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Tokushige SI, Matsumoto H, Matsuda SI, Inomata-Terada S, Kotsuki N, Hamada M, Tsuji S, Ugawa Y, Terao Y. Early detection of cognitive decline in Alzheimer's disease using eye tracking. Front Aging Neurosci 2023; 15:1123456. [PMID: 37025964 PMCID: PMC10070704 DOI: 10.3389/fnagi.2023.1123456] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/06/2023] [Indexed: 04/08/2023] Open
Abstract
Background Patients with Alzheimer's disease (AD) are known to exhibit visuospatial processing impairment, as reflected in eye movements from the early stages of the disease. We investigated whether the pattern of gaze exploration during visual tasks could be useful for detecting cognitive decline at the earliest stage. Methods Sixteen AD patients (age: 79.1 ± 7.9 years, Mini Mental State Examination [MMSE] score: 17.7 ± 5.3, mean ± standard deviation) and 16 control subjects (age: 79.4 ± 4.6, MMSE score: 26.9 ± 2.4) participated. In the visual memory task, subjects memorized presented line drawings for later recall. In the visual search tasks, they searched for a target Landolt ring of specific orientation (serial search task) or color (pop-out task) embedded among arrays of distractors. Using video-oculography, saccade parameters, patterns of gaze exploration, and pupil size change during task performance were recorded and compared between AD and control subjects. Results In the visual memory task, the number of informative regions of interest (ROIs) fixated was significantly reduced in AD patients compared to control subjects. In the visual search task, AD patients took a significantly longer time and more saccades to detect the target in the serial but not in pop-out search. In both tasks, there was no significant difference in the saccade frequency and amplitude between groups. On-task pupil modulation during the serial search task was decreased in AD. The number of ROIs fixated in the visual memory task and search time and saccade numbers in the serial search task differentiated both groups of subjects with high sensitivity, whereas saccade parameters of pupil size modulation were effective in confirming normal cognition from cognitive decline with high specificity. Discussion Reduced fixation on informative ROIs reflected impaired attentional allocation. Increased search time and saccade numbers in the visual search task indicated inefficient visual processing. Decreased on-task pupil size during visual search suggested decreased pupil modulation with cognitive load in AD patients, reflecting impaired function of the locus coeruleus. When patients perform the combination of these tasks to visualize multiple aspects of visuospatial processing, cognitive decline can be detected at an early stage with high sensitivity and specificity and its progression be evaluated.
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Affiliation(s)
- Shin-ichi Tokushige
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Neurology, Kyorin University, Tokyo, Japan
| | | | | | | | - Naoki Kotsuki
- Department of Neurology, Kyorin University, Tokyo, Japan
| | - Masashi Hamada
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Shoji Tsuji
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Institute of Medical Genomics, International University of Health and Welfare, Chiba, Japan
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | - Yasuo Terao
- Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Department of Medical Physiology, Kyorin University, Tokyo, Japan
- *Correspondence: Yasuo Terao,
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2
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Gotardi GC, Barbieri FA, Simão RO, Pereira VA, Baptista AM, Imaizumi LF, Moretto G, Navarro M, Polastri PF, Rodrigues ST. Parkinson's disease affects gaze behaviour and performance of drivers. ERGONOMICS 2022; 65:1302-1311. [PMID: 35023450 DOI: 10.1080/00140139.2022.2028901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 01/07/2022] [Indexed: 06/14/2023]
Abstract
The aim of this study was to investigate the effects of PD and ageing on gaze behaviour and performance of drivers in a simulated task. Ten drivers with PD, ten neurologically healthy older drivers, and ten neurologically healthy younger adult drivers were asked to drive in a car simulator for three minutes, maintaining car speed between 100 and 120 km/h and avoiding collisions. Driver's eye movements were recorded. Drivers with PD had more collisions and spent less time driving within the speed zone than the younger-drivers. Drivers with PD performed an increased number of fixations towards task-irrelevant areas of the visual scene and higher visual entropy, indicating a more random gaze behaviour. Older drivers restricted their visual search to the lane area in order to detect threat-related stimuli. PD led to drops in performance of drivers in the car simulator. Practitioner summary: Parkinson's disease (PD) and ageing process caused a drop in driving performance. Drivers with PD made fewer fixations on task-relevant information and showed higher visual entropy than young adults. Older drivers restricted their visual search to the lane than other areas of interest.
