 250.9±13.7 words correctly vs. 260.3±2.7 words for healthy patients (P=0.008). This difference was greatest for the older patient subgroup (>65 years), who had the disease longer (P=0.014). Tracking and fixation tests were more impaired in PD patients compared to healthy patients. CONCLUSION This study highlighted many reading disorders in PD. The use of the "alouette test" which can easily be implemented in clinical practice, could help to diagnose these disorders. Better evaluation of these difficulties would allow for better medical care of these patients.
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Affiliation(s)
- T Mathis
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; UMR-CNRS 5510 Matéis, 345, avenue Gasto-Berger, 69100 Villeurbane, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France.
| | - H Rauber
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - L Sautivet
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - C Chambard
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - P Denis
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; Université Lyon 1, institut des sciences et techniques de réadaptation, 8, avenue Rockfeller, 69373 Lyon cedex 08, France
| | - T Danaila
- Service de neurologie, troubles du mouvement et pathologies neuromusculaires, université Lyon 1, hôpital Pierre-Wertheimer, hospices civils de Lyon, 59, boulevard Pinel, 69677 Bron, France
| | - L Kodjikian
- Service d'ophtalmologie, université Lyon 1, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69317 Lyon cedex 04, France; UMR-CNRS 5510 Matéis, 345, avenue Gasto-Berger, 69100 Villeurbane, France
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Pretegiani E, Optican LM. Eye Movements in Parkinson's Disease and Inherited Parkinsonian Syndromes. Front Neurol 2017; 8:592. [PMID: 29170650 PMCID: PMC5684125 DOI: 10.3389/fneur.2017.00592] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 10/23/2017] [Indexed: 12/02/2022] Open
Abstract
Despite extensive research, the functions of the basal ganglia (BG) in movement control have not been fully understood. Eye movements, particularly saccades, are convenient indicators of BG function. Here, we review the main oculomotor findings reported in Parkinson’s disease (PD) and genetic parkinsonian syndromes. PD is a progressive, neurodegenerative disorder caused by dopaminergic cell loss within the substantia nigra pars compacta, resulting in depletion of striatal dopamine and subsequent increased inhibitory BG output from the internal globus pallidus and the substantia nigra pars reticulata. Eye movement abnormalities are common in PD: anomalies are more evident in voluntary than reflexive saccades in the initial stages, but visually guided saccades may also be involved at later stages. Saccadic hypometria (including abnormally fragmented saccades), reduced accuracy, and increased latency are among the most prominent deficits. PD patients show also unusually frequent and large square wave jerks and impaired inhibition of reflexive saccades when voluntary mirror saccades are required. Poor convergence ability and altered pursuit are common. Inherited parkinsonisms are a heterogeneous group of rare syndromes due to gene mutations causing symptoms resembling those of PD. Eye movement characteristics of some parkinsonisms have been studied. While sharing some PD features, each syndrome has a distinctive profile that could contribute to better define the clinical phenotype of parkinsonian disorders. Moreover, because the pathogenesis and the underlying neural circuit failure of inherited parkinsonisms are often well defined, they might offer a better prospect than idiopathic PD to understand the BG function.
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Affiliation(s)
- Elena Pretegiani
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, MD, United States
| | - Lance M Optican
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, MD, United States
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Kaski D, Bronstein AM. Ocular Tremor in Parkinson's Disease: Discussion, Debate, and Controversy. Front Neurol 2017; 8:134. [PMID: 28484420 PMCID: PMC5401892 DOI: 10.3389/fneur.2017.00134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 03/21/2017] [Indexed: 11/13/2022] Open
Abstract
The identification of ocular tremor in a small cohort of patients with Parkinson’s disease (PD) had lay somewhat dormant until the recent report of a pervasive ocular tremor as a universal finding in a large PD cohort that was, however, generally absent from a cohort of age-matched healthy subjects. The reported tremor had frequency characteristics similar to those of PD limb tremor, but the amplitude and frequency of the tremor did not correlate with clinical tremor ratings. Much controversy ensued as to the origin of such a tremor, and specifically as to whether a pervasive ocular tremor was a fundamental feature of PD, or rather a compensatory eye oscillation secondary to a transmitted head tremor, and thus a measure of a normal vestibulo-ocular reflex. In this mini review, we summarize some of the evidence for and against the case for a pervasive ocular tremor in PD and suggest future experiments that may help resolve these conflicting opinions.
