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Hapakova L, Necpal J, Kosutzka Z. The antisaccadic paradigm: A complementary neuropsychological tool in basal ganglia disorders. Cortex 2024; 178:116-140. [PMID: 38991475 DOI: 10.1016/j.cortex.2024.06.005] [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: 01/07/2024] [Revised: 04/20/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024]
Abstract
This review explores the role of the antisaccadic task in understanding inhibitory mechanisms in basal ganglia disorders. It conducts a comparative analysis of saccadic profiles in conditions such as Parkinson's disease, Tourette syndrome, obsessive-compulsive disorder, Huntington's disease, and dystonia, revealing distinct patterns and proposing mechanisms for impaired performance. The primary focus is on two inhibitory mechanisms: global, pre-emptive inhibition responsible for suppressing prepotent responses, and slower, selective response inhibition. The antisaccadic task demonstrates practicality in clinical applications, aiding in differential diagnoses, treatment monitoring and reflecting gait control. To further enhance its differential diagnostic value, future directions should address issues such as the standardization of eye-tracking protocol and the integration of eye-tracking data with other disease indicators in a comprehensive dataset.
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Affiliation(s)
- Lenka Hapakova
- 2nd Department of Neurology, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia.
| | - Jan Necpal
- Neurology Department, Hospital Zvolen, a. s., Zvolen, Slovakia.
| | - Zuzana Kosutzka
- 2nd Department of Neurology, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia.
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Terao Y, Fukuda H, Hikosaka O, Yugeta A, Matsuda SI, Fisicaro F, Ugawa Y, Hoshino K, Nomura Y. Age- and sex-related oculomotor manifestation of dopamine deficiency in Segawa disease. Clin Neurophysiol 2024; 157:73-87. [PMID: 38064930 DOI: 10.1016/j.clinph.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 10/28/2023] [Accepted: 11/11/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To investigate the oculomotor manifestations of Segawa disease (SD), considered to represent mild dopamine deficiency and discuss their pathophysiological basis. METHODS We recorded visually- (VGS) and memory-guided saccade (MGS) tasks in 31 SD patients and 153 age-matched control subjects to study how basal ganglia (BG) dysfunction in SD evolves with age for male and female subjects. RESULTS SD patients were impaired in initiating MGS, showing longer latencies with occasional failure. Patients showed impaired ability to suppress reflexive saccades; saccades to cues presented in MGS were more frequent and showed a shorter latency than in control subjects. These findings were more prominent in male patients, particularly between 13 and 25 years. Additionally, male patients showed larger delay in MGS latency in trials preceded by saccades to cue than those unpreceded. CONCLUSIONS The findings can be explained by a dysfunction of the BG-direct pathway impinging on superior colliculus (SC) due to dopamine deficiency. The disturbed inhibitory control of saccades may be explained by increased SC responsivity to visual stimuli. SIGNIFICANCE Oculomotor abnormalities in SD can be explained by dysfunction of the BG inhibitory pathways reaching SC, with a delayed maturation in male SD patients, consistent with previous pathological/physiological studies.
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Affiliation(s)
- Yasuo Terao
- Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; Department of Medical Physiology, Kyorin University, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan.
| | - Hideki Fukuda
- Segawa Memorial Neurological Clinic for Children, 2-8 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Okihide Hikosaka
- Section of Neuronal Networks, Laboratory of Sensorimotor Research, National Eye Institute, 49 Convent Drive, Bethesda 20892-4435, MD, USA
| | - Akihiro Yugeta
- Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Shun-Ichi Matsuda
- Department of Neurology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan
| | - Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Piazza Università, 2, 95131 Catalina, Italy
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Kyoko Hoshino
- Segawa Memorial Neurological Clinic for Children, 2-8 Kanda-Surugadai, Chiyoda-ku, Tokyo 101-0062, Japan
| | - Yoshiko Nomura
- Yoshiko Nomura Neurological Clinic for Children, Tokyo 113-0034, Japan
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Woo KA, Joun JH, Yoon EJ, Lee CY, Jeon B, Kim YK, Lee JY. Monoaminergic Degeneration and Ocular Motor Abnormalities in De Novo Parkinson's Disease. Mov Disord 2023; 38:2291-2301. [PMID: 37846885 DOI: 10.1002/mds.29623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/07/2023] [Accepted: 09/12/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Evaluating eye movements in Parkinson's disease (PD) provides valuable insights into the underlying pathophysiological changes. OBJECTIVE The aim was to investigate the relationship between monoaminergic degeneration and ocular motor abnormalities in de novo PD. METHODS Drug-naive PD patients who underwent N-(3-[18 F]fluoropropyl)-2-carbomethoxy-3-(4-iodophenyl) nortropane positron emission tomography scans and video-oculography at diagnosis were eligible. Measurements of saccadic accuracy, latency, and smooth pursuit gain and square wave jerk frequency were collected. Patients underwent Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and detailed cognitive tests. We investigated the associations between ocular motor measurements and specific tracer uptake ratios (SUR) in the caudate nucleus, anterior and posterior putamen, thalamus, and dorsal raphe nuclei, along with motor and cognitive symptoms. RESULTS One-hundred twenty-four subjects were included in this study. Saccadic accuracy was positively associated with parkinsonian motor severity expressed as Hoehn and Yahr stages, MDS-UPDRS Part III scores, and subscores for bradykinesia and rigidity but not with tremor scores (PFDR < 0.05). Saccadic accuracy correlated with poor performances in the Rey-Complex-Figure copy, and latency with the Digit Symbol Coding and the Montreal Cognitive Assessment scores (PFDR < 0.05). Prolonged saccadic latency correlated with reduced thalamic SUR, whereas decreased saccadic accuracy correlated with reduced SUR in the anterior and posterior putamen (PFDR < 0.05). Reduced smooth pursuit gain showed associations with reduced SUR in the dorsal raphe, a serotonin-predominant region, but did not correlate with parkinsonism severity scores. CONCLUSION Defective dopaminergic and nondopaminergic neural systems may discretely influence ocular motor function in de novo PD patients. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Kyung Ah Woo
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Joo Hong Joun
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Jin Yoon
- Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
- Memory Network Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Chan Young Lee
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Beomseok Jeon
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jee-Young Lee
- Department of Neurology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea
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Munoz MJ, Arora R, Rivera YM, Drane QH, Pal GD, Verhagen Metman L, Sani SB, Rosenow JM, Goelz LC, Corcos DM, David FJ. Medication only improves limb movements while deep brain stimulation improves eye and limb movements during visually-guided reaching in Parkinson's disease. Front Hum Neurosci 2023; 17:1224611. [PMID: 37850040 PMCID: PMC10577235 DOI: 10.3389/fnhum.2023.1224611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/18/2023] [Indexed: 10/19/2023] Open
Abstract
Background Antiparkinson medication and subthalamic nucleus deep brain stimulation (STN-DBS), two common treatments of Parkinson's disease (PD), effectively improve skeletomotor movements. However, evidence suggests that these treatments may have differential effects on eye and limb movements, although both movement types are controlled through the parallel basal ganglia loops. Objective Using a task that requires both eye and upper limb movements, we aimed to determine the effects of medication and STN-DBS on eye and upper limb movement performance. Methods Participants performed a visually-guided reaching task. We collected eye and upper limb movement data from participants with PD who were tested both OFF and ON medication (n = 34) or both OFF and ON bilateral STN-DBS while OFF medication (n = 11). We also collected data from older adult healthy controls (n = 14). Results We found that medication increased saccade latency, while having no effect on reach reaction time (RT). Medication significantly decreased saccade peak velocity, while increasing reach peak velocity. We also found that bilateral STN-DBS significantly decreased saccade latency while having no effect on reach RT, and increased saccade and reach peak velocity. Finally, we found that there was a positive relationship between saccade latency and reach RT, which was unaffected by either treatment. Conclusion These findings show that medication worsens saccade performance and benefits reaching performance, while STN-DBS benefits both saccade and reaching performance. We explore what the differential beneficial and detrimental effects on eye and limb movements suggest about the potential physiological changes occurring due to treatment.
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Affiliation(s)
- Miranda J. Munoz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Rishabh Arora
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
- USF Health Morsani College of Medicine, University of South Florida, Tampa, FL, United States
| | - Yessenia M. Rivera
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Quentin H. Drane
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Gian D. Pal
- Department of Neurology, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, United States
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, IL, United States
| | - Leo Verhagen Metman
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sepehr B. Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago, IL, United States
| | - Joshua M. Rosenow
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Lisa C. Goelz
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, United States
| | - Daniel M. Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
| | - Fabian J. David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, United States
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Mertiens S, Sure M, Schnitzler A, Florin E. Alterations of PAC-based resting state networks in Parkinson's disease are partially alleviated by levodopa medication. Front Syst Neurosci 2023; 17:1219334. [PMID: 37588811 PMCID: PMC10427244 DOI: 10.3389/fnsys.2023.1219334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/10/2023] [Indexed: 08/18/2023] Open
Abstract
Introduction Parkinson's disease (PD) is a neurodegenerative disorder affecting the whole brain, leading to several motor and non-motor symptoms. In the past, it has been shown that PD alters resting state networks (RSN) in the brain. These networks are usually derived from fMRI BOLD signals. This study investigated RSN changes in PD patients based on maximum phase-amplitude coupling (PAC) throughout the cortex. We also tested the hypothesis that levodopa medication shifts network activity back toward a healthy state. Methods We recorded 23 PD patients and 24 healthy age-matched participants for 30 min at rest with magnetoencephalography (MEG). PD patients were measured once in the dopaminergic medication ON and once in the medication OFF state. A T1-MRI brain scan was acquired from each participant for source reconstruction. After correcting the data for artifacts and performing source reconstruction using a linearly constrained minimum variance beamformer, we extracted visual, sensorimotor (SMN), and frontal RSNs based on PAC. Results We found significant changes in all networks between healthy participants and PD patients in the medication OFF state. Levodopa had a significant effect on the SMN but not on the other networks. There was no significant change in the optimal PAC coupling frequencies between healthy participants and PD patients. Discussion Our results suggest that RSNs, based on PAC in different parts of the cortex, are altered in PD patients. Furthermore, levodopa significantly affects the SMN, reflecting the clinical alleviation of motor symptoms and leading to a network normalization compared to healthy controls.
