Structural neural correlates of prosaccade and antisaccade eye movements in healthy humans

Structural and functional MRI evidence for significant contribution of precentral gyrus to flexible oculomotor control: evidence from the antisaccade task

Antisaccade task requires inhibition of a prepotent prosaccade to a peripheral target and initiation of a saccade to the opposite location, and, therefore, is used as a tool to investigate behavioral adjustment. The frontal and parietal cortices are both known for their activation during saccade generation, but it is unclear whether their neuroanatomical characteristics also contribute to antisaccades. Here, we took antisaccade cost (antisaccade latency minus prosaccade latency) as an index for additional time for generating antisaccades. Fifty-eight participants conducted pro and antisaccade tasks outside the magnetic resonance imaging (MRI) scanner and their structural MRI (sMRI) data were also collected to explore brain regions neuroanatomically related to antisaccade cost. Then, twelve participants performed saccade tasks in the scanner and their task-state functional MRI (fMRI) data were collected to verify the activation of structurally identified brain regions during the saccade generation. Voxel-based morphometry (VBM) results revealed that gray matter volume (GMV) of the left precentral gyrus and the left insula were positively correlated with the antisaccade cost, which was validated by the prediction analysis. Brain activation results showed the activation of the precentral during both pro and antisaccade execution period, but not the insula. Our results suggest that precentral gyrus and insula play vital roles to antisaccade cost, but possibly in different ways. The insula, a key node of the salience network, possibly regulates the saliency processing of the target, while the precentral gyrus possibly mediates the generation of saccades. Our study especially highlights an outstanding role of the precentral gyrus in flexible oculomotor control.

Toward an Automatic Assessment of Cognitive Dysfunction in Relapsing-Remitting Multiple Sclerosis Patients Using Eye Movement Analysis

Despite the importance of cognitive function in multiple sclerosis, it is poorly represented in the Expanded Disability Status Scale (EDSS), the commonly used clinical measure to assess disability, suggesting that an analysis of eye movement, which is generated by an extensive and well-coordinated functional network that is engaged in cognitive function, could have the potential to extend and complement this more conventional measure. We aimed to measure the eye movement of a case series of MS patients with relapsing−remitting MS to assess their cognitive status using a conventional gaze tracker. A total of 41 relapsing−remitting MS patients and 43 age-matched healthy controls were recruited for this study. Overall, we could not find a clear common pattern in the eye motor abnormalities. Vertical eye movement was more impaired in MS patients than horizontal movement. Increased latencies were found in the prosaccades and reflexive saccades of antisaccade tests. The smooth pursuit was impaired with more corrections (backup and catchup movements, p<0.01). No correlation was found between eye movement variables and EDSS or disease duration. Despite significant alterations in the behavior of the eye movements in MS patients, which are compatible with altered cognitive status, there is no common pattern of these alterations. We interpret this as a consequence of the patchy, heterogeneous distribution of white matter involvement in MS that provokes multiple combinations of impairment at different points in the different networks involved in eye motor control. Further studies are therefore required.

Emotional faces interfere with saccadic inhibition and attention re-orientation: An fMRI study

Modulation of reflex responses is crucial to adapt our behavior and cognition, and this is especially difficult when biological relevant stimuli are present such as emotional faces. The aim of this study was to identify the effect of peripherally presented happy and angry facial expressions in reflexive saccades and saccadic inhibition/re-orientation of attention. Behavior through eye-tracking technique and fMRI event-related BOLD signals activations were evaluated in adult males during the performance of an antisaccade task. fMRI signals obtained during task performance were compared to a baseline. Results showed that antisaccades had a lower percentage of correct responses and higher latency onsets than prosaccades. At the activation brain level, differences between both emotions and the baseline were found during stimuli presentation. Prosaccades for happy and angry faces recruited larger clusters with higher Z values mainly in occipito-parietal and temporal regions related to visual basic and integration processing, as well as regions of the oculomotor network. Meanwhile, when compared to the baseline, antisaccades recruited similar areas but a lower number of clusters with lower Z values as expected for peripheral processing of faces. At antisaccades, happy faces recruited parieto-occipital, temporal and cerebellar regions, while the angry faces added activation of orbital and ventrolateral prefrontal cortex related to emotional regulation. These results suggest that emotional facial expressions are being processed outside of the focus of attention. Particularly, angry expressions recruit a wider brain network in order to inhibit automatic behavior and re-orientate voluntary attention efficiently that may be due to its biological relevance.

The predictive value of local to remote functional connectivity changes in comitant exotropia patients

BACKGROUND

Comitant exotropia (CE) is a common eye disease with abnormal eye movement, whereas altered synchronous neural activity in CE patients is poorly understood. The purpose of our study was to investigate local to remote functional connectivity of blood oxygen level-dependent (BOLD) signals changes in CE patients.

MATERIAL AND METHODS

Thirty-four patients and thirty-four healthy controls (HCs) underwent resting-state MRI scans. The ReHo and FC method was applied to investigate the local to remote functional connectivity changes in CE patients.

