Metric issues in the study of eye movements in psychiatry

Evidence for an Association Between a pH-Dependent Potassium Channel, TWIK-1, and the Accuracy of Smooth Pursuit Eye Movements

Purpose

Within the healthy population there is a large variation in the ability to perform smooth pursuit eye movements. Our purpose was to investigate the genetic and physiological bases for this variation.

Methods

We carried out a whole-genome association study, recording smooth pursuit movements for 1040 healthy volunteers by infrared oculography. The primary phenotypic measure was root mean square error (RMSE) of eye position relative to target position. Secondary measures were pursuit gain, frequency of catch-up saccades, and frequency of anticipatory saccades. Ten percent of participants, chosen randomly, were tested twice, giving estimates of test-retest reliability.

Results

No significant association was found with three genes previously identified as candidate genes for variation in smooth pursuit: DRD3, COMT, NRG1. A strong association (P = 3.55 × 10-11) was found between RMSE and chromosomal region 1q42.2. The most strongly associated marker (rs701232) lies in an intron of KCNK1, which encodes a two-pore-domain potassium ion channel TWIK-1 (or K2P1) that affects cell excitability. Each additional copy of the A allele decreased RMSE by 0.29 standard deviation. When a psychophysical test of visually perceived motion was used as a covariate in the regression analysis, the association with rs701232 did not weaken (P = 5.38 × 10-12).

Conclusions

Variation in the sequence or the expression of the pH-dependent ion channel TWIK-1 is a likely source of variance in smooth pursuit. The variance associated with TWIK-1 appears not to arise from sensory mechanisms, because the use of a perceptual covariate left the association intact.

[Effects of postural control upon anti-saccade error rate in older people]

BACKGROUND

The anti-saccadic (AS) error-rate is used to diagnose neurological disorders. The natural aging process could generate difficulty in carrying out parallel neural processes of conscious motor inhibition and eye movement. Therefore, if balance control is imposed on an elderly person in biped positions during an AS movement, an increase in the AS error-rate is expected.

OBJECTIVE

To study the effects of postural control on the AS error-rate in older people.

METHODS

An intra and intergroup comparison was made of AS error-rate in an experimental group of older people (PM) and another control group of young people (PJ). For this, blocks of AS and pro-saccadic movements (control) were used randomly in four different postures: (1)sitting (SENT), (2)standing normally (NORMAL), (3)feet together (REDUC), and (4)feet in line (TANDEM).

RESULTS

The PM group, compared to the PJ group, showed a progressive increase in the AS error-rate from the sitting position to all standing positions, with the maximum AS error-rate in more complex vertical postures. In contrast, the PJ group did not present significative variability of this AS error-rate in all positions.

CONCLUSIONS

It is confirmed that the aging process is associated with an increase in the AS error-rate. This study reveals for the first time a significant increase in the AS error-rate when control of body balance is required for PM, implying a decrease in the multiple processing capacity in PM for the execution of complex and parallel tasks.

Neural mechanisms of background and velocity effects in smooth pursuit eye movements

Smooth pursuit eye movements (SPEM) are essential to guide behaviour in complex visual environments. SPEM accuracy is known to be degraded by the presence of a structured visual background and at higher target velocities. The aim of this preregistered study was to investigate the neural mechanisms of these robust behavioural effects. N = 33 participants performed a SPEM task with two background conditions (present and absent) at two target velocities (0.4 and 0.6 Hz). Eye movement and BOLD data were collected simultaneously. Both the presence of a structured background and faster target velocity decreased pursuit gain and increased catch-up saccade rate. Faster targets additionally increased position error. Higher BOLD response with background was found in extensive clusters in visual, parietal, and frontal areas (including the medial frontal eye fields; FEF) partially overlapping with the known SPEM network. Faster targets were associated with higher BOLD response in visual cortex and left lateral FEF. Task-based functional connectivity analyses (psychophysiological interactions; PPI) largely replicated previous results in the basic SPEM network but did not yield additional information regarding the neural underpinnings of the background and velocity effects. The results show that the presentation of visual background stimuli during SPEM induces activity in a widespread visuo-parieto-frontal network including areas contributing to cognitive aspects of oculomotor control such as medial FEF, whereas the response to higher target velocity involves visual and motor areas such as lateral FEF. Therefore, we were able to propose for the first time different functions of the medial and lateral FEF during SPEM.

Sensory gating is related to positive and disorganised schizotypy in contrast to smooth pursuit eye movements and latent inhibition

Since the characteristics and symptoms of both schizophrenia and schizotypy are manifested heterogeneously, it is possible that different endophenotypes and neurophysiological measures (sensory gating and smooth pursuit eye movement errors) represent different clusters of symptoms. Participants (N = 205) underwent a standard conditioned-pairing paradigm to establish their sensory gating ratio, a smooth-pursuit eye-movement task, a latent inhibition task, and completed the Schizotypal Personality Questionnaire. A Multidimensional Scaling analysis revealed that sensory gating was related to positive and disorganised dimensions of schizotypy. Latent inhibition and prepulse inhibition were not related to any dimension of schizotypy. Smooth pursuit eye movement error was unrelated to sensory gating and latent inhibition, but was related to negative dimensions of schizotypy. Our findings suggest that the symptom clusters associated with two main endophenotypes are largely independent. To fully understand symptomology and outcomes of schizotypal traits, the different subtypes of schizotypy (and potentially, schizophrenia) ought to be considered separately rather than together.

Ocular Asymmetry in Electrooculographic Responses

Between the cornea and the posterior pole of the eye, there is a transepithelial potential capable of being registered through an electrooculogram (EOG). It is questionable whether electrooculographic responses are similar in both eyes despite ocular dominance in human beings. We studied the effect of different electrooculographic stimulation parameters, in terms of directionality, linear and angular velocity, contrast, and state of adaptation to light/dark, that may induce possible interocular differences in visual function. The study was carried out with electroencephalography-type surface electrodes placed in the medial, lateral, superior, and inferior positions of both human eyes to record the eye movements. We found a greater amplitude of the EOG response in the left eye than to the right eye for light bars moving from right to left (p < 0.01; t-test). The EOG response amplitude was similar in both eyes for light bars moving in vertical directions, but greater than horizontal or rotational stimuli. We conclude that vertical stimuli should be used for EOG functional evaluation of eye movements, since horizontal stimuli generate significant interocular differences.