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Affiliation(s)
- Sean Mertiens
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Matthias Sure
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Esther Florin
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Yeon JS, Jung HN, Kim JY, Jung KI, Park HYL, Park CK, Kim HW, Kim MS, Kim YC. Deviated Saccadic Trajectory as a Biometric Signature of Glaucoma. Transl Vis Sci Technol 2023; 12:15. [PMID: 37440248 PMCID: PMC10353744 DOI: 10.1167/tvst.12.7.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/31/2023] [Indexed: 07/14/2023] Open
Abstract
Purpose To investigate whether the trajectories of saccadic eye movements (SEMs) significantly differ between glaucoma patients and controls. Methods SEMs were recorded by video-based infrared oculography in 53 patients with glaucoma and 41 age-matched controls. Participants were asked to bilaterally view 24°-horizontal, 14°-vertical, and 20°-diagonal eccentric Goldmann III-sized stimuli. SEMs were evaluated with respect to the saccadic reaction time (SRT), the mean velocity, amplitude, and two novel measures: departure angle (DA) and arrival angle (AA). These parameters were compared between the groups and the associations of SEM parameters with glaucoma parameters and integrated visual field defects were investigated. Results Glaucoma patients exhibited increased mean SRT, DA, and AA values compared with controls for 14°-vertical visual targets (P = 0.05, P < 0.01, and P < 0.01, respectively). The SRT, DA, and AA were significantly associated with the mean and pattern standard deviations of perimetry and with the mean RNFL thickness by OCT (all P < 0.001). Glaucoma was associated with the AA (P = 0.05) and both the SRT (P = 0.01) and DA (P = 0.04) were associated with integrated visual field defects. Conclusions The saccadic trajectories of glaucoma patients depart in an erroneous path and compensate the disparity by deviating the trajectory at arrival. Translational Relevance The initial deviation that we observed (despite continuous exposure to the stimulus) suggests the disoriented spatial perception of glaucoma patients which may be relevant to difficulties encountered daily.
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Affiliation(s)
- Ji Su Yeon
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Ha Na Jung
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Jae Young Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Kyong In Jung
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae-Young Lopilly Park
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chan Kee Park
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Won Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Man Soo Kim
- Gangnam St. Mary's One Eye Clinic, Seoul, Republic of Korea
| | - Yong Chan Kim
- College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Ophthalmology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Zhou MX, Wang Q, Lin Y, Xu Q, Wu L, Chen YJ, Jiang YH, He Q, Zhao L, Dong YR, Liu JR, Chen W. Oculomotor impairments in de novo Parkinson’s disease. Front Aging Neurosci 2022; 14:985679. [PMID: 36437987 PMCID: PMC9682176 DOI: 10.3389/fnagi.2022.985679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Reliable electrophysiological indicators are urgently needed in the precise evaluation of Parkinson’s disease (PD). It is still elusive whether oculomotor performance is impaired or has clinical value in early PD. This study aims to explore oculomotor performance in newly diagnosed, drug-naïve PD and its correlation with clinical phenotype. Methods Seventy-five patients with de novo PD, 75 patients with essential tremor (ET), and 46 gender-and age-matched healthy controls (HCs) were included in this cross-sectional study. All subjects underwent oculomotor test via videonystagmography. Visually guided saccade latency, saccadic accuracy and gain in smooth pursuit eye movement (SPEM) at three frequencies of the horizontal axis were compared among the three groups. Patients with PD also received detailed motor and non-motor evaluation by serial scales. The association between key oculomotor parameters and clinical phenotypes were explored in PD patients. Results Both de novo PD and ET patients showed prolonged saccadic latency and decreased saccadic accuracy relative to HCs. SPEM gain in PD was uniformly reduced at each frequency. SPEM gain at 0.4 Hz was also decreased in ET compared with HCs. However, there was no significant difference of oculomotor parameters between de novo PD and ET patients. Furthermore, prolonged saccadic latency was correlated with long disease duration, whereas decreased SPEM gain was associated with severe motor symptoms in de novo PD patients. Conclusion Ocular movements are impaired in de novo, drug naïve PD patients; these changes could be indicators for disease progression in PD.
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Affiliation(s)
- Meng-Xi Zhou
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qin Wang
- Department of Neurology, Zhongshan Hospital Fudan University, Shanghai, China
| | - Yin Lin
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qian Xu
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wu
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ya-Jing Chen
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yu-Han Jiang
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing He
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Zhao
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - You-Rong Dong
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Ren Liu
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Clinical Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- *Correspondence: Jian-Ren Liu,
| | - Wei Chen
- Department of Neurology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Wei Chen,
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Munoz MJ, Reilly JL, Pal GD, Verhagen Metman L, Rivera YM, Drane QH, Corcos DM, David FJ, Goelz LC. Medication adversely impacts visually-guided eye movements in Parkinson's disease. Clin Neurophysiol 2022; 143:145-153. [PMID: 35995722 DOI: 10.1016/j.clinph.2022.07.505] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We examined whether previous inconsistent findings about the effect of anti-Parkinsonian medication on visually-guided saccades (VGS) were due to the use of different paradigms, which change the timing of fixation offset and target onset, or different target eccentricities. METHODS Thirty-three participants with Parkinson's disease (PD) completed the VGS tasks OFF and ON medication, along with 13 healthy controls. Performance on 3 paradigms (gap, step, and overlap) and 2 target eccentricities was recorded. We used mixed models to determine the effect of medication, paradigm, and target eccentricity on saccade latency, gain, and peak velocity. RESULTS First, we confirmed known paradigm effects on latency, and target eccentricity effects on gain and peak velocity in participants with PD. Second, latency was positively associated with OFF medication Movement Disorders Society - Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor score in PD. Third, medication prolonged latency for the larger target eccentricity across the 3 paradigms, while decreasing gain and peak velocity in the step paradigm across target eccentricities. CONCLUSIONS Medication adversely affected and was not therapeutically beneficial for VGS. Previous inconsistencies may have resulted from chosen target eccentricity. SIGNIFICANCE The negative medication effect on VGS may be clinically significant, as many activities in daily life require oculomotor control, inhibitory control, and visually-guided shifts of attention.
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Affiliation(s)
- Miranda J Munoz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA.
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gian D Pal
- Department of Neurology, Rutgers University, New Brunswick, NJ, USA; Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, IL, USA
| | - Leo Verhagen Metman
- Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Rush University Medical Center, Chicago, IL, USA
| | - Yessenia M Rivera
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Quentin H Drane
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Daniel M Corcos
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Fabian J David
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA
| | - Lisa C Goelz
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL, USA; Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL, USA
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Mahanama B, Jayawardana Y, Rengarajan S, Jayawardena G, Chukoskie L, Snider J, Jayarathna S. Eye Movement and Pupil Measures: A Review. FRONTIERS IN COMPUTER SCIENCE 2022. [DOI: 10.3389/fcomp.2021.733531] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Our subjective visual experiences involve complex interaction between our eyes, our brain, and the surrounding world. It gives us the sense of sight, color, stereopsis, distance, pattern recognition, motor coordination, and more. The increasing ubiquity of gaze-aware technology brings with it the ability to track gaze and pupil measures with varying degrees of fidelity. With this in mind, a review that considers the various gaze measures becomes increasingly relevant, especially considering our ability to make sense of these signals given different spatio-temporal sampling capacities. In this paper, we selectively review prior work on eye movements and pupil measures. We first describe the main oculomotor events studied in the literature, and their characteristics exploited by different measures. Next, we review various eye movement and pupil measures from prior literature. Finally, we discuss our observations based on applications of these measures, the benefits and practical challenges involving these measures, and our recommendations on future eye-tracking research directions.
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Thepass G, Lemij HG, Vermeer KA, van der Steen J, Pel JJM. Slowed Saccadic Reaction Times in Seemingly Normal Parts of Glaucomatous Visual Fields. Front Med (Lausanne) 2021; 8:679297. [PMID: 34513866 PMCID: PMC8426641 DOI: 10.3389/fmed.2021.679297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/02/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: In eye movement perimetry, peripheral stimuli are confirmed by goal-directed eye movements toward the stimulus. The saccadic reaction time (SRT) is regarded as an index of visual field responsiveness, whereas in standard automated perimetry (SAP), the visual field sensitivity is tested. We investigated the relation between visual field sensitivity and responsiveness in corresponding locations of the visual field in healthy controls and in patients with mild, moderate and advanced glaucoma. Materials and Methods: Thirty-four healthy control subjects and 42 glaucoma patients underwent a 54-point protocol in eye movement perimetry (EMP) and a 24-2 SITA standard protocol in a Humphrey Field Analyzer. The visual field points were stratified by total deviation sensitivity loss in SAP into 6 strata. A generalized linear mixed model was applied to determine the influence of the various factors. Results: The generalized linear mixed model showed that the mean SRT increased with increasing glaucoma severity, from 479 ms in the control eyes to 678 ms in the eyes of patients with advanced glaucoma (p < 0.001). Mean SRTs significantly increased with increasing SAP sensitivity loss. Even at the locations where no sensitivity loss was detected by SAP (total deviation values greater or equal than 0 dB), we found lengthened SRTs in mild, moderate and advanced glaucoma compared to healthy controls (p < 0.05) and in moderate and advanced glaucoma compared to mild glaucoma (p < 0.05). At locations with total deviation values between 0 and −3 dB, −3 and −6 dB and −6 and −12 dB, we found similar differences. Conclusions: The lengthened SRT in areas with normal retinal sensitivities in glaucomatous eyes, i.e., planning and execution of saccades to specific locations, precede altered sensory perception as assessed with SAP. Better understanding of altered sensory processing in glaucoma might allow earlier diagnosis of emerging glaucoma.