RESULTS

Compared to the HC group, CE patients showed significant increased ReHo values in the left cerebellar_crus2 and left middle frontal gyrus. Meanwhile, CE patients showed significant decreased ReHo values in the right middle temporal gyrus, left postcentral gyrus and right angular. Moreover, CE patients showed an increased FC between the cerebellar network, sensorimotor network (SMN) and default-mode network (DMN). The support vector machine (SVM) classification was up to a total accuracy of 94.12%. The AUC of the classification model was 0.99 on the basis of ReHo map.

CONCLUSION

Our result highlights that CE patients had abnormal local to remote functional connectivity in the cerebellar network, SMN, DMN, which might indicate the neural mechanism of eye movements and stereo vision dysfunction in CE patients. Moreover, the SVM algorithm reveals ReHo maps as a potential biomarker for predicting clinical outcomes in CE patients.

Eye Movement Alterations in Post-COVID-19 Condition: A Proof-of-Concept Study

There is much evidence pointing out eye movement alterations in several neurological diseases. To the best of our knowledge, this is the first video-oculography study describing potential alterations of eye movements in the post-COVID-19 condition. Visually guided saccades, memory-guided saccades, and antisaccades in horizontal axis were measured. In all visual tests, the stimulus was deployed with a gap condition. The duration of the test was between 5 and 7 min per participant. A group of n=9 patients with the post-COVID-19 condition was included in this study. Values were compared with a group (n=9) of healthy volunteers whom the SARS-CoV-2 virus had not infected. Features such as centripetal and centrifugal latencies, success rates in memory saccades, antisaccades, and blinks were computed. We found that patients with the post-COVID-19 condition had eye movement alterations mainly in centripetal latency in visually guided saccades, the success rate in memory-guided saccade test, latency in antisaccades, and its standard deviation, which suggests the involvement of frontoparietal networks. Further work is required to understand these eye movements' alterations and their functional consequences.

Differences on Prosaccade Task in Skilled and Less Skilled Female Adolescent Soccer Players

Although the relationship between cognitive processes and saccadic eye movements has been outlined, the relationship between specific cognitive processes underlying saccadic eye movements and skill level of soccer players remains unclear. Present study used the prosaccade task as a tool to investigate the difference in saccadic eye movements in skilled and less skilled Chinese female adolescent soccer players. Fifty-six healthy female adolescent soccer players (range: 14–18years, mean age: 16.5years) from Fujian Youth Football Training Base (Fujian Province, China) took part in the experiment. In the prosaccade task, participants were instructed to fixate at the cross at the center of the screen as long as the target appeared peripherally. They were told to saccade to the target as quickly and accurately as possible once it appeared. The results indicated that skilled soccer players exhibited shorter saccade latency (p=0.031), decreased variability of saccade latency (p=0.013), and higher spatial accuracy of saccade (p=0.032) than their less skilled counterparts. The shorter saccade latency and decreased variability of saccade latency may imply that the attentional system of skilled soccer player is superior which leads to smaller attention fluctuation and less attentional lapse. Additionally, higher spatial accuracy of saccade may imply potential structural differences in brain underlying saccadic eye movement between skilled and less skilled soccer players. More importantly, the results of the present study demonstrated that soccer players’ cognitive capacities vary as a function of their skill levels. The limitations of the present study and future directions of research were discussed.

Effects of lorazepam on prosaccades and saccadic adaptation

BACKGROUND

Benzodiazepines have reliable adverse effects on saccadic eye movements, but the impact of sex as a potential modulator of these effects is less clear. A recent study reported stronger adverse effects on the spatial consistency of saccades in females, which may reflect sex differences in cerebellar mechanisms.

AIMS

We aimed to further examine the role of sex as a potential modulator of benzodiazepine effects by employing the saccadic adaptation paradigm, which is known to be sensitive to cerebellar functioning.

METHODS

A total of n=50 healthy adults performed a horizontal step prosaccade task and a saccadic adaptation task under 0.5 mg lorazepam, 1 mg lorazepam and placebo in a double-blind, within-subjects design.

RESULTS

In the prosaccade task, lorazepam had adverse effects on measures of peak velocity, latency and spatial consistency. The administration of 0.5 mg lorazepam led to significant reductions in gain-decrease adaptation, while a dose of 1 mg did not impair adaptation learning. Gain-increase adaptation was generally less pronounced, and unaffected by the drug. There were no significant drug×sex interactions in either task.

CONCLUSIONS

We conclude that a low dose of lorazepam impairs gain-decrease adaptation independent of sex. At higher doses, however, increasing fatigue may facilitate adaptation and thus counteract the adverse effects observed at lower doses. With regards to prosaccades, our findings confirm peak velocity as well as latency and spatial measures as sensitive biomarkers of GABAergic effects.