Replicability and reliability of the background and target velocity effects in smooth pursuit eye movements

When we follow a slowly moving target with our eyes, we perform smooth pursuit eye movements (SPEM). Previous investigations point to significantly and robustly reduced SPEM performance in the presence of a stationary background and at higher compared to lower target velocities. However, the reliability of these background and target velocity effects has not yet been investigated systematically. To address this issue, 45 healthy participants (17 m, 28 f) took part in two experimental sessions 7 days apart. In each session, participants were instructed to follow a horizontal SPEM target moving sinusoidally between ±7.89° at three different target velocities, corresponding to frequencies of 0.2, 0.4 and 0.6 Hz. Each target velocity was presented once with and once without a stationary background, resulting in six blocks. The blocks were presented twice per session in order to additionally explore potential task length effects. To assess SPEM performance, velocity gain was calculated as the ratio of eye to target velocity. In line with previous research, detrimental background and target velocity effects were replicated robustly in both sessions with large effect sizes. Good to excellent test-retest reliabilities were obtained at higher target velocities and in the presence of a stationary background, whereas lower reliabilities occurred with slower targets and in the absence of background stimuli. Target velocity and background effects resulted in largely good to excellent reliabilities. These findings not only replicated robust experimental effects of background and target velocity at group level, but also revealed that these effects can be translated into reliable individual difference measures.

Towards Clinically Relevant Oculomotor Biomarkers in Early Schizophrenia

In recent years, psychiatric research has focused on the evaluation and implementation of biomarkers in the clinical praxis. Oculomotor function deviances are among the most consistent and replicable cognitive deficits in schizophrenia and have been suggested as viable candidates for biomarkers. In this narrative review, we focus on oculomotor function in first-episode psychosis, recent onset schizophrenia as well as individuals at high risk for developing psychosis. We critically discuss the evidence for the possible utilization of oculomotor function measures as diagnostic, susceptibility, predictive, monitoring, and prognostic biomarkers for these conditions. Based on the current state of research we conclude that there are not sufficient data to unequivocally support the use of oculomotor function measures as biomarkers in schizophrenia.

Age differences in resting state EEG and their relation to eye movements and cognitive performance

Prior research has focused on EEG differences across age or EEG differences across cognitive tasks/eye tracking. There are few studies linking age differences in EEG to age differences in behavioural performance which is necessary to establish how neuroactivity corresponds to successful and impaired ageing. Eighty-six healthy participants completed a battery of cognitive tests and eye-tracking measures. Resting state EEG (n = 75, 31 young, 44 older adults) was measured for delta, theta, alpha and beta power as well as for alpha peak frequency. Age deficits in cognition were aligned with the literature, showing working memory and inhibitory deficits along with an older adult advantage in vocabulary. Older adults showed poorer eye movement accuracy and response times, but we did not replicate literature showing a greater age deficit for antisaccades than for prosaccades. We replicated EEG literature showing lower alpha peak frequency in older adults but not literature showing lower alpha power. Older adults also showed higher beta power and less parietal alpha power asymmetry than young adults. Interaction effects showed that better prosaccade performance was related to lower beta power in young adults but not in older adults. Performance at the trail making test part B (measuring task switching and inhibition) was improved for older adults with higher resting state delta power but did not depend on delta power for young adults. It is argued that individuals with higher slow-wave resting EEG may be more resilient to age deficits in tasks that utilise cross-cortical processing.

Perceptual-motor styles

Even for a stereotyped task, sensorimotor behavior is generally variable due to noise, redundancy, adaptability, learning or plasticity. The sources and significance of different kinds of behavioral variability have attracted considerable attention in recent years. However, the idea that part of this variability depends on unique individual strategies has been explored to a lesser extent. In particular, the notion of style recurs infrequently in the literature on sensorimotor behavior. In general use, style refers to a distinctive manner or custom of behaving oneself or of doing something, especially one that is typical of a person, group of people, place, context, or period. The application of the term to the domain of perceptual and motor phenomenology opens new perspectives on the nature of behavioral variability, perspectives that are complementary to those typically considered in the studies of sensorimotor variability. In particular, the concept of style may help toward the development of personalised physiology and medicine by providing markers of individual behaviour and response to different stimuli or treatments. Here, we cover some potential applications of the concept of perceptual-motor style to different areas of neuroscience, both in the healthy and the diseased. We prefer to be as general as possible in the types of applications we consider, even at the expense of running the risk of encompassing loosely related studies, given the relative novelty of the introduction of the term perceptual-motor style in neurosciences.

Functional connectivity during smooth pursuit eye movements

Smooth pursuit eye movements (SPEM) hold the image of a slowly moving stimulus on the fovea. The neural system underlying SPEM primarily includes visual, parietal, and frontal areas. In the present study, we investigated how these areas are functionally coupled and how these couplings are influenced by target motion frequency. To this end, healthy participants (n = 57) were instructed to follow a sinusoidal target stimulus moving horizontally at two different frequencies (0.2 Hz, 0.4 Hz). Eye movements and blood oxygen level-dependent (BOLD) activity were recorded simultaneously. Functional connectivity of the key areas of the SPEM network was investigated with a psychophysiological interaction (PPI) approach. How activity in five eye movement-related seed regions (lateral geniculate nucleus, V1, V5, posterior parietal cortex, frontal eye fields) relates to activity in other parts of the brain during SPEM was analyzed. The behavioral results showed clear deterioration of SPEM performance at higher target frequency. BOLD activity during SPEM versus fixation occurred in a geniculo-occipito-parieto-frontal network, replicating previous findings. PPI analysis yielded widespread, partially overlapping networks. In particular, frontal eye fields and posterior parietal cortex showed task-dependent connectivity to large parts of the entire cortex, whereas other seed regions demonstrated more regionally focused connectivity. Higher target frequency was associated with stronger activations in visual areas but had no effect on functional connectivity. In summary, the results confirm and extend previous knowledge regarding the neural mechanisms underlying SPEM and provide a valuable basis for further investigations such as in patients with SPEM impairments and known alterations in brain connectivity.NEW & NOTEWORTHY This study provides a comprehensive investigation of blood oxygen level-dependent (BOLD) functional connectivity during smooth pursuit eye movements. Results from a large sample of healthy participants suggest that key oculomotor regions interact closely with each other but also with regions not primarily associated with eye movements. Understanding functional connectivity during smooth pursuit is important, given its potential role as an endophenotype of psychoses.