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Affiliation(s)
- Gijs Thepass
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands.,Rotterdam Ophthalmic Institute, Rotterdam, Netherlands
| | - Hans G Lemij
- Glaucoma Service, Rotterdam Eye Hospital, Rotterdam, Netherlands
| | | | - Johannes van der Steen
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands.,Royal Dutch Visio, Huizen, Netherlands
| | - Johan J M Pel
- Vestibular and Ocular Motor Research Group, Department of Neuroscience, Erasmus MC, Rotterdam, Netherlands
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Wolf C, Lappe M. Vision as oculomotor reward: cognitive contributions to the dynamic control of saccadic eye movements. Cogn Neurodyn 2021; 15:547-568. [PMID: 34367360 PMCID: PMC8286912 DOI: 10.1007/s11571-020-09661-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/12/2020] [Accepted: 12/28/2020] [Indexed: 01/08/2023] Open
Abstract
Humans and other primates are equipped with a foveated visual system. As a consequence, we reorient our fovea to objects and targets in the visual field that are conspicuous or that we consider relevant or worth looking at. These reorientations are achieved by means of saccadic eye movements. Where we saccade to depends on various low-level factors such as a targets' luminance but also crucially on high-level factors like the expected reward or a targets' relevance for perception and subsequent behavior. Here, we review recent findings how the control of saccadic eye movements is influenced by higher-level cognitive processes. We first describe the pathways by which cognitive contributions can influence the neural oculomotor circuit. Second, we summarize what saccade parameters reveal about cognitive mechanisms, particularly saccade latencies, saccade kinematics and changes in saccade gain. Finally, we review findings on what renders a saccade target valuable, as reflected in oculomotor behavior. We emphasize that foveal vision of the target after the saccade can constitute an internal reward for the visual system and that this is reflected in oculomotor dynamics that serve to quickly and accurately provide detailed foveal vision of relevant targets in the visual field.
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Affiliation(s)
- Christian Wolf
- Institute for Psychology, University of Muenster, Fliednerstrasse 21, 48149 Münster, Germany
| | - Markus Lappe
- Institute for Psychology, University of Muenster, Fliednerstrasse 21, 48149 Münster, Germany
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Likitgorn T, Yan Y, Liao YJ. Freezing of saccades in dopa-responsive parkinsonian syndrome. Am J Ophthalmol Case Rep 2021; 23:101124. [PMID: 34169178 PMCID: PMC8208961 DOI: 10.1016/j.ajoc.2021.101124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 04/19/2021] [Accepted: 05/17/2021] [Indexed: 11/01/2022] Open
Abstract
Purpose Ocular motor abnormalities such as abnormal saccades are common in idiopathic Parkinson's disease (PD) and atypical parkinsonian syndrome, such as progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). In this study, we describe a case of patient with PD and show a video illustrating severe delay of reflexive saccades. Observations A 68-year-old Caucasian woman with diagnosis of PD presented for evaluation of diplopia. Neuro-ophthalmic examination revealed good visual acuity in both eyes and normal optic nerves but prominent ocular motor abnormalities, including hypometric saccades, impaired smooth pursuit, and convergence insufficiency causing diplopia at near. Despite treatment with carbidopa-levodopa three times per day, she exhibited episodic, severe delay of reflexive saccades. During these episodes, the patient appeared frozen and unable to initiate reflexive saccades for 20 s or longer. This freezing of reflexive saccades was variable and occurred suddenly during exam but could be interrupted by smooth pursuit. There was no gait freezing, eyelid apraxia, or prominent exacerbation of other motor symptoms. Freezing of saccades dramatically resolved after increasing dosage of carbidopa-levodopa. Conclusions and Importance We describe a patient with dopa-responsive parkinsonian syndrome with intermittent difficulty initiating reflexive saccades mimicking ocular motor apraxia. Resolution of saccadic freezing with higher carbidopa-levodopa is consistent with ocular motor impairment as a result of degeneration and dysfunction of the dopaminergic pathways in supranuclear ocular motor control.
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Affiliation(s)
- Techawit Likitgorn
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Ophthalmology Center, Thonburi Hospital, Bangkok, Thailand
| | - Yan Yan
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Ophthalmology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yaping Joyce Liao
- Department of Ophthalmology, Stanford University School of Medicine, Stanford, CA, USA.,Department of Neurology, Stanford University School of Medicine, Stanford, CA, USA
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13
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Singh S, Downie LE, Anderson AJ. Do Blue-blocking Lenses Reduce Eye Strain From Extended Screen Time? A Double-Masked Randomized Controlled Trial. Am J Ophthalmol 2021; 226:243-251. [PMID: 33587901 DOI: 10.1016/j.ajo.2021.02.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 01/29/2021] [Accepted: 02/09/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate if blue-blocking lenses are effective in reducing the ocular signs and symptoms of eye strain associated with computer use. DESIGN Double-masked, randomized controlled trial. METHODS A total of 120 symptomatic computer users were randomly assigned (1:1) into a "positive" or "negative" advocacy arm (ie, a clinician either advocating or not advocating for the intervention via a prerecorded video). Participants were further sub-randomized (1:1) to receive either clear (placebo) or blue-blocking spectacles. All participants were led to believe they had received an active intervention. Participants performed a 2-hour computer task while wearing their assigned spectacle intervention. The prespecified primary outcome measures were the mean change (post- minus pre-computer task) in eye strain symptom score and critical flicker-fusion frequency (CFF, an objective measure of eye strain). The study also investigated whether clinician advocacy of the intervention (in a positive or negative light) modulated clinical outcomes. RESULTS All participants completed the study. In the primary analysis, for CFF, no significant effect was found for advocacy type (positive or negative, p = .164) and spectacle intervention type (blue-blocking or clear lens, p = .304). Likewise, for eye strain symptom score, no differences were found for advocacy (p = .410) or spectacle lens types (p = .394). No adverse events were documented. CONCLUSIONS Blue-blocking lenses did not alter signs or symptoms of eye strain with computer use relative to standard clear lenses. Clinician advocacy type had no bearing on clinical outcomes.
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Affiliation(s)
- Sumeer Singh
- From the Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Laura E Downie
- From the Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Andrew J Anderson
- From the Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia..
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15
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Lal V, Mehta S, Takkar A, Ray S. Ophthalmological findings in movement disorders. ANNALS OF MOVEMENT DISORDERS 2021. [DOI: 10.4103/aomd.aomd_35_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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16
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Anderson AJ, Smyrnis N, Noorani I, Carpenter RHS. Modelling Prosaccade Latencies across Multiple Decision-Making Tasks. Neuroscience 2020; 452:345-353. [PMID: 33246069 DOI: 10.1016/j.neuroscience.2020.11.022] [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: 07/16/2020] [Revised: 10/26/2020] [Accepted: 11/12/2020] [Indexed: 11/24/2022]
Abstract
Oculomotor decision making can be investigated by a simple step task, where a person decides whether a target has jumped to the left or the right. More complex tasks include the countermanding task (look at the jumped target, except when a subsequent signal instructs you not to) and the Wheeless task (where the jumped target sometimes then quickly jumps to a new location). Different instantiations of the LATER (Linear Approach to Threshold with Ergodic Rate) model have been shown to explain the saccadic latency data arising from these tasks, despite it being almost inconceivable that completely separate decision-making mechanisms exist for each. However, these models have an identical construction with regards to predicting prosaccadic responses (all step task trials, and control trials in countermanding and Wheeless tasks, where no countermanding signal is given or when the target does not make a second jump). We measured saccadic latencies for 23 human observers each performing the three tasks, and modelled prosaccade latencies with LATER to see if model parameters were usefully preserved across tasks. We found no significant difference in reaction times and model parameters between the step and Wheeless tasks (mean 175 and 177 ms, respectively; standard deviation, SD 22 and 24 ms). In contrast, we identified prolonged latencies in the countermanding tasks (236 ms; SD 37 ms) explained by a slower rise and an elevated threshold of the decision making signal, suggesting elevated participant caution. Our findings support the idea that common machinery exists for oculomotor decision-making, which can be flexibly deployed depending upon task demands.
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Affiliation(s)
- Andrew J Anderson
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville 3010, Australia.
| | - Nikolaos Smyrnis
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "COSTAS STEFANIS", Athens, Greece; 2nd Psychiatry Department, National and Kapodistrian University of Athens, Medical School, University General Hospital "ATTIKON", Athens, Greece
| | - Imran Noorani
- Division of Academic Neurosurgery, Addenbrooke's Hospital, University of Cambridge, UK
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Stock L, Krüger-Zechlin C, Deeb Z, Timmermann L, Waldthaler J. Natural Reading in Parkinson's Disease With and Without Mild Cognitive Impairment. Front Aging Neurosci 2020; 12:120. [PMID: 32528271 PMCID: PMC7258085 DOI: 10.3389/fnagi.2020.00120] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 04/08/2020] [Indexed: 11/21/2022] Open
Abstract
Background: Patients with Parkinson’s disease (PD) show eye movement abnormalities and frequently complain about difficulties in reading. So far, it is unclear whether basal ganglia dysfunction or cognitive impairment has a greater impact on eye movements during reading. Objective: To analyze eye movement behavior during a natural reading task with respect to cognitive state and dopaminergic therapy in PD and healthy controls. Methods: Eye movements of 59 PD patients and 29 age- and education-matched healthy controls were recorded during mute, self-paced reading of a text. 25 cognitively normal PD patients performed the task additionally in off medication state. Clinical assessment included a comprehensive neuropsychological test battery and the motor section of MDS—Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Results: PD-mild cognitive impairment (MCI) was diagnosed in 21 patients. Reading speed was significantly reduced in PD-MCI compared to healthy controls and PD patients without MCI due to higher numbers of progressive saccades. Cognitively intact PD patients showed no significant alterations of reading speed or eye movement pattern during reading. The fixation duration tended to be prolonged in PD compared to healthy controls and decreased significantly after levodopa intake. Scores for executive functions, attention, and language correlated with reading speed in the PD group. Conclusion: The present study is the first to reveal (1) reduced reading speed with altered reading pattern in PD with MCI and (2) a relevant impact of levodopa on fixation duration during reading in PD. Further research is needed to determine whether therapeutic interventions, e.g., levodopa or neuropsychological training, improve the subjective reading experience for patients with PD.