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Affiliation(s)
- Gisele C Gotardi
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Information, Vision and Action, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Fabio A Barbieri
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Human Movement Research, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Rafael O Simão
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Information, Vision and Action, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Vinicius A Pereira
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Human Movement Research, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - André M Baptista
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Human Movement Research, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Luiz F Imaizumi
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Human Movement Research, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Gabriel Moretto
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Human Movement Research, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Martina Navarro
- Department of Sport and Exercise Science, Faculty of Science, University of Portsmouth, Portsmouth, United Kingdom
| | - Paula F Polastri
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Information, Vision and Action, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
| | - Sérgio T Rodrigues
- Graduate Program in Human Movement Science, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
- Laboratory of Information, Vision and Action, Department of Physical Education, Faculty of Sciences, São Paulo State University, Bauru, Brazil
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3
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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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4
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Lian N, Lv H, Guo W, Shen Y, Wu R, Liu Y, Zhu F, Hu M, Ou J, Zhao J. A comparative study of magnetic resonance imaging on the gray matter and resting-state function in prodromal and first-episode schizophrenia. Am J Med Genet B Neuropsychiatr Genet 2018; 177:537-545. [PMID: 30105860 DOI: 10.1002/ajmg.b.32644] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 12/06/2017] [Accepted: 04/16/2018] [Indexed: 12/11/2022]
Abstract
It is very difficult to predict the future development possibility of schizophrenia through the clinical symptoms of the high-risk cases. Therefore, how to determine the possibility of developing into schizophrenia individuals before the onset of the diseases are particularly important. The study investigated cerebral gray matter volume differences and resting-state functional connections among patients with psychosis risk syndrome (PRS), patients with first-episode schizophrenic (FES), and healthy controls (HC), aiming to provide scientific clinical evidence for schizophrenia early identification and intervention. A total of 19 PRS patients, 18 FES patients, and 29 HC were recruited. Gray matter volume and amplitude of low-frequency fluctuation (fALFF) during resting-state functional studies were measured. Comparison of gray matter volumes showed that PRS and FES groups had common reduced gray matter volume in the right caudate. PRS and FES patients showed altered connectivity mainly in the semantic processing-related brain areas. fALFF analysis found that PRF and FES patients had significant differences in fALFF values of the brain region mainly located in the subcortical network, visual recognition network, and auditory network. In addition, PRF individuals had a higher fALFF value and a lower fALFF value in the anterior wedge of the cerebral network than the HC group. Gray matter volume loss between related brain areas might appear prior to illness onset. Similar fALFF values occurred in PRS and FES groups indicated that multiple brain regions of neuronal activity abnormalities and unconventional neural network mechanism have been existed in PRS patients.