Emotional faces modulate eye movement control on an antisaccade task

The ability to modulate automatic responses, in order to favor voluntary actions is crucial for cognition and behavior, and this is particularly difficult when dealing with highly salient stimuli as emotional faces. The aim of this study was to evaluate the effects of angry faces on cortical activity during preparation of saccadic inhibition and voluntary reorientation of attention. Behavioral performance, eye movements and presaccadic event-related potentials were evaluated as 30 participants performed an antisaccadic task with neutral and angry faces presented in the peripheral visual field. Two components of the presaccadic activity were measured: positive presaccadic slope and spike potential. Results showed lower accuracy in the presence of angry faces than neutral ones. Saccade onset latency was longer for angry faces than for neutral ones on the prosaccadic trials, but the opposite result occurred on the antisaccadic trials. Finally, higher spike potential amplitudes were observed for the angry faces than the neutral ones. These results suggest that potentially threatening stimuli like angry facial expressions require greater effort to achieve inhibitory control and voluntary reorientation of attention.

Novel approach to evaluate central autonomic regulation in attention deficit/hyperactivity disorder (ADHD)

Attention deficit/hyperactivity disorder (ADHD) is one of the most commonly diagnosed developmental disorders in childhood characterized by hyperactivity, impulsivity and inattention. ADHD manifests in the child's development by deficits in cognitive, executive and perceptor-motor functions, emotional regulation and social adaptation. Although the exact cause has not yet been known, the crucial role in the development of this disease plays the interaction of genetic, neurobiological and epigenetic factors. According to current knowledge, ADHD is defined as a biological dysfunction of central nervous system with genetically or organically defined deficits in noradrenergic and dopaminergic neurotransmission associated with structural abnormalities, especially in prefronto-striatal regions. In this context, a significant part of the difficulties could be due to a faulty control of fronto-striato-thalamo-cortical circuits important for attention, arousal and executive functions. Moreover, ADHD is associated with abnormal autonomic regulation. Specifically, reduced cardiac-linked parasympathetic activity associated with relative sympathetic dominance indexed by low heart rate variability can represent a noninvasive marker for prefrontal hypoactivity. However, the mechanisms underlying altered autonomic regulation in ADHD are still unknown. In this aspect, the evaluation of central autonomic regulation by noninvasive methods, namely pupillometry and eye-tracking, may provide novel information for better understanding of the neurobiological pathomechanisms leading to ADHD.

Neuroanatomical Correlates of the Unity and Diversity Model of Executive Function in Young Adults

Understanding the neuroanatomical correlates of individual differences in executive function (EF) is integral to a complete characterization of the neural systems supporting cognition. While studies have investigated EF-neuroanatomy relationships in adults, these studies often include samples with wide variation in age, which may mask relationships between neuroanatomy and EF specific to certain neurodevelopmental time points, and such studies often use unreliable single task measures of EF. Here we address both issues. First, we focused on a specific age at which the majority of neurodevelopmental changes are complete but at which age-related atrophy is not likely (N = 251; mean age of 28.71 years, SD = 0.57). Second, we assessed EF through multiple tasks, deriving three factors scores guided by the unity/diversity model of EF, which posits a common EF factor that influences all EF tasks, as well as an updating-specific and shifting-specific factor. We found that better common EF was associated with greater volume and surface area of regions in right middle frontal gyrus/frontal pole, right inferior temporal gyrus, as well as fractional anisotropy in portions of the right superior longitudinal fasciculus (rSLF) and the left anterior thalamic radiation. Better updating-specific ability was associated with greater cortical thickness of a cluster in left cuneus/precuneus, and reduced cortical thickness in regions of right superior frontal gyrus and right middle/superior temporal gyrus, but no aspects of white matter diffusion. In contrast, better shifting-specific ability was not associated with gray matter characteristics, but rather was associated with increased mean diffusivity and reduced radial diffusivity throughout much of the brain and reduced axial diffusivity in distinct clusters of the left superior longitudinal fasciculus, the corpus callosum, and the right optic radiation. These results demonstrate that associations between individual differences in EF ability and regional neuroanatomical properties occur not only within classic brain networks thought to support EF, but also in a variety of other regions and white matter tracts. These relationships appear to differ from observations made in emerging adults (Smolker et al., 2015), which might indicate that the brain systems associated with EF continue to experience behaviorally relevant maturational process beyond the early 20s.

Participation of the caudal cerebellar lobule IX to the dorsal attentional network

BACKGROUND

We seeked for specific cerebellar contribution within the dorsal attentional network (DAN), using Independent Component Analysis (ICA).

METHODS

ICA-based analysis was performed on brain resting-state functional images of 19 volunteers.

RESULTS

We confirmed that DAN includes bilaterally: lobules VI-VII (crus I) and VIIB-VIIIA, as previously reported by Region-Of-Interest (ROI)-based functional connectivity studies. We also found that lobule IX (tonsillae), and as well as the superior and, likely, inferior colliculi. Also belong to DAN. The part of lobule IX in relation to DAN is located more caudally and laterally, and less extensive than the more rostral part of this lobule belonging to the default-mode network (DMN).

CONCLUSION

Rostral and caudal tonsillae partake in the DMN and DAN, respectively. The latter could subserve either eye movement control in relation to the oculomotor parieto-frontal network, partially congruent with the DAN, or more cognitive functions due to functional reallocation within the DAN.