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Affiliation(s)
- Lena Stock
- Department of Neurology, University Hospital Marburg, Marburg, Germany
| | | | - Zain Deeb
- Department of Neurology, University Hospital Marburg, Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Marburg, Germany
| | - Josefine Waldthaler
- Department of Neurology, University Hospital Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Marburg, Germany
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18
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Waldthaler J, Krüger-Zechlin C, Stock L, Deeb Z, Timmermann L. New insights into facial emotion recognition in Parkinson's disease with and without mild cognitive impairment from visual scanning patterns. Clin Park Relat Disord 2019; 1:102-108. [PMID: 34316611 PMCID: PMC8288515 DOI: 10.1016/j.prdoa.2019.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 10/27/2019] [Accepted: 11/16/2019] [Indexed: 11/28/2022] Open
Abstract
Background Recognizing emotional facial expressions is crucial for social interactions. Cognitive impairment and oculomotor abnormalities are common features of Parkinson's disease (PD) which may contribute to the performance in facial emotion recognition (FER) in PD. Objective The aim of this study was to analyze eye movement behavior during a facial emotion recognition (FER) task with respect to cognitive state in PD patients and healthy controls. Methods Eye movements of 24 non-demented, non-depressed PD patients (12 with intact cognitive functions and 12 with Mild Cognitive Impairment (MCI) according to MDS task force criteria level 2), and 12 age-, sex and education-matched healthy controls were recorded during visual exploration of 28 emotional (happiness, surprise, disgust, anger, fear and sadness) and neutral faces. Participants were asked to identify the displayed emotion out of a sevenfold multiple choice question. Results PD-MCI patients showed reduced FER with specific impairment of anger recognition. Although the scanned area of PD patients with intact cognition was significantly restricted, they did not differ in FER from healthy subjects. While healthy subjects and cognitively intact PD patients scanned faces with preference for mouth and eyes, patients with PD-MCI tended to look at the center of the face and spent significantly less time fixating the mouth. Conclusions Ineffective visual exploration may contribute to impaired emotion recognition in PD. Visual scanning of emotional faces is altered in PD even in the absence of cognitive impairment. The progression to PD-MCI may result in further deterioration of scanning behavior and FER impairment.
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Affiliation(s)
- Josefine Waldthaler
- Department of Neurology, University Hospital Marburg, Germany.,Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
| | | | - Lena Stock
- Department of Neurology, University Hospital Marburg, Germany
| | - Zain Deeb
- Department of Neurology, University Hospital Marburg, Germany
| | - Lars Timmermann
- Department of Neurology, University Hospital Marburg, Germany.,Center for Mind, Brain and Behavior - CMBB, Universities Marburg and Gießen, Germany
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The effect of levodopa on saccades – Oxford Quantification in Parkinsonism study. Parkinsonism Relat Disord 2019; 68:49-56. [DOI: 10.1016/j.parkreldis.2019.09.029] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 09/25/2019] [Accepted: 09/27/2019] [Indexed: 11/18/2022]
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20
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Stuart S, Lawson RA, Yarnall AJ, Nell J, Alcock L, Duncan GW, Khoo TK, Barker RA, Rochester L, Burn DJ. Pro-Saccades Predict Cognitive Decline in Parkinson's Disease: ICICLE-PD. Mov Disord 2019; 34:1690-1698. [PMID: 31442355 DOI: 10.1002/mds.27813] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Cumulative dementia incidence in Parkinson's disease (PD) is significant, with major personal and socioeconomic impacts on individuals with PD and their carers. Early identification of dementia risk is vital to ensuring optimal intervention. Saccadic deficits often distinguish neurodegenerative disorders and cognitive impairment, but their ability to predict cognitive decline in PD has yet to be determined. The aims of this study were to (1) evaluate baseline (6.4 ± 6.1 months since PD diagnosis) differences in pro-saccadic metrics between those with early PD and healthy age-matched adults; and (2) assess the ability of baseline pro-saccades to predict subsequent cognitive decline over 4.5 years. METHODS One hundred and forty-one PD and 90 age-matched participants recruited at diagnosis underwent saccadometric assessment of pro-saccades at baseline and had cognition assessed at baseline, 18, 36, and 54 months. Pro-saccadic characteristics included latency, duration, amplitude, peak, and average velocity. Cognitive assessment included executive function, attention, fluctuating attention, and memory. Linear mixed-effects models examined pro-saccadic metrics as predictors of cognitive decline over 54 months. RESULTS Pro-saccades were significantly impaired at baseline in PD compared with controls. Pro-saccadic characteristics of latency, duration, peak, and average velocity predicted decline in global cognition, executive function, attention, and memory over 54 months in PD. In addition, only reduction in global cognition and attention were predicted by pro-saccadic metrics in age-matched adults, indicating that PD findings were not purely age related. CONCLUSIONS Saccadic characteristics are impaired in early PD and are predictive of cognitive decline in several domains. Assessment of saccades may provide a useful non-invasive biomarker for long-term PD cognitive decline in early disease. © 2019 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Samuel Stuart
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Department of Neurology, Balance Disorders Laboratory, Oregon Health & Science University, Portland, Oregon, USA
| | - Rachael A Lawson
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Alison J Yarnall
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Jeremy Nell
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - Lisa Alcock
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK
| | - Gordon W Duncan
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Tien K Khoo
- School of Medicine & Menzies Health Institute Queensland, Griffith University, Australia.,School of Medicine, University of Wollongong, Wallongong, New South Wales, Australia
| | - Roger A Barker
- Cambridge University, John van Geest Centre for Brain Repair and Department of Neurology, E.D. Adrian Building, Cambridge, UK
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute for Ageing, Clinical Ageing Research Unit, Newcastle University, Newcastle Upon Tyne, UK.,Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
| | - David J Burn
- Faculty of Medical Science, Newcastle University, Newcastle Upon Tyne, UK
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Barbosa P, Kaski D, Castro P, Lees AJ, Warner TT, Djamshidian A. Saccadic Direction Errors are Associated with Impulsive Compulsive Behaviours in Parkinson’s Disease Patients. JOURNAL OF PARKINSONS DISEASE 2019; 9:625-630. [DOI: 10.3233/jpd-181460] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Pedro Barbosa
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
- The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Diego Kaski
- Department of Clinical and Movement Neurosciences, University College London, London, UK
- Department of Neuro-Otology, Charing Cross Hospital, Imperial College London, London, UK
| | - Patricia Castro
- Escuela de Fonoaudiologia, Facultad de Medicina, Clinica Alemana Universidad del Desarrollo, Santiago, Chile
| | - Andrew J. Lees
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas T. Warner
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
- The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Atbin Djamshidian
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology, University College London, London, UK
- Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
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22
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Oculomotor effects of medical and surgical treatments of Parkinson's disease. PROGRESS IN BRAIN RESEARCH 2019; 249:297-305. [PMID: 31325988 DOI: 10.1016/bs.pbr.2019.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Oculomotor abnormalities are fast becoming a proxy for disease diagnosis and progression. Saccades-ballistic eye movements-are known to be affected by dopaminergic cell loss in the basal ganglia, caused by Parkinson's disease. Pharmaceutical and neurosurgical interventions such as deep brain stimulation and functional neurosurgery have both been noted to have an effect on saccades. Comparing and contrasting these effects may yield insights into Parkinson's disease pathophysiology, and the mechanisms of pharmacological and neurosurgical treatments. Computational models of saccadic control, such as the LATER model, can help to interpret the distribution of saccadic latencies, providing a framework for objectively comparing the effects of pharmaceutical interventions and deep brain stimulation.
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Zhang Y, Yan A, Liu B, Wan Y, Zhao Y, Liu Y, Tan J, Song L, Gu Y, Liu Z. Oculomotor Performances Are Associated With Motor and Non-motor Symptoms in Parkinson's Disease. Front Neurol 2018; 9:960. [PMID: 30546341 PMCID: PMC6280559 DOI: 10.3389/fneur.2018.00960] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 10/25/2018] [Indexed: 12/22/2022] Open
Abstract
Background: Parkinson's disease (PD) patients exhibit deficits in oculomotor behavior, yet the results are inconsistent across studies. In addition, how these results are associated with clinical symptoms is unclear, especially in China. Methods: We designed a case-control study in China including 37 PD patients and 39 controls. Clinical manifestations in PD patients were recorded. Oculomotor performance was measured by a video-based eye tracker system. Results: We found that six oculomotor parameters, including fixation stability, saccadic latency, smooth pursuit gain, saccade frequency, viewing range, and saccade frequency during free-viewing context, were significantly different in PD patients and control group. Combining application of these six parameters could improve diagnostic accuracy to over 90%. Moreover, pursuit gain was significantly associated with PD duration, UPDRS III, in PD patients. Saccade latency was significantly associated with PD duration, Berg balance score, RBD score, and Total LEDD in PD patients. Conclusions: PD patients commonly exhibit oculomotor deficits in multiple behavioral contexts, which are associated with both motor and non-motor symptoms. Oculomotor test may provide a valuable tool for the clinical assessment of PD.