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Affiliation(s)
- Nan Lian
- Department of Psychiatry, First Affiliated Hospital, Zhengzhou University, Zhengzhou, China.,Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hailong Lv
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Wenbing Guo
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Yidong Shen
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Renlong Wu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Yong Liu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Furong Zhu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Maorong Hu
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Jianjun Ou
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
| | - Jingping Zhao
- Institute of Mental Health, The Second Xiangya Hospital, Central South University, Changsha, China.,The National Clinical Research Center for Mental Health Disorders, Changsha, China.,The National Technology Institute of Psychiatry, Changsha, China.,Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, China
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5
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Stuart S, Galna B, Delicato LS, Lord S, Rochester L. Direct and indirect effects of attention and visual function on gait impairment in Parkinson's disease: influence of task and turning. Eur J Neurosci 2017; 46:1703-1716. [PMID: 28444834 DOI: 10.1111/ejn.13589] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 04/11/2017] [Accepted: 04/12/2017] [Indexed: 12/26/2022]
Abstract
Gait impairment is a core feature of Parkinson's disease (PD) which has been linked to cognitive and visual deficits, but interactions between these features are poorly understood. Monitoring saccades allows investigation of real-time cognitive and visual processes and their impact on gait when walking. This study explored: (i) saccade frequency when walking under different attentional manipulations of turning and dual-task; and (ii) direct and indirect relationships between saccades, gait impairment, vision and attention. Saccade frequency (number of fast eye movements per-second) was measured during gait in 60 PD and 40 age-matched control participants using a mobile eye-tracker. Saccade frequency was significantly reduced in PD compared to controls during all conditions. However, saccade frequency increased with a turn and decreased under dual-task for both groups. Poorer attention directly related to saccade frequency, visual function and gait impairment in PD, but not controls. Saccade frequency did not directly relate to gait in PD, but did in controls. Instead, saccade frequency and visual function deficit indirectly impacted gait impairment in PD, which was underpinned by their relationship with attention. In conclusion, our results suggest a vital role for attention with direct and indirect influences on gait impairment in PD. Attention directly impacted saccade frequency, visual function and gait impairment in PD, with connotations for falls. It also underpinned indirect impact of visual and saccadic impairment on gait. Attention therefore represents a key therapeutic target that should be considered in future research.
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Affiliation(s)
- Samuel Stuart
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.,Newcastle upon Tyne Hospitals NHS foundation trust, Newcastle upon Tyne, UK
| | - Brook Galna
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Louise S Delicato
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.,School of Psychology, University of Sunderland, Sunderland, UK
| | - Sue Lord
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK
| | - Lynn Rochester
- Clinical Ageing Research Unit, Institute of Neuroscience, Newcastle University Institute of Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, NE4 5PL, UK.,Newcastle upon Tyne Hospitals NHS foundation trust, Newcastle upon Tyne, UK
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6
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Matsumoto H. A neurophysiological examination of basal ganglia and cerebellum. Clin Neurophysiol 2016; 127:1007-1008. [DOI: 10.1016/j.clinph.2015.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 08/05/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
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7
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Stuart S, Lord S, Hill E, Rochester L. Gait in Parkinson's disease: A visuo-cognitive challenge. Neurosci Biobehav Rev 2016; 62:76-88. [PMID: 26773722 DOI: 10.1016/j.neubiorev.2016.01.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 12/15/2015] [Accepted: 01/05/2016] [Indexed: 12/18/2022]
Abstract
Vision and cognition have both been related to gait impairment in Parkinson's disease (PD) through separate strands of research. The cumulative and interactive effect of both (which we term visuo-cognition) has not been previously investigated and little is known about the influence of cognition on vision with respect to gait. Understanding the role of vision, cognition and visuo-cognition in gait in PD is critical for data interpretation and to infer and test underlying mechanisms. The purpose of this comprehensive narrative review was to examine the interdependent and interactive role of cognition and vision in gait in PD and older adults. Evidence from a broad range of research disciplines was reviewed and summarised. A key finding was that attention appears to play a pivotal role in mediating gait, cognition and vision, and should be considered emphatically in future research in this field.
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Affiliation(s)
- Samuel Stuart
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Sue Lord
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Elizabeth Hill
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Lynn Rochester
- Institute of Neuroscience/Newcastle University Institute of Ageing, Clinical Ageing Research Unit, Campus for Ageing and Vitality Newcastle University, Newcastle upon Tyne, United Kingdom.