Effects of lorazepam on saccadic eye movements: the role of sex, task characteristics and baseline traits

BACKGROUND

Saccadic eye movements are controlled by a network of parietal, frontal, striatal, cerebellar and brainstem regions. The saccadic peak velocity is an established biomarker of benzodiazepine effects, with benzodiazepines reliably reducing the peak velocity.

AIMS

In this study, we aimed to replicate the effects of benzodiazepines on peak velocity and we investigated effects on previously less studied measures of saccades. We also explored the roles of sex, task characteristics and the baseline variables age, intelligence and trait anxiety in these effects.

METHOD

Healthy adults ( N = 34) performed a horizontal step prosaccade task under 1 mg lorazepam, 2 mg lorazepam and placebo in a double-blind, within-subjects design.

RESULTS

We replicated the dose-dependent reduction in peak velocity with lorazepam and showed that this effect is stronger for saccades to targets at smaller eccentricities. We also demonstrated that this effect is independent of sex and other baseline variables. Lorazepam effects were widespread, however, occurring on mean and variability measures of most saccadic variables. Additionally, there were sex-dependent lorazepam effects on spatial consistency of saccades, indicating more adverse effects in females.

CONCLUSIONS

We conclude that saccadic peak velocity is a sensitive and robust biomarker of benzodiazepine effects. However, lorazepam has pronounced effects also on other parameters of horizontal saccades. Sex-dependent drug effects on spatial consistency may reflect cerebellar mechanisms, given the role of the cerebellum in saccadic spatial accuracy.

Structural and Functional Brain Mapping Correlates of Impaired Eye Movement Control in Parkinsonian Syndromes: A Systems-Based Concept

The investigation of the human oculomotor system by eye movement recordings provides an approach to behavior and its alterations in disease. The neurodegenerative process underlying parkinsonian syndromes, including Parkinson’s disease (PD), progressive supranuclear palsy (PSP), and multisystem atrophy (MSA) changes structural and functional brain organization, and thus affects eye movement control in a characteristic manner. Video-oculography has been established as a non-invasive recording device for eye movements, and systematic investigations of eye movement control in a clinical framework have emerged as a functional diagnostic tool in neurodegenerative parkinsonism. Disease-specific brain atrophy in parkinsonian syndromes has been reported for decades, these findings were refined by studies utilizing diffusion tensor imaging (DTI) and task-based/task-free functional MRI—both MRI techniques revealed disease-specific patterns of altered structural and functional brain organization. Here, characteristic disturbances of eye movement control in parkinsonian syndromes and their correlations with the structural and functional brain network alterations are reviewed. On this basis, we discuss the growing field of graph-based network analysis of the structural and functional connectome as a promising candidate for explaining abnormal phenotypes of eye movement control at the network level, both in health and in disease.

Regional microstructural damage and patterns of eye movement impairment: a DTI and video-oculography study in neurodegenerative parkinsonian syndromes

Characteristic alterations of eye movement control are a common feature of neurodegenerative parkinsonism, including Parkinson's disease (PD), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA). Regional microstructural alterations as assessed by diffusion tensor imaging (DTI) have been reported in PD, PSP, and MSA. Therefore, we investigated the specific association between eye movement disturbances and microstructural impairment in these diseases. Video-oculographic recordings of smooth pursuit and visually guided reactive saccades as well as fractional anisotropy (FA) maps computed from whole-brain DTI data were analyzed for 36 PD, 30 PSP, 18 MSA patients, and 23 matched healthy control subjects. In PSP, peak eye velocity was pathologically slowed compared to controls (p < 0.001) and correlated significantly with microstructural impairment in the midbrain (p < 0.001, corrected). Smooth pursuit eye movements were substantially disturbed in MSA mainly by characteristic 'catch-up' saccades resulting in significantly reduced pursuit gain (p < 0.001, corrected), and the shape of saccadized pursuit in MSA was significantly correlated with FA reductions in the middle cerebral peduncle (p < 0.001, FDR corrected). The prevalence of saccadic intrusions as a measure for inhibitory control was significantly increased in PD compared with controls (p < 0.001), but was uncorrelated with FA in cortical and subcortical white matter. Eye movement disturbances in PSP and MSA-but not in PD-are associated with diagnosis-specific regional microstructural alterations in the white matter. The non-invasive quantified oculomotor function analysis can give clues to the underlying structural connectivity network pathology and underpins its role as a technical marker in PSP and MSA.

Eye Movement in Unipolar and Bipolar Depression: A Systematic Review of the Literature

BACKGROUND

The analysis of eye movements (EM) by eye-tracking has been carried out for several decades to investigate mood regulation, emotional information processing, and psychomotor disturbances in depressive disorders.

METHOD

A systematic review of all English language PubMed articles using the terms "saccadic eye movements" OR "eye-tracking" AND "depression" OR "bipolar disorders" was conducted using PRISMA guidelines. The aim of this review was to characterize the specific alterations of EM in unipolar and bipolar depression.