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Affiliation(s)
- Yu Zhang
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aijuan Yan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bingyu Liu
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Ying Wan
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuchen Zhao
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Ying Liu
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Jiangxiu Tan
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Lu Song
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yong Gu
- Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Neuroscience, Chinese Academy of Sciences, Shanghai, China
| | - Zhenguo Liu
- Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Effect of subthalamic nucleus deep brain stimulation on visual scanning. Clin Neurophysiol 2018; 129:2421-2432. [DOI: 10.1016/j.clinph.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 07/12/2018] [Accepted: 08/22/2018] [Indexed: 11/19/2022]
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Ahmed A. EMDR Therapy for an Elderly Woman With Depression, Traumatic Memories, and Parkinson’s Disease Dementia: A Case Study. JOURNAL OF EMDR PRACTICE AND RESEARCH 2018. [DOI: 10.1891/1933-3196.12.1.16] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This case study looks at the application of eye movement desensitization and reprocessing (EMDR) therapy in an 83-year-old White woman with preexisting diagnoses of Parkinson’s disease and Parkinson’s disease dementia. She presented to the community mental health team with depressive symptoms, and during assessment, which included the use of the Trauma Screening Questionnaire, several traumatic life events emerged. Following six sessions of EMDR, subjective reporting on trauma symptoms and resilience improved and this was maintained 9 months later. Depression and anxiety scores (Hospital Anxiety and Depression Scale) remained consistent, though a lack of improvement in these scores was thought to be associated with progression of her physical health symptoms and related poor quality of life. This case highlights the potential use of EMDR in those with dementia and traumatic memories and the success of the standard EMDR protocol, despite difficulties with eye movements due to neurological effects of Parkinson’s disease. Further research in the application of EMDR in later life and in those with neurodegenerative medical conditions is recommended.
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Puri S, Shaikh AG. Basic and translational neuro-ophthalmology of visually guided saccades: disorders of velocity. EXPERT REVIEW OF OPHTHALMOLOGY 2017; 12:457-473. [PMID: 30774705 PMCID: PMC6377082 DOI: 10.1080/17469899.2017.1395695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Saccades are rapid, yoked eye movements in an effort to direct a target over fovea. The complex circuitry of saccadic eye movements has been exhaustively described. As a result clinicians can elegantly localize the pathology if it falls on the neuraxis responsible for saccades. Traditionally saccades are studied with their quantitative characteristics such as amplitude, velocity, duration, direction, latency and accuracy. AREAS COVERED Amongst all subtypes, the physiology of the visually guided saccades is most extensively studied. Here we will review the basic and pertinent neuro-anatomy and physiology of visually guided saccade and then discuss common or classic disorders affecting the velocity of visually guided saccades. We will then discuss the basic mechanism for saccade slowing in these disorders. EXPERT COMMENTARY Prompt appreciation of disorders of saccade velocity is critical to reach appropriate diagnosis. Disorders of midbrain, cerebellum, or basal ganglia can lead to prolonged transition time during gaze shift and decreased saccade velocity.
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Affiliation(s)
- Sushant Puri
- Dept. of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, United States
| | - Aasef G. Shaikh
- Dept. of Neurology, University Hospitals Cleveland Medical Center and Case Western Reserve University, Cleveland, Ohio, United States
- Daroff-DelOsso Ocular Motility Laboratory, Cleveland VA Medical Center, Cleveland, Ohio, United States
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Lotankar S, Prabhavalkar KS, Bhatt LK. Biomarkers for Parkinson's Disease: Recent Advancement. Neurosci Bull 2017; 33:585-597. [PMID: 28936761 PMCID: PMC5636742 DOI: 10.1007/s12264-017-0183-5] [Citation(s) in RCA: 132] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/03/2017] [Indexed: 12/12/2022] Open
Abstract
As a multi-factorial degenerative disease, Parkinson's disease (PD) leads to tremor, gait rigidity, and hypokinesia, thus hampering normal living. As this disease is usually detected in the later stages when neurons have degenerated completely, cure is on hold, ultimately leading to death due to the lack of early diagnostic techniques. Thus, biomarkers are required to detect the disease in the early stages when prevention is possible. Various biomarkers providing early diagnosis of the disease include those of imaging, cerebrospinal fluid, oxidative stress, neuroprotection, and inflammation. Also, biomarkers, alone or in combination, are used in the diagnosis and evolution of PD. This review encompasses various biomarkers available for PD and discusses recent advances in their development.
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Affiliation(s)
- Sharvari Lotankar
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
| | - Kedar S Prabhavalkar
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India.
| | - Lokesh K Bhatt
- Department of Pharmacology, SVKM's Dr Bhanuben Nanavati College of Pharmacy, Vile Parle (W), Mumbai, India
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Opposite effects of l -dopa and DBS-STN on saccadic eye movements in advanced Parkinson's disease. Neurol Neurochir Pol 2017; 51:354-360. [DOI: 10.1016/j.pjnns.2017.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Revised: 04/02/2017] [Accepted: 06/04/2017] [Indexed: 11/15/2022]
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Ranchet M, Orlosky J, Morgan J, Qadir S, Akinwuntan AE, Devos H. Pupillary response to cognitive workload during saccadic tasks in Parkinson's disease. Behav Brain Res 2017; 327:162-166. [PMID: 28366772 DOI: 10.1016/j.bbr.2017.03.043] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 03/24/2017] [Accepted: 03/27/2017] [Indexed: 11/17/2022]
Abstract
The relationship between cognitive workload and cognitive impairments in Parkinson's disease (PD) is currently not well known. This study compared cognitive workload during saccadic tasks between patients with PD and controls. Sixteen controls, 11 patients with no obvious cognitive impairment (PD-NCI) (MOCA score≥26), and 10 PD patients with cognitive impairment (PD-CI) (MOCA score<26) performed prosaccade and antisaccade tasks. Cognitive workload, extracted via pupil recording, and other eye metrics were compared between the three groups. PD-NCI patients exhibited greater cognitive workload than controls in the prosaccade task. PD-CI patients also showed more cognitive workload in the prosaccade task than PD-NCI patients and controls. No other differences in eye metrics were found between the three groups. Cognitive workload could be used to differentiate between different cognitive states in PD. The causal relationship between increased cognitive workload and cognitive decline in PD-NCI should be the focus of future studies.
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Affiliation(s)
- M Ranchet
- Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, USA; University of Lyon, F-69000 Lyon, France; French Institute of Science and Technology for Transport, Development and Networks (IFSTTAR), TS2, LESCOT, F-69500 Bron, France.
| | - J Orlosky
- Cybermedia Center, Toyonaka Educational Research Center 5F, Osaka University, 1-32 Machikaneyama, Toyonaka, Osaka 560-0043, Japan
| | - J Morgan
- Movement and Cognitive Disorders Center, Department of Neurology, Augusta University, GA, USA
| | - S Qadir
- Medical College of Georgia, Augusta University, GA, USA
| | - A E Akinwuntan
- Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, USA; Dean's Office, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
| | - H Devos
- Department of Physical Therapy, College of Allied Health Sciences, Augusta University, Augusta, GA, USA; Department of Physical Therapy and Rehabilitation Science, School of Health Professions, The University of Kansas Medical Center, Kansas City, KS, USA
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Heinzle J, Aponte EA, Stephan KE. Computational models of eye movements and their application to schizophrenia. Curr Opin Behav Sci 2016. [DOI: 10.1016/j.cobeha.2016.03.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
OBJECTIVE To investigate whether repeat saccadic reaction time (SRT) measurements using a portable saccadometer is useful to monitor patients with mild traumatic brain injury (mTBI). METHODS Seven patients with newly-diagnosed mTBI and five agematched controls were prospectively recruited from an emergency Department. Saccadic eye movements, symptom self-reporting and neuropsychological tests were performed within one week of injury and again at follow-up three weeks post-injury. Control patients underwent saccade recordings at similar intervals. RESULTS Median saccade reaction times were significantly prolonged within one week post-injury in mTBI compared to controls. At follow-up assessment there was no significant between-groups difference. Changes in median SRT between the two assessments were not statistically significant. Four of the seven mTBI patients showed significantly increased SRT at follow-up; three of the mTBI patients and all controls showed no significant change. Among the three mTBI patients with persistent decreased SRT, two experienced loss of consciousness and reported the greatest symptoms, while the third was the only subject with significant decrease in neuropsychological testing scores at both assessments. CONCLUSION In three of seven mTBI patients, saccadic eye movements remained delayed within three weeks post-injury. These three patients also showed persistent symptoms or no improvement on neuropsychological testing. This pilot study using a portable saccadometer suggests that comparing SRT from three weeks post-injury to that within one week of injury may be useful for early detection of a subpopulation at risk of persistent disability from mTBI. This finding suggests that further investigation in a large study population is warranted. Les saccades oculaires dans le traumatisme cérébral léger : une étude pilote.
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Ambati VNP, Saucedo F, Murray NG, Powell DW, Reed-Jones RJ. Constraining eye movement in individuals with Parkinson's disease during walking turns. Exp Brain Res 2016; 234:2957-65. [PMID: 27324086 DOI: 10.1007/s00221-016-4698-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 06/05/2016] [Indexed: 11/30/2022]
Abstract
Walking and turning is a movement that places individuals with Parkinson's disease (PD) at increased risk for fall-related injury. However, turning is an essential movement in activities of daily living, making up to 45 % of the total steps taken in a given day. Hypotheses regarding how turning is controlled suggest an essential role of anticipatory eye movements to provide feedforward information for body coordination. However, little research has investigated control of turning in individuals with PD with specific consideration for eye movements. The purpose of this study was to examine eye movement behavior and body segment coordination in individuals with PD during walking turns. Three experimental groups, a group of individuals with PD, a group of healthy young adults (YAC), and a group of healthy older adults (OAC), performed walking and turning tasks under two visual conditions: free gaze and fixed gaze. Whole-body motion capture and eye tracking characterized body segment coordination and eye movement behavior during walking trials. Statistical analysis revealed significant main effects of group (PD, YAC, and OAC) and visual condition (free and fixed gaze) on timing of segment rotation and horizontal eye movement. Within group comparisons, revealed timing of eye and head movement was significantly different between the free and fixed gaze conditions for YAC (p < 0.001) and OAC (p < 0.05), but not for the PD group (p > 0.05). In addition, while intersegment timings (reflecting segment coordination) were significantly different for YAC and OAC during free gaze (p < 0.05), they were not significantly different in PD. These results suggest individuals with PD do not make anticipatory eye and head movements ahead of turning and that this may result in altered segment coordination during turning. As such, eye movements may be an important addition to training programs for those with PD, possibly promoting better coordination during turning and potentially reducing the risk of falls.