Effects of blocked vs. interleaved administration mode on saccade preparatory set revealed using pupillometry

Eye movements have been used extensively to assess information processing and cognitive function. However, significant variability in saccade performance has been observed, which could arise from methodological variations across different studies. For example, prosaccades and antisaccades have been studied using either a blocked or interleaved design, which has a significant influence on error rates and latency. This is problematic as it makes it difficult to compare saccade performance across studies and may limit the ability to use saccades as a behavioural assay to assess neurocognitive function. Thus, the current study examined how administration mode influences saccade related preparatory activity by employing pupil size as a non-invasive proxy for neural activity related to saccade planning and execution. Saccade performance and pupil dynamics were examined in eleven participants as they completed pro- and antisaccades in blocked and interleaved paradigms. Results showed that administration mode significantly modulated saccade performance and preparatory activity. Reaction times were longer for both pro- and antisaccades in the interleaved condition, compared to the blocked condition (p < 0.05). Prosaccade pupil dilations were larger in the interleaved condition (p < 0.05), while antisaccade pupil dilations did not significantly differ between administration modes. Additionally, ROC analysis provided preliminary evidence that pupil size can effectively predict saccade directional errors prior to saccade onset. We propose that task-evoked pupil dilations reflect an increase in preparatory activity for prosaccades and the corresponding cognitive demands associated with interleaved administration mode. Overall, the results highlight the importance that administration mode plays in the design of neurocognitive tasks.

Peak saccadic eye velocity across menstrual phases in naturally cycling women; A pilot study

Peak saccadic eye velocity (pSEV) has been investigated in studies that characterise the pathophysiology of menstrual cycle related mood disorders, such as premenstrual dysphoric disorder (PMDD). pSEV is a stable and sensitive measure of gamma-aminobutyric acid A (GABA_A) receptor function. Dysregulation of the GABA pathway has been associated with the onset of PMDD. Despite a growing number of studies utilising pSEV as an outcome measure in interventional drug studies for menstrual cycle related mood disorders, there are no reported studies that have investigated whether pSEV is sensitive to hormone fluctuations across the natural menstrual cycle. To address this gap, this pilot study aimed to characterise pSEV in women across the menstrual cycle. Participants were monitored across two menstrual cycles and saccadic eye movements were measured in both luteal and follicular phases. Seven participants completed the full study and were included in the final analysis. Results revealed luteal phase pSEV was significantly less than follicular phase pSEV. This finding is novel and forms a stepping-stone for further understanding the associations between menstrual hormone profiles and GABA_A receptors.

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Peak saccadic eye velocity is used as a proxy measure of GABA_A function.

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Peak saccadic eye velocity was measured in the follicular and luteal phases of the menstrual cycle.

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Median peak saccadic eye velocity was significantly lower in luteal phase.

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Saccadic eye velocity is sensitive to hormone fluctuations across menstrual cycle.

Effects of nicotine on smooth pursuit eye movements in healthy non-smokers

RATIONALE

The non-selective nicotinic acetylcholine receptor (nAChR) agonist nicotine has been argued to improve attention via enhanced filtering of irrelevant stimuli. Here, we tested this hypothesis in the context of smooth pursuit eye movements (SPEMs), an oculomotor function previously shown to improve with nicotine in some but not all studies.

OBJECTIVES

In order to test whether nicotine improves performance particularly when the inhibition of distracting stimuli is required, SPEM was elicited in conditions with or without peripheral distractors. Additionally, different target frequencies were employed in order to parametrically vary general processing demands on the SPEM system.

METHODS

Healthy adult non-smokers (N = 18 females, N = 13 males) completed a horizontal sinusoidal SPEM task at different target frequencies (0.2 Hz, 0.4 Hz, 0.6 Hz) in the presence or absence of peripheral distractors in a double-blind, placebo-controlled, cross-over design using a 2 mg nicotine gum.

RESULTS

Nicotine increased peak pursuit gain relative to placebo (p < .001), but an interaction with distractor condition (p = .001) indicated that this effect was most pronounced in the presence of distractors. Catch-up saccade frequency was reduced by nicotine (p = .01), particularly at higher target frequencies (two-way interaction, p = .04). However, a three-way interaction (p = .006) indicated that the reduction with nicotine was strongest at the highest target frequency (0.6 Hz) only without distractors, whereas in the presence of distractors, it was strongest at 0.4-Hz target frequency. There were no effects of nicotine on subjective state measures.

CONCLUSIONS

Together, these findings support a role of both distractor inhibition and general processing load in the effects of nicotine on smooth pursuit.

Shared variance of oculomotor phenotypes in a large sample of healthy young men

This study used canonical correlation analysis to investigate patterns of shared variance between parameters measured in seven different occulomotor function tasks, namely the visually guided saccade task, the antisaccade task, the closed-loop smooth-pursuit task, the open-loop smooth-pursuit task, and three active visual fixation tasks. These tasks were performed by 2130 young army recruits. Only a small percentage (1-10%) of shared variance existed between sets of parameters for all oculomotor function tasks measured. The most correlated tasks were the visually guided saccade and the antisaccade. The first common factor correlated with speed of performance between these tasks (latency), while the second and third correlated with accuracy of performance. Better performance in active visual fixation tasks correlated with better performance accuracy (lower error rate) and increased speed (lower latency) in the antisaccade and saccade tasks as well as better performance in the closed-loop smooth-pursuit task (increase in gain and decrease in the rate of unwanted saccades during pursuit). Better performance in the closed-loop smooth-pursuit task (increased gain and decreased number of unwanted saccades) also correlated with increased accuracy and increased speed of performing saccades and antisaccades. Finally, the open-loop fixation task had no correlation with all other oculomotor tasks except for a very weak negative correlation with the closed-loop pursuit task where better performance (increased gain) in one correlated with worse performance (decreased gain) in the other. The results of this analysis showed that a small percentage of variance is shared among different oculomotor function tasks. The structure of this shared variance could be used to derive common oculomotor function indices to study their relation to genetic and other sources of inter-subject variation.