RESULTS

Findings regarding psychomotor disturbance showed an increase in reaction time in prosaccade and antisaccade tasks in both unipolar and bipolar disorders. In both disorders, patients have been reported to have an attraction for negative emotions, especially for negative pictures in unipolar and threatening images in bipolar disorder. However, the pattern could change with aging, elderly unipolar patients disengaging key features of sad and neutral stimuli. METHODological limitations generally include small sample sizes with mixed unipolar and bipolar depressed patients.

CONCLUSION

Eye movement analysis can be used to discriminate patients with depressive disorders from controls, as well as patients with bipolar disorder from patients with unipolar depression. General knowledge concerning psychomotor alterations and affective regulation strategies associated with each disorder can also be gained thanks to the analysis. Future directions for research on eye movement and depression are proposed in this review.

Cortical Coupling Reflects Bayesian Belief Updating in the Deployment of Spatial Attention

The deployment of visuospatial attention and the programming of saccades are governed by the inferred likelihood of events. In the present study, we combined computational modeling of psychophysical data with fMRI to characterize the computational and neural mechanisms underlying this flexible attentional control. Sixteen healthy human subjects performed a modified version of Posner's location-cueing paradigm in which the percentage of cue validity varied in time and the targets required saccadic responses. Trialwise estimates of the certainty (precision) of the prediction that the target would appear at the cued location were derived from a hierarchical Bayesian model fitted to individual trialwise saccadic response speeds. Trial-specific model parameters then entered analyses of fMRI data as parametric regressors. Moreover, dynamic causal modeling (DCM) was performed to identify the most likely functional architecture of the attentional reorienting network and its modulation by (Bayes-optimal) precision-dependent attention. While the frontal eye fields (FEFs), intraparietal sulcus, and temporoparietal junction (TPJ) of both hemispheres showed higher activity on invalid relative to valid trials, reorienting responses in right FEF, TPJ, and the putamen were significantly modulated by precision-dependent attention. Our DCM results suggested that the precision of predictability underlies the attentional modulation of the coupling of TPJ with FEF and the putamen. Our results shed new light on the computational architecture and neuronal network dynamics underlying the context-sensitive deployment of visuospatial attention.

SIGNIFICANCE STATEMENT

Spatial attention and its neural correlates in the human brain have been studied extensively with the help of fMRI and cueing paradigms in which the location of targets is pre-cued on a trial-by-trial basis. One aspect that has so far been neglected concerns the question of how the brain forms attentional expectancies when no a priori probability information is available but needs to be inferred from observations. This study elucidates the computational and neural mechanisms under which probabilistic inference governs attentional deployment. Our results show that Bayesian belief updating explains changes in cortical connectivity; in that directional influences from the temporoparietal junction on the frontal eye fields and the putamen were modulated by (Bayes-optimal) updates.

Single session imaging of cerebellum at 7 Tesla: obtaining structure and function of multiple motor subsystems in individual subjects

The recent increase in the use of high field MR systems is accompanied by a demand for acquisition techniques and coil systems that can take advantage of increased power and accuracy without being susceptible to increased noise. Physical location and anatomical complexity of targeted regions must be considered when attempting to image deeper structures with small nuclei and/or complex cytoarchitechtonics (i.e. small microvasculature and deep nuclei), such as the brainstem and the cerebellum (Cb). Once these obstacles are overcome, the concomitant increase in signal strength at higher field strength should allow for faster acquisition of MR images. Here we show that it is technically feasible to quickly and accurately detect blood oxygen level dependent (BOLD) signal changes and obtain anatomical images of Cb at high spatial resolutions in individual subjects at 7 Tesla in a single one-hour session. Images were obtained using two high-density multi-element surface coils (32 channels in total) placed beneath the head at the level of Cb, two channel transmission, and three-dimensional sensitivity encoded (3D, SENSE) acquisitions to investigate sensorimotor activations in Cb. Two classic sensorimotor tasks were used to detect Cb activations. BOLD signal changes during motor activity resulted in concentrated clusters of activity within the Cb lobules associated with each task, observed consistently and independently in each subject: Oculomotor vermis (VI/VII) and CrusI/II for pro- and anti-saccades; ipsilateral hemispheres IV-VI for finger tapping; and topographical separation of eye- and hand- activations in hemispheres VI and VIIb/VIII. Though fast temporal resolution was not attempted here, these functional patches of highly specific BOLD signal changes may reflect small-scale shunting of blood in the microvasculature of Cb. The observed improvements in acquisition time and signal detection are ideal for individualized investigations such as differentiation of functional zones prior to surgery.

The role of motivation, glucose and self-control in the antisaccade task

Research shows that self-control is resource limited and there is a gradual weakening in consecutive self-control task performance akin to muscle fatigue. A body of evidence suggests that the resource is glucose and consuming glucose reduces this effect. This study examined the effect of glucose on performance in the antisaccade task - which requires self-control through generating a voluntary eye movement away from a target - following self-control exertion in the Stroop task. The effects of motivation and individual differences in self-control were also explored. In a double-blind design, 67 young healthy adults received a 25g glucose or inert placebo drink. Glucose did not enhance antisaccade performance following self-control exertion in the Stroop task. Motivation however, predicted performance on the antisaccade task; more specifically high motivation ameliorated performance decrements observed after initial self-control exertion. In addition, individuals with high levels of self-control performed better on certain aspects of the antisaccade task after administration of a glucose drink. The results of this study suggest that the antisaccade task might be a powerful paradigm, which could be used as a more objective measure of self-control. Moreover, the results indicate that level of motivation and individual differences in self-control should be taken into account when investigating deficiencies in self-control following prior exertion.