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Affiliation(s)
- V N Pradeep Ambati
- Department of Kinesiology, Southern Illinois University, Carbondale, Illinois, USA
| | - Fabricio Saucedo
- Department of Kinesiology, University of Texas at El Paso, El Paso, TX, USA
| | - Nicholas G Murray
- School of Health and Kinesiology, Georgia Southern University, Statesboro, GA, USA
| | - Douglas W Powell
- Department of Exercise Science, University of Memphis, Memphis, TN, USA
| | - Rebecca J Reed-Jones
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE, Canada.
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Coubard OA. An Integrative Model for the Neural Mechanism of Eye Movement Desensitization and Reprocessing (EMDR). Front Behav Neurosci 2016; 10:52. [PMID: 27092064 PMCID: PMC4820440 DOI: 10.3389/fnbeh.2016.00052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 03/03/2016] [Indexed: 01/25/2023] Open
Abstract
Since the seminal report by Shapiro that bilateral stimulation induces cognitive and emotional changes, 26 years of basic and clinical research have examined the effects of Eye Movement Desensitization and Reprocessing (EMDR) in anxiety disorders, particularly in post-traumatic stress disorder (PTSD). The present article aims at better understanding EMDR neural mechanism. I first review procedural aspects of EMDR protocol and theoretical hypothesis about EMDR effects, and develop the reasons why the scientific community is still divided about EMDR. I then slide from psychology to physiology describing eye movements/emotion interaction from the physiological viewpoint, and introduce theoretical and technical tools used in movement research to re-examine EMDR neural mechanism. Using a recent physiological model for the neuropsychological architecture of motor and cognitive control, the Threshold Interval Modulation with Early Release-Rate of rIse Deviation with Early Release (TIMER-RIDER)-model, I explore how attentional control and bilateral stimulation may participate to EMDR effects. These effects may be obtained by two processes acting in parallel: (i) activity level enhancement of attentional control component; and (ii) bilateral stimulation in any sensorimotor modality, both resulting in lower inhibition enabling dysfunctional information to be processed and anxiety to be reduced. The TIMER-RIDER model offers quantitative predictions about EMDR effects for future research about its underlying physiological mechanisms.
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Nemanich ST, Earhart GM. Freezing of gait is associated with increased saccade latency and variability in Parkinson's disease. Clin Neurophysiol 2016; 127:2394-401. [PMID: 27178858 DOI: 10.1016/j.clinph.2016.03.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Freezing of gait (FOG) is a locomotor disturbance in Parkinson disease (PD) related to impaired motor automaticity. In this study, we investigated the impact of freezing on automaticity in the oculomotor system using an anti-saccade paradigm. METHODS Subjects with PD with (PD-FOG, n=13) and without (PD-NON, n=13) FOG, and healthy age-matched controls (CTRL, n=12) completed automatic pro-saccades and non-automatic anti-saccades. Primary outcomes were saccade latency, velocity, and gain. RESULTS PD-FOG (pro-saccade latency=271ms, anti-saccade latency=412ms) were slower to execute both types of saccades compared to PD-NON (253ms, 330ms) and CTRL (246ms, 327ms). Saccade velocity and gain variability was also increased in PD-FOG. CONCLUSIONS Saccade performance was affected in PD-FOG for both types of saccades, indicating differences in automaticity and control in the oculomotor system related to freezing. SIGNIFICANCE These results and others show that FOG impacts non-gait motor functions, suggesting global motor impairment in PD-FOG.
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Affiliation(s)
- Samuel T Nemanich
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave., Campus Box 8502, St. Louis, MO 63108, USA
| | - Gammon M Earhart
- Program in Physical Therapy, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave., Campus Box 8502, St. Louis, MO 63108, USA; Department of Neuroscience, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., Campus Box 8108, St. Louis, MO 63110, USA; Department of Neurology, Washington University School of Medicine in St. Louis, 660 S. Euclid Ave., Campus Box 8111, St. Louis, MO 63110, USA.
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Pieruccini-Faria F, Jones J, Almeida Q. Insight into dopamine-dependent planning deficits in Parkinson’s disease: A sharing of cognitive & sensory resources. Neuroscience 2016; 318:219-29. [DOI: 10.1016/j.neuroscience.2016.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/16/2015] [Accepted: 01/08/2016] [Indexed: 11/15/2022]
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Salvi C, Bowden EM. Looking for Creativity: Where Do We Look When We Look for New Ideas? Front Psychol 2016; 7:161. [PMID: 26913018 PMCID: PMC4753696 DOI: 10.3389/fpsyg.2016.00161] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 01/28/2016] [Indexed: 11/13/2022] Open
Abstract
Recent work using the eye movement monitoring technique has demonstrated that when people are engaged in thought they tend to disengage from the external world by blinking or fixating on an empty portion of the visual field, such as a blank wall, or out the window at the sky. This 'looking at nothing' behavior has been observed during thinking that does not explicitly involve visual imagery (mind wandering, insight in problem solving, memory encoding and search) and it is associated with reduced analysis of the external visual environment. Thus, it appears to indicate (and likely facilitate) a shift of attention from external to internal stimuli that benefits creativity and problem solving by reducing the cognitive load and enhancing attention to internally evolving activation. We briefly mention some possible reasons to collect eye movement data in future studies of creativity.
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Affiliation(s)
- Carola Salvi
- Department of Psychology, Northwestern UniversityEvanston, IL, USA; Rehabilitation Institute of ChicagoChicago, IL, USA
| | - Edward M Bowden
- Department of Psychology, University of Wisconsin-Parkside, Kenosha, WI USA
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Zhang J, Rittman T, Nombela C, Fois A, Coyle-Gilchrist I, Barker RA, Hughes LE, Rowe JB. Different decision deficits impair response inhibition in progressive supranuclear palsy and Parkinson's disease. Brain 2016; 139:161-73. [PMID: 26582559 PMCID: PMC4949391 DOI: 10.1093/brain/awv331] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 09/16/2015] [Accepted: 09/29/2015] [Indexed: 01/01/2023] Open
Abstract
Progressive supranuclear palsy and Parkinson's disease have distinct underlying neuropathology, but both diseases affect cognitive function in addition to causing a movement disorder. They impair response inhibition and may lead to impulsivity, which can occur even in the presence of profound akinesia and rigidity. The current study examined the mechanisms of cognitive impairments underlying disinhibition, using horizontal saccadic latencies that obviate the impact of limb slowness on executing response decisions. Nineteen patients with clinically diagnosed progressive supranuclear palsy (Richardson's syndrome), 24 patients with clinically diagnosed Parkinson's disease and 26 healthy control subjects completed a saccadic Go/No-Go task with a head-mounted infrared saccadometer. Participants were cued on each trial to make a pro-saccade to a horizontal target or withhold their responses. Both patient groups had impaired behavioural performance, with more commission errors than controls. Mean saccadic latencies were similar between all three groups. We analysed behavioural responses as a binary decision between Go and No-Go choices. By using Bayesian parameter estimation, we fitted a hierarchical drift-diffusion model to individual participants' single trial data. The model decomposes saccadic latencies into parameters for the decision process: decision boundary, drift rate of accumulation, decision bias, and non-decision time. In a leave-one-out three-way classification analysis, the model parameters provided better discrimination between patients and controls than raw behavioural measures. Furthermore, the model revealed disease-specific deficits in the Go/No-Go decision process. Both patient groups had slower drift rate of accumulation, and shorter non-decision time than controls. But patients with progressive supranuclear palsy were strongly biased towards a pro-saccade decision boundary compared to Parkinson's patients and controls. This indicates a prepotency of responding in combination with a reduction in further accumulation of evidence, which provides a parsimonious explanation for the apparently paradoxical combination of disinhibition and severe akinesia. The combination of the well-tolerated oculomotor paradigm and the sensitivity of the model-based analysis provides a valuable approach for interrogating decision-making processes in neurodegenerative disorders. The mechanistic differences underlying participants' poor performance were not observable from classical analysis of behavioural data, but were clearly revealed by modelling. These differences provide a rational basis on which to develop and assess new therapeutic strategies for cognition and behaviour in these disorders.
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Affiliation(s)
- Jiaxiang Zhang
- 1 School of Psychology, Cardiff University, Cardiff CF10 3AT, UK 2 Cognition and Brain Sciences Unit, Medical Research Council, Cambridge CB2 7EF, UK
| | - Timothy Rittman
- 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Cristina Nombela
- 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Alessandro Fois
- 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Ian Coyle-Gilchrist
- 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Roger A Barker
- 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK
| | - Laura E Hughes
- 2 Cognition and Brain Sciences Unit, Medical Research Council, Cambridge CB2 7EF, UK 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK
| | - James B Rowe
- 2 Cognition and Brain Sciences Unit, Medical Research Council, Cambridge CB2 7EF, UK 3 Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 2QQ, UK 4 Behavioural and Clinical Neuroscience Institute, Cambridge, CB2 3EB, UK
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Antisaccade errors reveal cognitive control deficits in Parkinson's disease with freezing of gait. J Neurol 2015; 262:2745-54. [PMID: 26464101 DOI: 10.1007/s00415-015-7910-5] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 09/02/2015] [Accepted: 09/14/2015] [Indexed: 10/23/2022]
Abstract
Freezing of gait is a poorly understood symptom of Parkinson's disease (PD) that is commonly accompanied by executive dysfunction. This study employed an antisaccade task to measure deficits in inhibitory control in patients with freezing, and to determine if these are associated with a specific pattern of grey matter loss using voxel-based morphometry. PD patients with (n = 15) and without (n = 11) freezing along with 10 age-matched controls were included. A simple prosaccade task was administered, followed by a second antisaccade task that required subjects to either look towards or away from a peripheral target. Behavioral results from the antisaccade task were entered as covariates in the voxel-based morphometry analysis. Patient and control groups performed equally well on the first task. However, patients with freezing were significantly worse on the second, which was driven by a specific impairment in suppressing their responses toward the target on the antisaccade trials. Impaired antisaccade performance was associated with grey matter loss across bilateral visual and fronto-parietal regions. These results suggest that patients with freezing have a significant deficit of inhibitory control that is associated with volume reductions in regions crucial for orchestrating both complex motor behaviors and cognitive control. These findings highlight the inter-relationship between freezing of gait and cognition and confirm that dysfunction along common neural pathways is likely to mediate the widespread cognitive dysfunction that emerges with this symptom.