Impaired Antisaccades in Obsessive-Compulsive Disorder: Evidence From Meta-Analysis and a Large Empirical Study

Increasing evidence indicates that patients with obsessive-compulsive disorder (OCD) exhibit alterations in fronto-striatal circuitry. Performance deficits in the antisaccade task would support this model, but results from previous small-scale studies have been inconclusive as either increased error rates, prolonged antisaccade latencies, both or neither have been reported in OCD patients. In order to address this issue, we investigated antisaccade performance in a large sample of OCD patients (n = 169) and matched control subjects (n = 183). As impaired antisaccade performance constitutes a potential endophenotype of OCD, unaffected first-degree relatives of OCD patients (n = 100) were assessed, as well. Furthermore, we conducted a quantitative meta-analysis to integrate our data with previous findings. In the empirical study, OCD patients exhibited significantly increased antisaccade latencies, intra-subject variability (ISV) of antisaccade latencies, and antisaccade error rates. The latter effect was driven by errors with express latency (80-130 ms), as patients did not differ significantly from controls with regards to regular errors (>130 ms). Notably, unaffected relatives of OCD patients showed elevated antisaccade express error rates and increased ISV of antisaccade latencies, as well. Antisaccade performance was not associated with state anxiety within groups. Among relatives, however, we observed a significant correlation between antisaccade error rate and harm avoidance. Medication status of OCD patients, symptom severity, depressive comorbidity, comorbid anxiety disorders and OCD symptom dimensions did not significantly affect antisaccade performance. Meta-analysis of 10 previous and the present empirical study yielded a medium-sized effect (SMD = 0.48, p < 0.001) for higher error rates in OCD patients, while the effect for latencies did not reach significance owing to strong heterogeneity (SMD = 0.51, p = 0.069). Our results support the assumption of impaired antisaccade performance in OCD, although effects sizes were only moderately large. Furthermore, we provide the first evidence that increased antisaccade express error rates and ISV of antisaccade latencies may constitute endophenotypes of OCD. Findings regarding these more detailed antisaccade parameters point to potentially underlying mechanisms, such as early pre-stimulus inhibition of the superior colliculus.

Oculomotricity and Neurological Soft Signs: Can we refine the endophenotype? A study in subjects belonging to the spectrum of schizophrenia

Alterations in eye tracking and motor impairments as well as Neurological Soft Signs (NSS) are frequently reported in patients with schizophrenia as well as in their relatives, and are proposed as endophenotype of the disease. This study investigated smooth pursuit eye movement and fixation task with distractors with a gap condition, two markers of inhibitory control mechanism, in 49 patients with schizophrenia, 24 ultra-high risk subjects, 41 full biological clinical siblings of patients and 48 controls. NSS were assessed as a marker of abnormal neurodevelopment. The results revealed more intrusive saccades respectively in smooth pursuit eye movement and in fixation task with distractors with a gap condition in patients, respect to controls and full siblings. Ultra high-risk participants with high NSS committed intrusive saccades compared to controls. Patients with schizophrenia with high NSS also displayed more of these abnormalities, compared to patients with schizophrenia with low NSS and controls. These findings highlight a global inhibitory control defect, and suggested that ultra-high risk subjects and patients with schizophrenia could share oculomotor abnormalities, especially when they express a high neurodevelopmental deviance. These oculomotor alterations might suggest that cerebral structures such as prefrontal and cerebellum could be involved in the expression of this vulnerability.

Topology for gaze analyses - Raw data segmentation

Recent years have witnessed a remarkable growth in the way mathematics, informatics, and computer science can process data. In disciplines such as machine learning, pattern recognition, computer vision, computational neurology, molecular biology, information retrieval, etc., many new methods have been developed to cope with the ever increasing amount and complexity of the data. These new methods offer interesting possibilities for processing, classifying and interpreting eye-tracking data. The present paper exemplifies the application of topological arguments to improve the evaluation of eye-tracking data. The task of classifying raw eye-tracking data into saccades and fixations, with a single, simple as well as intuitive argument, described as coherence of spacetime, is discussed, and the hierarchical ordering of the fixations into dwells is shown. The method, namely identification by topological characteristics (ITop), is parameter-free and needs no pre-processing and post-processing of the raw data. The general and robust topological argument is easy to expand into complex settings of higher visual tasks, making it possible to identify visual strategies.

Back to basics: The effects of block vs. interleaved trial administration on pro- and anti-saccade performance

The pro and anti-saccade task (PAT) is a widely used tool in the study of overt and covert attention with promising potential role in neurocognitive and psychiatric assessment. However, specific PAT protocols can vary significantly between labs, potentially resulting in large variations in findings across studies. In light of recent calls towards a standardization of PAT the current study's objective was to systematically and purposely evaluate the effects of block vs. interleaved administration—a fundamental consideration—on PAT measures in a within subject design. Additionally, this study evaluated whether measures of a Posner-type cueing paradigm parallels measures of the PAT paradigm. As hypothesized, results indicate that PAT performance is highly susceptible to administration mode. Interleaved mode resulted in larger error rates not only for anti (blocks: M = 22%; interleaved: M = 42%) but also for pro-saccades (blocks: M = 5%; interleaved: M = 12%). This difference between block and interleaved administration was significantly larger in anti-saccades compared to pro-saccades and cannot be attributed to a 'speed/accuracy tradeoff'. Interleaved mode produced larger pro and anti-saccade differences in error rates while block administration produced larger latency differences. Results question the reflexive nature of pro-saccades, suggesting they are not purely reflexive. These results were further discussed and compared to previous studies that included within subject data of blocks and interleaved trials.

Insights to the schizophrenia continuum: A systematic review of saccadic eye movements in schizotypy and biological relatives of schizophrenia patients

Myles, J.B., S. Rossell, A. Phillipou, Thomas, E and C. Gurvich. A systematic review of saccadic eye movements across the schizophrenia continuum: Characterisation, pathophysiology and genetic associations. NEUROSCI BIOBEHAV REV 21(1) XXX-XXX, 2015. One of the cognitive hallmarks of schizophrenia is impaired eye movements, particularly for the antisaccade task. Less saccade research has been conducted in relation to the broader schizophrenia continuum, that is, people with high schizotypy or first-degree relatives of people with schizophrenia. This systematic review sought to identify, collate and appraise prosaccade, antisaccade and memory-guided saccade studies involving behavioural, neuroimaging and genetic data published between 1980 and September 2016 in individuals with high schizotypy and first-degree relatives. A systematic literature search was conducted, using Ovid MEDLINE, PsycINFO, PubMed and SCOPUS databases. Of 913 references screened, 18 schizotypy, 29 family studies and two schizotypy and relatives articles studies were eligible for inclusion. Antisaccade error rate was the most consistent deficit found for high schizotypy. Relatives had intermediate antisaccade error rates between patients and healthy controls. Results from the limited genetic and neuroimaging studies echoed schizophrenia findings. Confounds were also identified. It was concluded that future research is required to refine the saccade endophenotype and to expand genetic and neuroimaging research.