Eye movements reveal impaired inhibitory control in adult male fragile X premutation carriers asymptomatic for FXTAS

OBJECTIVE

Fragile X premutation carriers (fXPCs) have an expansion of 55-200 CGG repeats in the FMR1 gene. Male fXPCs are at risk for developing a neurodegenerative motor disorder (FXTAS) often accompanied by inhibitory control impairments, even in fXPCs without motor symptoms. Inhibitory control impairments might precede, and thus indicate elevated risk for motor impairment associated with FXTAS. We tested whether inhibitory impairments are observable in fXPCs by assessing oculomotor performance.

METHOD

Participants were males aged 18-48 years asymptomatic for FXTAS. FXPCs (n = 21) and healthy age-matched controls (n = 22) performed four oculomotor tasks. In a Fixation task, participants fixated on a central cross and maintained gaze position when a peripheral stimulus appeared. In a Pursuit task, participants maintained gaze on a square moving at constant velocity. In a Prosaccade task, participants fixated on a central cross, then looked at a peripheral stimulus. An Antisaccade task was identical to the Prosaccade task, except participants looked in the direction opposite the stimulus. Inhibitory cost was the difference in saccade latency between the Antisaccade and Prosaccade tasks.

RESULTS

Relative to controls, fXPCs had longer saccade latency in the Antisaccade task. In fXPCs, inhibitory cost was positively associated with vermis area in lobules VI-VII.

CONCLUSION

Antisaccades require inhibitory control to inhibit reflexive eye movements. We found that eye movements are sensitive to impaired inhibitory control in fXPCs asymptomatic for FXTAS. Thus, eye movements may be useful in assessing FXTAS risk or disease progression.

Individual differences in regional prefrontal gray matter morphometry and fractional anisotropy are associated with different constructs of executive function

Although the relationship between structural differences within the prefrontal cortex (PFC) and executive function (EF) has been widely explored in cognitively impaired populations, little is known about this relationship in healthy young adults. Using optimized voxel-based morphometry (VBM), surface-based morphometry (SBM), and fractional anisotropy (FA) we determined the association between regional PFC grey matter (GM) morphometry and white matter tract diffusivity with performance on tasks that tap different aspects of EF as drawn from Miyake et al.'s three-factor model of EF. Reductions in both GM volume (VBM) and cortical folding (SBM) in the ventromedial PFC (vmPFC), ventrolateral PFC (vlPFC), and dorsolateral PFC (dlPFC) predicted better common EF, shifting-specific, and updating-specific performance, respectively. Despite capturing different components of GM morphometry, voxel- and surface-based findings were highly related, exhibiting regionally overlapping relationships with EF. Increased white matter FA in fiber tracts that connect the vmPFC and vlPFC with posterior regions of the brain also predicted better common EF and shifting-specific performance, respectively. These results suggest that the neural mechanisms supporting distinct aspects of EF may differentially rely on distinct regions of the PFC, and at least in healthy young adults, are influenced by regional morphometry of the PFC and the FA of major white matter tracts that connect the PFC with posterior cortical and subcortical regions.

Horizontal and vertical eye movement metrics: what is important?

OBJECTIVE

To assist other eye movement investigators in the design and analysis of their studies.

METHODS

We examined basic saccadic eye movements and smooth pursuit in the horizontal and vertical directions with video-oculography in a group of 145 healthy subjects between 19 and 82 years of age.

RESULTS

Gender and education level did not influence eye movement metrics. With age, the latency of leftward and vertical pro- and antisaccades increased (p<0.001), velocity of upward prosaccades decreased (p<0.001), gain of rightward and upward prosaccades diminished (p<0.001), and the error rate of antisaccades increased (p<0.001). Prosaccades and antisaccades were influenced by the direction of the target, resulting in a right/left and up/down asymmetry. The skewness of the saccade velocity profile was stable throughout the lifespan, and within the range of saccades analyzed in the present study, correlated with amplitude and duration only for antisaccades (p<0.001).

CONCLUSIONS

Some eye movement metrics must be separated by the direction of movement, others according to subject age, while others may be pooled.

SIGNIFICANCE

This study provides important information for new oculomotor laboratories concerning the constitution of subject groups and the analysis of eye movement metrics.

Multicenter validation of a bedside antisaccade task as a measure of executive function

OBJECTIVE

To create and validate a simple, standardized version of the antisaccade (AS) task that requires no specialized equipment for use as a measure of executive function in multicenter clinical studies.