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Buhmann C, Kraft S, Hinkelmann K, Krause S, Gerloff C, Zangemeister WH. Visual Attention and Saccadic Oculomotor Control in Parkinson's Disease. Eur Neurol 2015; 73:283-93. [PMID: 25925289 DOI: 10.1159/000381335] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 02/22/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND In patients with Parkinson's disease (PD) we aimed at differentiating the relation between selective visual attention, deficits of programming and dynamics of saccadic eye movements while searching for a target and hand-reaction time as well as hand-movement time. Visual attention is crucial for concentrating selectively on one aspect of the visual field while ignoring other aspects. Eye movements are anatomically and functionally related to mechanisms of visual attention. Saccadic dysfunction might confound selective visual attention in PD. METHODS We studied visual selective attention in 22 medicated PD patients (clinical ON status, mild to moderate disease severity) and 22 age matched controls. We looked for possible interferences through oculomotor deficits. Two tasks were compared: free viewing of photographs and time optimal visual search of a hidden target. Visual search times (VST), task related dynamics of saccades, and hand-reaction and hand-movement times were analyzed. RESULTS In the free viewing task mild to moderately affected PD patients did not differ statistically from healthy subjects with respect to saccade dynamics. However, patients differed significantly from healthy subjects in the time optimal visual search task with 25% lower rates of successful searches. Hand movement reaction time did not differ in both groups, whereas hand movement execution time was significantly prolonged in PD patients. CONCLUSION Saccadic oculomotor control and hand movement reaction times were intact, whereas in our less severely affected treated PD patients, visual selective attention was not. The highly reduced successful search rate might be related to disturbed programming and delayed execution of saccades during time optimal visual search due to decreased execution of serial-order sequential generation of saccades.
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Affiliation(s)
- Carsten Buhmann
- Department of Neurology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
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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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Ernst F, Rauchenzauner M, Zoller H, Griesmacher A, Hammerer-Lercher A, Carpenter R, Schuessler G, Joannidis M. Effects of 24 h working on-call on psychoneuroendocrine and oculomotor function: a randomized cross-over trial. Psychoneuroendocrinology 2014; 47:221-31. [PMID: 24955858 DOI: 10.1016/j.psyneuen.2014.05.019] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 04/16/2014] [Accepted: 05/24/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES On-call duty (OCD) is frequently associated with health and safety risks for both physicians and patients. The lack of studies conducted in clinical care environments and the ongoing public dialogue concerning OCD led to a detailed investigation of a working schedule including sleep fragmentation and extended work hours. DESIGN Within-person randomized cross-over trial. SETTING Comparison of a 24h on-call shift (OCD) compared to a routine working-day (non on call, NOC) in hospital. PARTICIPANTS 30 residents and senior physicians of the Department of Internal Medicine, Neurology and Otorhinolaryngology at the University Hospital Innsbruck. MAIN OUTCOME MEASURES Sleep variables, cognitive performance (Concentration-Endurance d2 test), emotional status (Eigenschaftswoerterliste 60S), serum-cortisol, urinary cortisol and noradrenaline, heart-rate variability, and saccadic eye movements were determined before and after OCD and NOC respectively. RESULTS Concentration-endurance performance was significantly reduced after OCD as compared to NOC by 16.4% (p<0.001). Changes in emotional status consisted in a reduction of subjective concentration and performance related activation after OCD by 17.4% (p<0.001) and 16.0% (p<0.001) respectively together with a 21.8% increase of general deactivation (p<0.001) and a 29.2% rise of fatigue (p<0.001). On the contrary, subjective activation and raised mood showed an 18.3% and 21.7% increase after OCD (p<0.01). Urinary noradrenaline excretion (46 μg/24 h, 19-97) was greater during OCD when compared to NOC (36 μg/24 h, 10-54, p<0.01). Sympathetic activity measured by heart rate variability was significantly higher during OCD in contrast to NOC (p<0.05). Serum-cortisol was lower in the morning after (132 ng/l, 60-273) than the morning before OCD (p<0.01). Finally, the number of short saccadic latencies was reduced after OCD (p<0.05) compared to NOC. CONCLUSIONS 24 h OCD alters both, the sympathetic-adrenomedullary system as well as the hypothalamic pituitary-adrenocortical axis. Moreover, physicians' emotional state, cognitive and oculomotor performance seems to be influenced independently from sleep interruptions. The discrepancy between subjective feeling and objective cognitive impairments pose a risk for performing complex manual and cognitive tasks. Hence, our findings argue against an oversimplified interpretation of alterations in the physicians' psychoneuroendocrine structure in terms of impaired mood and neurocognitive deterioration combined with up-/dysregulated stress axes associated with OCD as a consequence of sleep deprivation.
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Affiliation(s)
- Florian Ernst
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria; Department of Neurology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Markus Rauchenzauner
- Department of Pediatrics, Saint Vincent Hospital Zams, Zams, Austria; Department of Pediatrics IV, Medical University Innsbruck, Innsbruck, Austria
| | - Heinz Zoller
- Department of Gastroenterology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andrea Griesmacher
- Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - Angelika Hammerer-Lercher
- Institute of Medical and Chemical Laboratory Diagnostics (ZIMCL), University Hospital Innsbruck, Innsbruck, Austria
| | - Roger Carpenter
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Gerhard Schuessler
- Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Joannidis
- Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria.
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Busettini C, Frölich MA. Effects of mild to moderate sedation on saccadic eye movements. Behav Brain Res 2014; 272:286-302. [PMID: 25026096 DOI: 10.1016/j.bbr.2014.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/02/2014] [Accepted: 07/07/2014] [Indexed: 10/25/2022]
Abstract
Sedatives alter the metrics of saccadic eye movements. If these effects are nonspecific consequences of sedation, like drowsiness and loss of attention to the task, or differ between sedatives is still unresolved. A placebo-controlled multi-step infusion of one of three sedatives, propofol or midazolam, both GABA-A agonists, or dexmedetedomidine, an α2-adrenergic agonist, was adopted to compare the effects of these three drugs in exactly the same experimental conditions. 60 healthy human volunteers, randomly divided in 4 groups, participated in the study. Each infusion step, delivered by a computer-controlled infusion pump, lasted 20min. During the last 10min of each step, the subject executed a saccadic task. Target concentration was doubled at each step. This block was repeated until the subject was too sedated to continue or for a maximum of 6 blocks. Subjects were unaware which infusion they were receiving. A video eye tracker was used to record the movements of the right eye. Saccadic parameters were modeled as a function of block number, estimated sedative plasma concentration, and subjective evaluation of sedation. Propofol and midazolam had strong effects on the dynamics and latency of the saccades. Midazolam, and to a less extent, propofol, caused saccades to become increasingly hypometric. Dexmedetedomidine had less impact on saccadic metrics and presented no changes in saccadic gain. Suppression of the sympathetic system associated with dexmedetomidine has different effects on eye movements from the increased activity of the inhibitory GABA-A receptors by propofol and midazolam even when the subjects reported similar sedation level.
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Affiliation(s)
- C Busettini
- Department of Vision Sciences and Vision Science Research Center, University of Alabama at Birmingham, Birmingham, AL 35294-4390, USA.
| | - M A Frölich
- Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, AL 35294-6810, USA
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Leventhal DK, Stoetzner C, Abraham R, Pettibone J, DeMarco K, Berke JD. Dissociable effects of dopamine on learning and performance within sensorimotor striatum. ACTA ACUST UNITED AC 2014; 4:43-54. [PMID: 24949283 DOI: 10.1016/j.baga.2013.11.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Striatal dopamine is an important modulator of current behavior, as seen in the rapid and dramatic effects of dopamine replacement therapy in Parkinson Disease (PD). Yet there is also extensive evidence that dopamine acts as a learning signal, modulating synaptic plasticity within striatum to affect future behavior. Disentangling these "performance" and "learning" functions is important for designing effective, long-term PD treatments. We conducted a series of unilateral drug manipulations and dopamine terminal lesions in the dorsolateral striatum of rats highly-trained to perform brief instructed head/neck movements (two-alternative forced choice task). Reaction times and accuracy were measured longitudinally to determine if task behavior changed immediately, progressed over time, and/or persisted after drug withdrawal. Enhanced dopamine signaling with amphetamine caused an immediate, nonprogressive, and bilateral decrease in reaction times (RT). The altered RT distributions were consistent with reduced distance to threshold in the linear approach to threshold with ergodic rate (LATER) model of decision-making. Conversely, the dopamine antagonist flupenthixol caused experience-dependent, persistent changes in RT and accuracy indicative of a "learning" effect. These RT distributions were consistent with a slowed rate of approach to decision threshold. Our results show that dopaminergic signaling makes dissociable contributions to current and future behavior even within a single striatal subregion, and provide important clues for both models of normal decision-making and the design of novel drug therapies in PD.