Effects of ketamine on brain function during smooth pursuit eye movements

The uncompetitive NMDA receptor antagonist ketamine has been proposed to model symptoms of psychosis. Smooth pursuit eye movements (SPEM) are an established biomarker of schizophrenia. SPEM performance has been shown to be impaired in the schizophrenia spectrum and during ketamine administration in healthy volunteers. However, the neural mechanisms mediating SPEM impairments during ketamine administration are unknown. In a counter-balanced, placebo-controlled, double-blind, within-subjects design, 27 healthy participants received intravenous racemic ketamine (100 ng/mL target plasma concentration) on one of two assessment days and placebo (intravenous saline) on the other. Participants performed a block-design SPEM task during functional magnetic resonance imaging (fMRI) at 3 Tesla field strength. Self-ratings of psychosis-like experiences were obtained using the Psychotomimetic States Inventory (PSI). Ketamine administration induced psychosis-like symptoms, during ketamine infusion, participants showed increased ratings on the PSI dimensions cognitive disorganization, delusional thinking, perceptual distortion and mania. Ketamine led to robust deficits in SPEM performance, which were accompanied by reduced blood oxygen level dependent (BOLD) signal in the SPEM network including primary visual cortex, area V5 and the right frontal eye field (FEF), compared to placebo. A measure of connectivity with V5 and FEF as seed regions, however, was not significantly affected by ketamine. These results are similar to the deviations found in schizophrenia patients. Our findings support the role of glutamate dysfunction in impaired smooth pursuit performance and the use of ketamine as a pharmacological model of psychosis, especially when combined with oculomotor biomarkers. Hum Brain Mapp 37:4047-4060, 2016. © 2016 Wiley Periodicals, Inc.

Shared and distinct oculomotor function deficits in schizophrenia and obsessive compulsive disorder

Detailed analysis of oculomotor function phenotypes in antisaccade, smooth eye pursuit, and active fixation tasks was performed in a sample of 44 patients with schizophrenia, 34 patients with obsessive compulsive disorder (OCD), and 45 matched healthy controls. A common pattern of performance deficits in both schizophrenia and OCD emerged including higher antisaccade error rate, increased latency for corrective antisaccades, as well as higher rates of unwanted saccades in smooth eye pursuit compared to healthy controls. This common pattern could be related to the dysfunction of a network of cognitive control that is present in both disorders, including the dorsolateral prefrontal cortex, the posterior parietal cortex, and the anterior cingulate cortex. In contrast, only patients with schizophrenia showed a specific increase for correct antisaccade mean latency and the intrasubject variability of latency for error prosaccades as well as a decrease in the gain for smooth eye pursuit, suggesting a specific deficit in saccadic motor control and the frontal eye field in schizophrenia that is not present in OCD. A specific deficit in fixation stability (increased frequency of unwanted saccades during active fixation) was observed only for OCD patients pointing to a deficit in the frontostriatal network controlling fixation. This deficit was pronounced for OCD patients receiving additional antipsychotic medication. In conclusion, oculomotor function showed shared and distinct patterns of deviance for schizophrenia and OCD pointing toward shared and specific neurobiological substrates for these psychiatric disorders.

Eye movements of patients with schizophrenia in a natural environment

Alterations of eye movements in schizophrenia patients have been widely described for laboratory settings. For example, gain during smooth tracking is reduced, and fixation patterns differ between patients and healthy controls. The question remains, whether such results are related to the specifics of the experimental environment, or whether they transfer to natural settings. Twenty ICD-10 diagnosed schizophrenia patients and 20 healthy age-matched controls participated in the study, each performing four different oculomotor tasks corresponding to natural everyday behavior in an indoor environment: (I) fixating stationary targets, (II) sitting in a hallway with free gaze, (III) walking down the hallway, and (IV) visually tracking a target on the floor while walking straight-ahead. In all conditions, eye movements were continuously recorded binocularly by a mobile lightweight eye tracker (EyeSeeCam). When patients looked at predefined targets, they showed more fixations with reduced durations than controls. The opposite was true when participants were sitting in a hallway with free gaze. During visual tracking, patients showed a significantly greater root-mean-square error (representing the mean deviation from optimal) of retinal target velocity. Different from previous results on smooth-pursuit eye movements obtained in laboratory settings, no such difference was found for velocity gain. Taken together, we have identified significant differences in fundamental oculomotor parameters between schizophrenia patients and healthy controls during natural behavior in a real environment. Moreover, our data provide evidence that in natural settings, patients overcome some impairments, which might be present only in laboratory studies, by as of now unknown compensatory mechanisms or strategies.

Effects of aging on eye movements in the real world

The effects of aging on eye movements are well studied in the laboratory. Increased saccade latencies or decreased smooth-pursuit gain are well established findings. The question remains whether these findings are influenced by the rather untypical environment of a laboratory; that is, whether or not they transfer to the real world. We measured 34 healthy participants between the age of 25 and 85 during two everyday tasks in the real world: (I) walking down a hallway with free gaze, (II) visual tracking of an earth-fixed object while walking straight-ahead. Eye movements were recorded with a mobile light-weight eye tracker, the EyeSeeCam (ESC). We find that age significantly influences saccade parameters. With increasing age, saccade frequency, amplitude, peak velocity, and mean velocity are reduced and the velocity/amplitude distribution as well as the velocity profile become less skewed. In contrast to laboratory results on smooth pursuit, we did not find a significant effect of age on tracking eye-movements in the real world. Taken together, age-related eye-movement changes as measured in the laboratory only partly resemble those in the real world. It is well-conceivable that in the real world additional sensory cues, such as head-movement or vestibular signals, may partially compensate for age-related effects, which, according to this view, would be specific to early motion processing. In any case, our results highlight the importance of validity for natural situations when studying the impact of aging on real-life performance.

Smooth pursuit eye movements and schizophrenia: literature review

OBJECTIVE

To review the scientific literature about the relationship between impairment on smooth pursuit eye movements and schizophrenia.

METHODS

Narrative review that includes historical articles, reports about basic and clinical investigation, systematic reviews, and meta-analysis on the topic.

RESULTS

Up to 80% of schizophrenic patients have impairment of smooth pursuit eye movements. Despite the diversity of test protocols, 65% of patients and controls are correctly classified by their overall performance during this pursuit. The smooth pursuit eye movements depend on the ability to anticipate the target's velocity and the visual feedback, as well as on learning and attention. The neuroanatomy implicated in smooth pursuit overlaps to some extent with certain frontal cortex zones associated with some clinical and neuropsychological characteristics of the schizophrenia, therefore some specific components of smooth pursuit anomalies could serve as biomarkers of the disease. Due to their sedative effect, antipsychotics have a deleterious effect on smooth pursuit eye movements, thus these movements cannot be used to evaluate the efficacy of the currently available treatments.

CONCLUSION

Standardized evaluation of smooth pursuit eye movements on schizophrenia will allow to use specific aspects of that pursuit as biomarkers for the study of its genetics, psychopathology, or neuropsychology.