METHODS

The bedside AS (BAS) task consisted of 40 pseudorandomized AS trials presented on a laptop computer. BAS performance was compared with AS performance measured using an infrared eye tracker in normal elders (NE) and individuals with mild cognitive impairment (MCI) or dementia (n = 33). The neuropsychological domain specificity of the BAS was then determined in a cohort of NE, MCI, and dementia (n = 103) at UCSF, and the BAS was validated as a measure of executive function in a 6-center cohort (n = 397) of normal adults and patients with a variety of brain diseases.

RESULTS

Performance on the BAS and laboratory AS task was strongly correlated and BAS performance was most strongly associated with neuropsychological measures of executive function. Even after controlling for disease severity and processing speed, BAS performance was associated with multiple assessments of executive function, most strongly the informant-based Frontal Systems Behavior Scale.

CONCLUSIONS

The BAS is a simple, valid measure of executive function in aging and neurologic disease.

Executive deficits detected in mild Alzheimer's disease using the antisaccade task

The antisaccade task, a hands- and language-free metric, may provide a functional index of the dorsolateral prefrontal cortex (DLPFC), a region damaged in the later stages of Alzheimer's disease (AD). Our objective was to determine if patients with mild AD made more errors relative to age-matched controls. Thirty patients with mild AD (Mini Mental Status Exam [MMSE] ≥ 17) and 31 age-matched controls completed a laptop version of the prosaccades and antisaccades tasks. Patients with AD made more antisaccade errors, and corrected fewer errors, than age-matched controls. Error rates, corrected or uncorrected, were not correlated with AD MMSE or Dementia Rating Scale scores. Our findings indicate that antisaccade impairments exist in mild AD, suggesting clinically detectable DLPFC pathology may be present earlier than suggested by previous studies.

Anti-saccade performance predicts executive function and brain structure in normal elders

OBJECTIVE

To assess the neuropsychological and anatomical correlates of anti-saccade (AS) task performance in normal elders.

BACKGROUND

The AS task correlates with neuropsychological measures of executive function and frontal lobe volume in neurological diseases, but has not been studied in a well-characterized normal elderly population. Because executive dysfunction can indicate an increased risk for cognitive decline in cognitively normal elders, we hypothesized that AS performance might be a sensitive test of age-related processes that impair cognition.

METHOD

The percentage of correct AS responses was evaluated in 48 normal elderly subjects and associated with neuropsychological test performance using linear regression analysis and gray matter volume measured on magnetic resonance imaging scans using voxel-based morphometry.

RESULTS

The percentage of correct AS responses was associated with measures of executive function, including modified trails, design fluency, Stroop inhibition, abstraction, and backward digit span, and correlated with gray matter volume in 2 brain regions involved in inhibitory control: the left inferior frontal junction and the right supplementary eye field. The association of AS correct responses with neuropsychological measures of executive function was strongest in individuals with fewer years of education.

CONCLUSIONS

The AS task is sensitive to executive dysfunction and frontal lobe structural alterations in normal elders.

Dynamic interactions in the fronto-parietal network during a manual stimulus-response compatibility task

Attentional orienting can be modulated by stimulus-driven bottom-up as well as task-dependent top-down processes. In a recent study we investigated the interaction of both processes in a manual stimulus-response compatibility task. Whereas the intraparietal sulcus (IPS) and the dorsal premotor cortex (dPMC) were involved in orienting towards the stimulus side facilitating congruent motor responses, the right temporoparietal junction (TPJ), right dorsolateral prefrontal cortex (DLPFC) as well as the preSMA sustained top-down control processes involved in voluntary reorienting. Here we used dynamic causal modelling to investigate the contributions and task-dependent interactions between these regions. Thirty-six models were tested, all of which included bilateral IPS, dPMC and primary motor cortex (M1) as a network transforming visual input into motor output as well as the right TPJ, right DLPFC and the preSMA as task-dependent top-down regions influencing the coupling within the dorsal network. Our data showed the right temporoparietal junction to play a mediating role during attentional reorienting processes by modulating the inter-hemispheric balance between both IPS. Analysis of connection strength supported the proposed role of the preSMA in controlling motor responses promoting or suppressing activity in primary motor cortex. As the results did not show a clear tendency towards a role of the right DLPFC, we propose this region, against the usual interpretation of an inhibitory influence in stimulus-response compatibility tasks, to subserve generic monitoring processes. Our DCM study hence provides evidence for context-dependent top-down control of right TPJ and DLPFC as well as the preSMA in stimulus-response compatibility.