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Affiliation(s)
- Diego Kaski
- Division of Brain Sciences, Department of Neuro-Otology, Imperial College London, London, UK.,Department of Neuro-Otology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
| | - Adolfo M Bronstein
- Division of Brain Sciences, Department of Neuro-Otology, Imperial College London, London, UK.,Department of Neuro-Otology, University College London, National Hospital for Neurology and Neurosurgery, London, UK
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Shaikh AG, Ghasia FF, DeLong MR, Jinnah HA, Freeman A, Factor SA. Ocular palatal tremor plus dystonia - new syndromic association. Mov Disord Clin Pract 2015; 2:267-270. [PMID: 26889496 DOI: 10.1002/mdc3.12193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Ocular palatal tremor typically develops after a breach in the Guillian-Mollaret triangle. We herein describe a variant of this syndrome in which dystonia is also present, hence called, here, ocular palatal tremor plus dystonia. METHODS We assessed eye-head movements and dystonia in six patients with ocular palatal plus dystonia. RESULTS Among six patients with ocular palatal tremor two had focal dystonia, three had multifocal dystonia, and one had generalized dystonia. The dystonia affected the upper extremities and neck in four patients, the lower extremities in three and the face in two. Three out of four cervical dystonia patients had head tremor. Two patients also had speech involvement. Lack of correlation between eye and head oscillations suggested that head oscillations were not compensatory or secondary to the eye oscillations and vice versa. CONCLUSIONS We describe a novel variant of ocular palatal tremor with dystonia. We speculate that in such variant the dystonia is possibly could be a result of abnormal cerebellar outflow in patients with a breach in Guillain-Mollaret triangle.
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Gitchel GT, Wetzel PA, Baron MS. Slowed saccades and increased square wave jerks in essential tremor. Tremor Other Hyperkinet Mov (N Y) 2013; 3:tre-03-178-4116-2. [PMID: 24116343 PMCID: PMC3779821 DOI: 10.7916/d8251gxn] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 07/11/2013] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Eye movements in essential tremor (ET) are poorly described and may present useful information on the underlying pathophysiology of the disorder. METHODS Sixty patients with ET, including 15 de novo untreated patients, and 60 age-matched controls constitute the study population. A video-based eye tracker was used to assess binocular eye position. Oculomotor function was assessed while subjects followed random horizontally and vertically step-displaced targets. RESULTS For all reflexive saccades, latencies were increased in ET subjects by a mean of 16.3% (p<0.01). Saccades showed reduced peak velocities with a lengthy, wavering velocity plateau, followed by slowed decelerations. For larger 30°+ saccades, peak velocities were decreased by a mean of 25.2% (p<0.01) and durations increased by 31.8% (p<0.01). The frequency of square wave jerks (SWJs) in patients was more than triple that of controls (p<0.0001). Despite frequent interruptions by SWJs, fixations were otherwise stable and indistinguishable from controls (root mean square [RMS] velocity, p = 0.324). The abnormal eye movement parameters were independent of disease duration, tremor severity, and medication therapy. DISCUSSION In contrast to normally swift onset and efficient acceleration/deceleration movements, saccades in ET are characterized by abnormally prolonged latencies and slowed velocity profiles. Although ET subjects maintain highly stable fixations, they are interrupted by increased numbers of SWJs. This study reveals novel oculomotor deficits in ET, which are distinct from the eye movement dysfunction of other movement disorders, supporting a role for eye tracking to assist in the differential diagnoses of not only atypical, but also more common movement disorders.
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Affiliation(s)
- George T. Gitchel
- Southeast Parkinson’s Disease Research, Education, and Clinical Center (PADRECC), Hunter-Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, United States of America
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Paul A. Wetzel
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Mark S. Baron
- Southeast Parkinson’s Disease Research, Education, and Clinical Center (PADRECC), Hunter-Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, United States of America
- Department of Neurology, Virginia Commonwealth University, Richmond, Virginia, USA
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