Vergence eye movements in patients with schizophrenia

Previous studies have shown that smooth pursuit eye movements are impaired in patients with schizophrenia. However, under normal viewing conditions, targets move not only in the frontoparallel plane but also in depth, and tracking them requires both smooth pursuit and vergence eye movements. Although previous studies in humans and non-human primates suggest that these two eye movement subsystems are relatively independent of one another, to our knowledge, there have been no prior studies of vergence tracking behavior in patients with schizophrenia. Therefore, we have investigated these eye movements in patients with schizophrenia and in healthy controls. We found that patients with schizophrenia exhibited substantially lower gains compared to healthy controls during vergence tracking at all tested speeds (e.g. 0.25 Hz vergence tracking mean gain of 0.59 vs. 0.86). Further, consistent with previous reports, patients with schizophrenia exhibited significantly lower gains than healthy controls during smooth pursuit at higher target speeds (e.g. 0.5 Hz smooth pursuit mean gain of 0.64 vs. 0.73). In addition, there was a modest (r≈0.5), but significant, correlation between smooth pursuit and vergence tracking performance in patients with schizophrenia. Our observations clearly demonstrate substantial vergence tracking deficits in patients with schizophrenia. In these patients, deficits for smooth pursuit and vergence tracking are partially correlated suggesting overlap in the central control of smooth pursuit and vergence eye movements.

Modulation of antisaccade costs through manipulation of target-location probability: only under decisional uncertainty

Latencies of antisaccades made in the direction opposite to a peripheral target are typically slower longer than of prosaccades towards such a target by 50-100 ms. Antisaccades have proved to be an important tool for diagnostic purposes in neurology, psychology and psychiatry, providing invaluable insights into attentional function, decision making and the functionality of eye movement control. Recent findings have suggested, however, that latency differences between pro- and antisaccades can be eliminated by manipulating target-location probabilities. Pro- and antisaccades were equally fast to locations where a target rarely appeared, a finding that may be of promise for more elaborate diagnoses of neurological and psychiatric illness and further understanding of the eye movement system. Here, we tested probability manipulations for a number of different pro- and antisaccade tasks of varied difficulty. Probability only modulated antisaccade costs in a difficult antisaccade task involving decisional uncertainty with low target saliency. For other tasks including standard ones from the literature, target-location probability asymmetries had minimal effects. Probability modulation of antisaccade costs may therefore reflect effects upon decision making rather than saccade generation. This may limit the usefulness of probability manipulations of antisaccades for diagnostic purposes in neurology, psychology and related disciplines.

Impulsivity in binge eating disorder: food cues elicit increased reward responses and disinhibition

Background

Binge eating disorder (BED) represents a distinct eating disorder diagnosis. Current approaches assume increased impulsivity to be one factor leading to binge eating and weight gain. We used eye tracking to investigate both components of impulsivity, namely reward sensitivity and rash-spontaneous behaviour towards food in BED for the first time.

Methods

Overweight and obese people with BED (BED+; n = 25), without BED (BED−; n = 26) and healthy normal-weight controls (NWC; n = 25) performed a free exploration paradigm measuring reward sensitivity (experiment 1) and a modified antisaccade paradigm measuring disinhibited, rash-spontaneous behaviour (experiment 2) using food and nonfood stimuli. Additionally, trait impulsivity was assessed.

Results

In experiment 1, all participants located their initial fixations more often on food stimuli and BED+ participants gazed longer on food stimuli in comparison with BED− and NWC participants. In experiment 2, BED+ participants had more difficulties inhibiting saccades towards food and nonfood stimuli compared with both other groups in first saccades, and especially towards food stimuli in second saccades and concerning sequences of first and second saccades. BED− participants did not differ significantly from NWC participants in both experiments. Additionally, eye tracking performance was associated with self-reported reward responsiveness and self-control.

Conclusions

According to these results, food-related reward sensitivity and rash-spontaneous behaviour, as the two components of impulsivity, are increased in BED in comparison with weight-matched and normal-weight controls. This indicates that BED represents a neurobehavioural phenotype of obesity that is characterised by increased impulsivity. Interventions for BED should target these special needs of affected patients.

Characterising eye movement dysfunction in myalgic encephalomyelitis/chronic fatigue syndrome

BACKGROUND

People who suffer from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) often report that their eye movements are sluggish and that they have difficulties tracking moving objects. However, descriptions of these visual problems are based solely on patients' self-reports of their subjective visual experiences, and there is a distinct lack of empirical evidence to objectively verify their claims. This paper presents the first experimental research to objectively examine eye movements in those suffering from ME/CFS.

METHODS

Patients were assessed for ME/CFS symptoms and were compared to age, gender, and education matched controls for their ability to generate saccades and smooth pursuit eye movements.

RESULTS

Patients and controls exhibited similar error rates and saccade latencies (response times) on prosaccade and antisaccade tasks. Patients showed relatively intact ability to accurately fixate the target (prosaccades), but were impaired when required to focus accurately in a specific position opposite the target (antisaccades). Patients were most markedly impaired when required to direct their gaze as closely as possible to a smoothly moving target (smooth pursuit).

CONCLUSIONS

It is hypothesised that the effects of ME/CFS can be overcome briefly for completion of saccades, but that continuous pursuit activity (accurately tracking a moving object), even for a short time period, highlights dysfunctional eye movement behaviour in ME/CFS patients. Future smooth pursuit research may elucidate and improve diagnosis of ME/CFS.

Antisaccadic training to improve impulsivity in binge eating disorder

Patients with binge eating disorder (BED) show generally increased impulsivity and especially increased food-related impulsivity. Both are closely linked to the core pathology of BED, which relates to regular binge eating episodes with experienced loss of control. The antisaccade task is an established paradigm assessing response inhibition as a pivotal component of impulsivity. It requires participants to execute antisaccades; that is, they are supposed to look in the opposite direction of a stimulus that automatically catches attention by appearing in the peripheral visual field. High rates of prosaccades to the peripheral stimuli are considered indicators of increased impulsivity. Presenting food pictures as peripheral stimuli, this task can be used to investigate food-related impulsivity. We propose modifications of this task in order to design it as an antisaccadic training in which BED patients practise the suppression of food-related responses, which should result in enhanced control over their eating behaviour.

Subthalamic deep brain stimulation improves smooth pursuit and saccade performance in patients with Parkinson's disease

Background

Deep brain stimulation (DBS) in the subthalamic nucleus (STN) significantly reduces symptoms of Parkinson’s disease (PD) such as bradykinesia, tremor and rigidity. It also reduces the need for anti-PD medication, and thereby potential side-effects of _L-Dopa. Although DBS in the STN is a highly effective therapeutic intervention in PD, its mechanism and effects on oculomotor eye movement control and particularly smooth pursuit eye movements have to date rarely been investigated. Furthermore, previous reports provide conflicting information. The aim was to investigate how DBS in STN affected oculomotor performance in persons with PD using novel analysis techniques.