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8
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Matsuda S, Matsumoto H, Furubayashi T, Fukuda H, Hanajima R, Tsuji S, Ugawa Y, Terao Y. Visual Scanning Area is Abnormally Enlarged in Hereditary Pure Cerebellar Ataxia. THE CEREBELLUM 2014; 14:63-71. [PMID: 25231433 DOI: 10.1007/s12311-014-0600-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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9
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Evaluating the influence of motor control on selective attention through a stochastic model: the paradigm of motor control dysfunction in cerebellar patient. BIOMED RESEARCH INTERNATIONAL 2014; 2014:162423. [PMID: 24672782 PMCID: PMC3932822 DOI: 10.1155/2014/162423] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 11/03/2013] [Accepted: 11/07/2013] [Indexed: 11/17/2022]
Abstract
Attention allows us to selectively process the vast amount of information with which we are confronted, prioritizing some aspects of information and ignoring others by focusing on a certain location or aspect of the visual scene. Selective attention is guided by two cognitive mechanisms: saliency of the image (bottom up) and endogenous mechanisms (top down). These two mechanisms interact to direct attention and plan eye movements; then, the movement profile is sent to the motor system, which must constantly update the command needed to produce the desired eye movement. A new approach is described here to study how the eye motor control could influence this selection mechanism in clinical behavior: two groups of patients (SCA2 and late onset cerebellar ataxia LOCA) with well-known problems of motor control were studied; patients performed a cognitively demanding task; the results were compared to a stochastic model based on Monte Carlo simulations and a group of healthy subjects. The analytical procedure evaluated some energy functions for understanding the process. The implemented model suggested that patients performed an optimal visual search, reducing intrinsic noise sources. Our findings theorize a strict correlation between the "optimal motor system" and the "optimal stimulus encoders."
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Stuart S, Alcock L, Galna B, Lord S, Rochester L. The measurement of visual sampling during real-world activity in Parkinson's disease and healthy controls: a structured literature review. J Neurosci Methods 2013; 222:175-88. [PMID: 24291711 DOI: 10.1016/j.jneumeth.2013.11.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/18/2013] [Accepted: 11/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Visual sampling techniques are used to investigate the complex role of vision during real-world activities in Parkinson's disease. Earlier research is limited to static simple tasks or measurement of eye movements alone, but more recent investigations involve more real-world activities. The approach to the objective measurement of eye movements varies with respect to instrumentation, testing protocols, and mediating factors that may influence visual sampling. OBJECTIVES The aim of this review was to examine previous work measuring visual sampling during real-world activities in Parkinson's disease to inform the development of robust protocols. Within this review a real-world activity was considered to be a goal-orientated motor task involving more than one body segment such as reaching or walking. METHODS Medline, Embase, PsychInfo, Scopus, Web of Knowledge, PubMed and the Cochrane library databases were searched. Two independent reviewers and an adjudicator screened articles that described quantitative visual sampling in people with Parkinson's disease and healthy controls. RESULTS Twenty full-text articles were screened and 15 met inclusion/exclusion criteria. A wide range of instruments and outcome measures were reported which were generally used in a task-dependent manner. Instrument reliability and validity was insufficiently reported in all studies. Few studies considered mediators of visual sampling such as visual or cognitive deficits. CONCLUSIONS Future research is required to accurately characterise visual impairments in Parkinson's disease and during real-world activities. Composite use of instruments may be required to achieve reliability and validity of visual sampling outcomes which need to be standardised. Recommendations also include assessment of cognition and basic visual function.
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Affiliation(s)
- Samuel Stuart
- Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - Lisa Alcock
- Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - Brook Galna
- Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - Sue Lord
- Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom
| | - Lynn Rochester
- Institute for Ageing and Health, Clinical Ageing Research Unit, Newcastle University, United Kingdom.
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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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12
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Matsumoto H, Terao Y, Ugawa Y. Ocular paradoxical movement and severity of Parkinson’s disease. Brain 2013; 136:e250. [DOI: 10.1093/brain/awt124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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