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Affiliation(s)
- Daniel K Leventhal
- Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109 ; Movement Disorders Program, University of Michigan, Ann Arbor, Michigan 48109 ; Neuroscience Program, University of Michigan, Ann Arbor, Michigan 48109
| | - Colin Stoetzner
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Rohit Abraham
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Jeff Pettibone
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Kayla DeMarco
- Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
| | - Joshua D Berke
- Movement Disorders Program, University of Michigan, Ann Arbor, Michigan 48109 ; Neuroscience Program, University of Michigan, Ann Arbor, Michigan 48109 ; Department of Psychology, University of Michigan, Ann Arbor, Michigan 48109
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A longitudinal study of motor, oculomotor and cognitive function in progressive supranuclear palsy. PLoS One 2013; 8:e74486. [PMID: 24058574 PMCID: PMC3769232 DOI: 10.1371/journal.pone.0074486] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 08/02/2013] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVE We studied the annual change in measures of motor, oculomotor and cognitive function in progressive supranuclear palsy. This had twin objectives, to assess the potential for clinical parameters to monitor disease progression in clinical trials and to illuminate the progression of pathophysiology. METHODS Twenty three patients with progressive supranuclear palsy (Richardson's syndrome) were compared to 22 matched controls at baseline and 16 of these patients compared at baseline and one year using: the progressive supranuclear palsy rating scale; the unified Parkinson's disease rating scale; the revised Addenbrooke's cognitive examination; the frontal assessment battery; the cubes section of the visual object and space perception battery; the Hayling and Brixton executive tests; and saccadic latencies. RESULTS Patients were significantly impaired in all domains at baseline. However, cognitive performance was maintained over a year on the majority of tests. The unified Parkinson's disease rating scale, saccadic latency and progressive supranuclear palsy rating scale deteriorated over a year, with the latter showing the largest change. Power estimates indicate that using the progressive supranuclear palsy rating scale as an outcome measure in a clinical trial would require 45 patients per arm, to identify a 50% reduction in rate of decline with 80% power. CONCLUSIONS Motor, oculomotor and cognitive domains deteriorate at different rates in progressive supranuclear palsy. This may be due to differential degeneration of their respective cortical-subcortical circuits, and has major implications for the selection of outcome measures in clinical trials due to wide variation in sensitivity to annual rates of decline.
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Parkinson's disease, L-Dopa and "express" saccades: superior colliculus dyskinesias? Clin Neurophysiol 2013; 125:647-8. [PMID: 24001969 DOI: 10.1016/j.clinph.2013.06.188] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 06/07/2013] [Accepted: 06/12/2013] [Indexed: 11/21/2022]
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Terao Y, Fukuda H, Ugawa Y, Hikosaka O. New perspectives on the pathophysiology of Parkinson’s disease as assessed by saccade performance: A clinical review. Clin Neurophysiol 2013; 124:1491-506. [DOI: 10.1016/j.clinph.2013.01.021] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 01/01/2013] [Accepted: 01/15/2013] [Indexed: 10/27/2022]
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Velázquez-Pérez L, Rodríguez-Labrada R, Álvarez-González L, Aguilera-Rodríguez R, Álvarez Sánchez M, Canales-Ochoa N, Galicia Polo L, Haro-Valencia R, Medrano-Montero J, Vázquez-Mojena Y, Peña-Acosta A, Estupiñán-Rodríguez A, Rodríguez Pupo N. Lisuride reduces involuntary periodic leg movements in spinocerebellar ataxia type 2 patients. THE CEREBELLUM 2013; 11:1051-6. [PMID: 22477456 DOI: 10.1007/s12311-012-0382-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Periodic leg movements (PLMs) are a common sleep disorder in spinocerebellar ataxia type 2 (SCA2) being associated to higher disease severity and altered sleep patterns. To assess the efficacy and safety of lisuride for the treatment of PLMs in SCA2 patients, an open-label clinical trial was conducted in 12 SCA2 patients suffering from PLMs associated to other subjective sleep complaints. All subjects received 0.1 mg of oral lisuride daily for 4 weeks. Primary outcome measure was the change of PLMs index. Changes in the subjective sleep quality, other polysomnographical sleep parameters, Scale for the Assessment and Rating of Ataxia score, and saccadic velocity were assessed as secondary outcome parameters. Safety assessments included hemoglobin, hematocrit, cholesterol, creatinine, and TGP. A significant decrease in both the PLMs index and R stage latency were observed during the treatment, associated to subjective improvement of frequent awakenings, early insomnia, restless leg syndrome, and nocturnal limb paresthesias in most cases. Ataxia score and saccadic pathology were unchanged. No significantly adverse events were observed. Our study suggests the efficacy of dopamine agonist therapy in the treatment of PLMs in SCA2, improving various subjective sleep complaints. These findings serve to promote the adequate management of sleep-related disorders in SCA2, which could improve the life quality of the patients.
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Affiliation(s)
- Luis Velázquez-Pérez
- Centre for the Research and Rehabilitation of Hereditary Ataxias, Carretera Central Km 5 1/2 Reparto Edecio Pérez, 80100, Holguín, Cuba.
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Archibald NK, Hutton SB, Clarke MP, Mosimann UP, Burn DJ. Visual exploration in Parkinson's disease and Parkinson's disease dementia. Brain 2013; 136:739-50. [PMID: 23436502 DOI: 10.1093/brain/awt005] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Parkinson's disease, typically thought of as a movement disorder, is increasingly recognized as causing cognitive impairment and dementia. Eye movement abnormalities are also described, including impairment of rapid eye movements (saccades) and the fixations interspersed between them. Such movements are under the influence of cortical and subcortical networks commonly targeted by the neurodegeneration seen in Parkinson's disease and, as such, may provide a marker for cognitive decline. This study examined the error rates and visual exploration strategies of subjects with Parkinson's disease, with and without cognitive impairment, whilst performing a battery of visuo-cognitive tasks. Error rates were significantly higher in those Parkinson's disease groups with either mild cognitive impairment (P = 0.001) or dementia (P < 0.001), than in cognitively normal subjects with Parkinson's disease. When compared with cognitively normal subjects with Parkinson's disease, exploration strategy, as measured by a number of eye tracking variables, was least efficient in the dementia group but was also affected in those subjects with Parkinson's disease with mild cognitive impairment. When compared with control subjects and cognitively normal subjects with Parkinson's disease, saccade amplitudes were significantly reduced in the groups with mild cognitive impairment or dementia. Fixation duration was longer in all Parkinson's disease groups compared with healthy control subjects but was longest for cognitively impaired Parkinson's disease groups. The strongest predictor of average fixation duration was disease severity. Analysing only data from the most complex task, with the highest error rates, both cognitive impairment and disease severity contributed to a predictive model for fixation duration [F(2,76) = 12.52, P ≤ 0.001], but medication dose did not (r = 0.18, n = 78, P = 0.098, not significant). This study highlights the potential use of exploration strategy measures as a marker of cognitive decline in Parkinson's disease and reveals the efficiency by which fixations and saccades are deployed in the build-up to a cognitive response, rather than merely focusing on the outcome itself. The prolongation of fixation duration, present to a small but significant degree even in cognitively normal subjects with Parkinson's disease, suggests a disease-specific impact on the networks directing visual exploration, although the study also highlights the multi-factorial nature of changes in exploration and the significant impact of cognitive decline on efficiency of visual search.
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Affiliation(s)
- Neil K Archibald
- Consultant Neurologist, The James Cook University Hospital, Middlesbrough, TS4 3BW, UK.
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Fridley J, Adams G, Sun P, York M, Atassi F, Lai E, Simpson R, Viswanathan A, Yoshor D. Effect of Subthalamic Nucleus or Globus Pallidus Interna Stimulation on Oculomotor Function in Patients with Parkinsons Disease. Stereotact Funct Neurosurg 2013; 91:113-21. [DOI: 10.1159/000343200] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 09/01/2012] [Indexed: 11/19/2022]
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Kanjee R, Yücel YH, Steinbach MJ, González EG, Gupta N. Delayed saccadic eye movements in glaucoma. Eye Brain 2012; 4:63-68. [PMID: 28539782 DOI: 10.2147/eb.s38467] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To determine whether saccadic eye movements are altered in glaucoma patients. PATIENTS AND METHODS Sixteen patients with glaucoma and 21 control subjects were prospectively studied. Patients participated in a pro-saccade step task. Saccades were recorded using a noninvasive infrared oculometric device with head-mounted target projection. Medians of saccade reaction time, duration, amplitude, and peak velocity; frequency of express saccades; and percentage of trials with direction error were recorded. t-tests were used to compare the glaucoma and age-matched control groups. A correlation analysis of saccade parameters with visual field loss was also performed. RESULTS Median saccade reaction times were significantly prolonged in glaucoma patients compared with controls (220.9 ± 49.02 ms vs 192.1 ± 31.24 ms; t-test: P = 0.036). Median duration, median amplitude, and median peak velocity of saccades did not show significant differences between glaucoma and control groups (P > 0.05). Frequency of express saccades was significantly decreased in glaucoma patients compared with controls (1.75 ± 2.32 vs 7.0 ± 6.99; t-test: P = 0.007). Saccade parameters in glaucoma patients showed no significant correlation with visual field loss. CONCLUSION Saccadic eye movements are significantly delayed in patients with early, moderate, or advanced glaucoma. Determination of median saccade reaction time may offer a novel functional test to quantify visual function in glaucoma patients. Further studies are needed to determine pathological processes implicated in delayed initiation of saccades, and to assess whether alteration of saccades affects daily activities in glaucoma patients.
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Affiliation(s)
- Raageen Kanjee
- Ophthalmology and Vision Sciences, Laboratory Medicine and Pathobiology, St Michael's Hospital, University of Toronto
| | - Yeni H Yücel
- Ophthalmology and Vision Sciences, Laboratory Medicine and Pathobiology, St Michael's Hospital, University of Toronto.,Keenan Research Centre at the Li Ka Shing Knowledge Institute of St Michael's Hospital
| | - Martin J Steinbach
- Toronto Western Hospital, University Health Network.,Centre for Vision Research, York University
| | - Esther G González
- Toronto Western Hospital, University Health Network.,Centre for Vision Research, York University
| | - Neeru Gupta
- Ophthalmology and Vision Sciences, Laboratory Medicine and Pathobiology, St Michael's Hospital, University of Toronto.,Keenan Research Centre at the Li Ka Shing Knowledge Institute of St Michael's Hospital.,Glaucoma and Nerve Protection Unit, St Michael's Hospital, Toronto, ON, Canada
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