Methods

Twenty-five patients were eligible (22 males, 3 females) according to the clinical inclusion criteria: idiopathic PD responsive to _L-Dopa and having had bilateral STN stimulation for at least one year to ensure stable DBS treatment. Fifteen patients were excluded due to the strict inclusion criteria applied to avoid interacting and confounding factors when determining the effects of DBS applied alone without PD medication. One patient declined participation. Nine PD patients (median age 63, range 59–69 years) were assessed after having their PD medications withdrawn overnight. They were examined with DBS ON and OFF, with the ON/OFF order individually randomized.

Results

DBS ON increased smooth pursuit velocity accuracy (p < 0.001) and smooth pursuit gain (p = 0.005), especially for faster smooth pursuits (p = 0.034). DBS ON generally increased saccade amplitude accuracy (p = 0.007) and tended to increase peak saccade velocity also (p = 0.087), specifically both saccade velocity and amplitude accuracy for the 20 and 40 degree saccades (p < 0.05). Smooth pursuit latency tended to be longer (p = 0.090) approaching normal with DBS ON. Saccade latency was unaffected.

Conclusions

STN stimulation from DBS alone significantly improved both smooth pursuit and saccade performance in patients with PD. The STN stimulation enhancement found for oculomotor performance suggests clear positive implications for patients’ ability to perform tasks that rely on visual motor control and visual feedback. The new oculomotor analysis methods provide a sensitive vehicle to detect subtle pathological modifications from PD and the functional enhancements produced by STN stimulation from DBS alone.

An internationally standardised antisaccade protocol

Detailed measurements of saccadic latency--the time taken to make an eye movement to a suddenly-presented visual target--have proved a valuable source of detailed and quantitative information in a wide range of neurological conditions, as well as shedding light on the mechanisms of decision, currently of intense interest to cognitive neuroscientists. However, there is no doubt that more complex oculomotor tasks, and in particular the antisaccade task in which a participant must make a saccade in the opposite direction to the target, are potentially more sensitive indicators of neurological dysfunction, particularly in neurodegenerative conditions. But two obstacles currently hinder their widespread adoption for this purpose. First, that much of the potential information from antisaccade experiments, notably about latency distribution and amplitude, is typically thrown away. Second, that there is no standardised protocol for carrying out antisaccade experiments, so that results from one laboratory cannot easily be compared with those from another. This paper, the outcome of a recent international meeting of oculomotor scientists and clinicians with an unusually wide experience of such measurements, sets out a proposed protocol for clinical antisaccade trials: its adoption will greatly enhance the clinical and scientific benefits of making these kinds of measurements.

Schizophrenia-related RGS4 gene variations specifically disrupt prefrontal control of saccadic eye movements

BACKGROUND

The gene encoding the regulator of G-protein signaling subtype 4 (RGS4), located on chromosome 1q23-3, has been proposed as a possible susceptibility gene for schizophrenia and has been specifically linked to prefrontal cortical structural and functional integrity.

METHOD

The effects of four core single nucleotide polymorphisms (SNPs) within the RGS4 gene on oculomotor parameters in a battery of oculomotor tasks (saccade, antisaccade, smooth eye pursuit, fixation) were investigated in a sample of 2243 young male military conscripts.

RESULTS

The risk allele of RGS4SNP18 was found to be associated with two variables of antisaccade performance, increased error rate and variation in the correct antisaccade latency. By contrast, the same allele and also the risk allele of RGS4SNP4 led to an improvement in smooth eye pursuit performance (increased gain). Structural equation modeling confirmed that the combined gene variation of RGS4SNP4 and RGS4SNP18 was a significant predictor of antisaccade but not smooth eye pursuit performance.

CONCLUSIONS

These results provide evidence for a specific effect of schizophrenia-related RGS4 genotype variations to prefrontal dysfunction measured by oculomotor indices of performance in normal individuals, further validating the hypothesis that RGS4 is related to prefrontal dysfunction in schizophrenia.

An assessment of optokinetic nystagmus (OKN) in persons with Down syndrome

Down syndrome (DS), the most common genetically defined cause of intellectual disability, is the phenotypic consequence of a supernumerary chromosome 21. Persons with DS commonly display deficits in visuomotor integration, motor coordination, and balance. Despite the key roles of the optokinetic and vestibular systems in these submodalities of motor function, a systematic investigation of the optokinetic nystagmus (OKN) and vestibulo-ocular reflex (VOR) in persons with DS had lacked in the literature. Accordingly, this study generated quantitative data on oculomotor function in persons with DS under optokinetic and sinusoidal smooth pursuit stimulation. Thirty-two participants with DS (14-36 years old, equally divided by gender) and 32 chronological age- and gender-matched typically developing controls were recruited from the community. Eye movements were recorded by binocular video oculography and an LCD projector produced visual stimulation. Assessments of the gain and frequency of slow phase of OKN beats and number and mean amplitude of intruding saccades during smooth pursuit were performed. Individuals with DS displayed angular velocity-dependent reduction in OKN gain and number of produced nystagmus beats compared to controls. The gain of the smooth pursuit was not significantly different between participants with DS and control participants. However, the number and mean amplitude of intruding saccades during smooth pursuit were increased in participants with DS compared to control participants. These findings may have implications to the understanding of the neurological basis of the motor dysfunction that affects performance in many practical tasks persons with DS encounter in their everyday lives.

Schizophrenia-related neuregulin-1 single-nucleotide polymorphisms lead to deficient smooth eye pursuit in a large sample of young men

Neuregulin-1 (NRG1) variations have been shown to modulate schizophrenia candidate endophenotypes related to brain structure and function. The aim of this study was to determine the effect of NRG1 on several oculomotor schizophrenia endophenotypes. The effects of 5 core single-nucleotide polymorphisms (SNPs) within the NRG1 gene to oculomotor parameters in a battery of oculomotor tasks (saccade, antisaccade, smooth eye pursuit, fixation) were investigated in a sample of 2243 young male military conscripts. Additive regression models, bootstrap and permutation techniques, were used as well as structural equation modeling and haplotype analysis. A deficit in global smooth eye pursuit performance measured using the root-mean-square error (RMSE) was related to the risk allele of SNP8NRG243177, and a deficit in global smooth eye pursuit performance measured using the saccade frequency was related with the risk allele of SNP8NRG433E1006. Structural equation modeling confirmed a global effect of NRG1 genotype on smooth eye pursuit performance using the RMSE, while the effect on saccade frequency was not confirmed. Haplotype analysis further confirmed the prediction from the structural equation modeling that a combination of alleles corresponding to the Icelandic high-risk haplotype was related to a deficit in global pursuit performance. NRG1 genotype variations were related to smooth eye pursuit variations both at the SNP level and at the haplotype level adding to the validation of this gene as a candidate gene for the disorder.

Methodological approaches in developmental neuroimaging studies

Pediatric neuroimaging is increasingly providing insights into the neural basis of cognitive development. Indeed, we have now arrived at a stage where we can begin to identify optimal methodological and statistical approaches to the acquisition and analysis of developmental imaging data. In this article, we describe a number of these approaches and how their selection impacts the ability to examine and interpret developmental effects. We describe preferred approaches to task selection, definition of age groups, selection of fMRI designs, definition of regions of interest (ROI), optimal baseline measures, and treatment of timecourse data. Consideration of these aspects of developmental neuroimaging reveals that unlike single-group neuroimaging studies, developmental studies pose unique challenges that impact study planning, task design, data analysis, and the interpretation of findings.

Association of Neuregulin 1 rs3924999 genotype with antisaccades and smooth pursuit eye movements

Neuregulin 1 (NRG1) has been identified as one of the leading candidate genes for schizophrenia. However, its functional mechanisms and its effects on neurocognition remain unclear. In this study, we used two well-established oculomotor endophenotypes, the antisaccade (AS) and smooth pursuit eye movement (SPEM) tasks, to investigate the functional mechanisms of a single nucleotide polymorphism (SNP) in NRG1 (rs3924999) at the neurocognitive level in a healthy volunteer sample. A total of 114 healthy Caucasian volunteers completed genotyping for NRG1 rs3924999 and infrared oculographic assessment of AS and SPEM (at target velocities of 12 degrees , 24 degrees and 36 degrees per second). Additionally, self-report questionnaires of schizotypy, neuroticism, attention deficit hyperactivity and obsessive-compulsive traits were included. A significant effect of rs3924999 genotype, with gender as a covariate, was found for AS amplitude gain (P < 0.01), with an increasing number of A alleles being associated with increasingly hypermetric performance. No statistically significant associations were found for other AS and SPEM variables or questionnaire scores. These findings indicate that NRG1 rs3924999 affects spatial accuracy on the AS task, suggesting an influence of the gene on the neural mechanisms underlying visuospatial sensorimotor transformations, a mechanism that has been previously found to be impaired in patients with schizophrenia and their relatives.

Cognitive correlates of anti-saccade task performance

The anti-saccade task (AST) is widely used in experimental, clinical, and neuroscience research as a pronounced test of executive functions. AST research includes to some extent also the investigation into its cognitive correlates. In the present study, we have examined cognitive correlates of the AST in the short-term/working memory, executive functions, and intelligence domains in healthy adults. We have obtained the following results. In line with previous research, the global percentage of direction errors PDE comprised of two only negligibly correlated components, direction errors with express or regular latencies. Substantial correlations with the other cognitive measures were obtained only for regular direction errors and, less so, for the global PDE. Results add to the evidence that distinguishes express and regular direction errors and underline that the complex requirements of the AST are reflected in a comparatively rich set of non-redundant parameters.

SPEM dysfunction and general schizotypy as measured by the SSQ: a controlled study

Background

SPEM dysfunction is a well-known phenomenon in schizophrenia. The principal aim of the present study was to examine whether SPEM dysfunction is already observable in subjects scoring high on a specific measure of schizotypy (SSQ General Schizotypy) that was selected because of its intimate relationship with schizophrenic prodromal unfolding.

Methods

Applying ANOVAs, we determined the relationship of subjects' scores on SSQ General Schizotypy and eye movements elicited by targets of different speed. We also examined whether there exists an association between our schizotypy measure and pupil size.

Results

We found more SPEM dysfunction in subjects scoring high on SSQ General Schizotypy than in subjects scoring average on that factor, irrespective of the speed of the target. No relationship was found between baseline pupil size and General Schizotypy.

Conclusion

The present study provides additional evidence that SPEM dysfunction is associated with schizotypic features that precede the onset of schizophrenia and is already observable in general population subjects that show these features.

Pharmacological treatment effects on eye movement control

The increasing use of eye movement paradigms to assess the functional integrity of brain systems involved in sensorimotor and cognitive processing in clinical disorders requires greater attention to effects of pharmacological treatments on these systems. This is needed to better differentiate disease and medication effects in clinical samples, to learn about neurochemical systems relevant for identified disturbances, and to facilitate identification of oculomotor biomarkers of pharmacological effects. In this review, studies of pharmacologic treatment effects on eye movements in healthy individuals are summarized and the sensitivity of eye movements to a variety of pharmacological manipulations is established. Primary findings from these studies of healthy individuals involving mainly acute effects indicate that: (i) the most consistent finding across several classes of drugs, including benzodiazepines, first- and second- generation antipsychotics, anticholinergic agents, and anticonvulsant/mood stabilizing medications is a decrease in saccade and smooth pursuit velocity (or increase in saccades during pursuit); (ii) these oculomotor effects largely reflect the general sedating effects of these medications on central nervous system functioning and are often dose-dependent; (iii) in many cases changes in oculomotor functioning are more sensitive indicators of pharmacological effects than other measures; and (iv) other agents, including the antidepressant class of serotonergic reuptake inhibitors, direct serotonergic agonists, and stimulants including amphetamine and nicotine, do not appear to adversely impact oculomotor functions in healthy individuals and may well enhance aspects of saccade and pursuit performance. Pharmacological treatment effects on eye movements across several clinical disorders including schizophrenia, affective disorders, attention deficit hyperactivity disorder, Parkinson's disease, and Huntington's disease are also reviewed. While greater recognition and investigation into pharmacological treatment effects in these disorders is needed, both beneficial and adverse drug effects are identified. This raises the important caveat for oculomotor studies of neuropsychiatric disorders that performance differences from healthy individuals cannot be attributed to illness effects alone. In final sections of this review, studies are presented that illustrate the utility of eye movements for use as potential biomarkers in pharmacodynamic and pharmacogenetic studies. While more systematic studies are needed, we conclude that eye movement measurements hold significant promise as tools to investigate treatment effects on cognitive and sensorimotor processes in clinical populations and that their use may be helpful in speeding the drug development pathway for drugs targeting specific neural systems and in individualizing pharmacological treatments.