Dissociating bottom-up and top-down processes in a manual stimulus-response compatibility task

Speed and accuracy of motor responses to lateralized stimuli are influenced by the spatial overlap between stimulus location and required response. Responses showing high spatial overlap with peripheral cues benefit from a bottom-up driven enhancement of attention to the respective location, whereas low overlap requires top-down modulated reorienting of resources. Here we investigated the interaction between these two processes using a spatial stimulus-response compatibility task. Subjects had to react to lateralized visual stimuli with a button press using either the ipsilateral (congruent condition) or the contralateral (incongruent condition) index finger. Stimulus-driven bottom-up processes were associated with significant contralateral activation in V5, the intraparietal sulcus (IPS) and the premotor cortex (PMC). Incongruent versus congruent responses evoked significant activation in bilateral IPS and PMC, highly overlapping with the activations found for stimulus-driven bottom-up processes, as well as additional activation in bilateral anterior insula and right dorsolateral prefrontal cortex (DLPFC) and temporoparietal junction (TPJ). Moreover, a region anterior to the bottom-up driven activation in the IPS was associated with top-down modulated directionality-specific reorienting of motor attention during incongruent motor responses. Based on these results, we propose that stimulus-driven activation of contralateral IPS and PMC represent key neuronal substrates for the behavioral advantage observed when reacting toward a congruently lateralized stimulus. Additional activation in bilateral insula and right DLPFC and TPJ during incongruent responses should reflect top-down control mechanisms mediating contextual (i.e., task) demands. Furthermore, this study provides evidence for both overlapping and disparate substrates of bottom-up and top-down modulated attentional processes in the IPS.

Parkinson's disease as a disconnection syndrome

Parkinson's disease (PD) is a major neurodegenerative disorder that is usually considered in terms of midbrain and basal ganglia dysfunction. Regarding PD instead as a disconnection syndrome may prove beneficial to understanding aspects of cognition, perception, and other neuropsychological domains in the disease. PD is usually of unilateral onset, providing evidence of intrahemispheric dissociations and an imbalance in the usual relative strengths of the right and left hemispheres. Hence, in order to appreciate the neuropsychology of PD, it is important to apply to this disease our understanding of hemispheric lateralization effects and within-hemisphere circuitry from brainstem to higher-order association cortex. The focus of this review is on the relevance of PD-related disconnections among subcortical and cortical structures to cognition, perception, emotion, and associated brainstem-based domains such as sleep and mood disturbance. Besides providing information on disease characteristics, regarding PD as a disconnection syndrome allows us to more completely understand normal brain-behavior relations in general.

Visual exploration of emotional facial expressions in Parkinson's disease

Parkinson's disease (PD) is associated with impairments in facial emotion recognition as well as visual and executive dysfunction. We investigated whether facial emotion categorization impairments in PD are attributable to visual scanning abnormalities by recording the eye movements of 16 non-demented PD and 20 healthy control (HC) participants during an emotion recognition task. We examined the influence of several factors that can affect visual scanning, including oculomotor, basic visual, and cognitive abilities (executive function). Increases in the number and duration of fixations in the top regions of surprise facial expressions were related to increases in recognition accuracy for this emotion in PD participants with left-sided motor-symptom onset. Compared to HC men, HC women spent less time fixating on fearful expressions. PD participants displayed oculomotor abnormalities (antisaccades), but these were unrelated to scanning patterns. Performance on visual measures (acuity, contrast sensitivity) correlated with scanning patterns in the PD group only. Poorer executive function was associated with longer fixation times in PD and with a greater number of fixations in HC. Our findings indicate a specific relation between facial emotion categorization impairments and scanning of facial expressions in PD. Furthermore, PD and HC participants' scanning behaviors during an emotion categorization task were driven by different perceptual processes and cognitive strategies. Our results underscore the need to consider differences in perceptual and cognitive abilities in studies of visual scanning, particularly when examining this ability in patient populations for which both vision and cognition are impaired.

Anatomical correlate of impaired covert visual attentional processes in patients with cerebellar lesions

In the past years, claims of cognitive and attentional function of the cerebellum have first been raised but were later refuted. One reason for this controversy might be that attentional deficits only occur when specific cerebellar structures are affected. To further elucidate this matter and to determine which cerebellar regions might be involved in deficits of covert visual attention, we used new brain imaging tools of lesion mapping that allow a direct comparison with control patients. A total of 26 patients with unilateral right-sided cerebellar infarcts were tested on a covert visual attention task. Eight (31%) patients showed markedly slowed responses, especially in trials in which an invalid cue necessitated reorienting of the focus of attention for target detection. Compared with the 18 patients who performed within the range of healthy control subjects, only the impaired patients had lesions of cerebellar vermal structures such as the pyramid. We suggest that these midcerebellar regions are indirectly involved in covert visual attention via oculomotor control mechanisms. Thus, specific cerebellar structures do influence attentional orienting, whereas others do not.

Age-related trends in saccade characteristics among the elderly

Eye movement recordings are useful for assessing neurological disorders, the prevalence of which increases with age. However, there is little rigorous quantitative data on describing oculomotor changes that occur during healthy aging. Here, we measured the ability of 81 normal elderly subjects (60-85 years) to perform two saccadic eye movement tasks: a pro-saccade task, requiring an automatic response to look towards a stimulus and an anti-saccade task, requiring inhibition of the automatic response to instead initiate a voluntary saccade away from the stimulus. Saccadic ability decreased with age: the oldest subjects were slower to initiate saccades and they made more direction errors (i.e., erroneous pro-saccades) in the anti-saccade task. Intra-subject variability in reaction time also correlated positively with age in both saccade tasks. Voluntary saccade control, as assessed by the anti-saccade task, was far more affected by aging than automatic control, as assessed by the pro-saccade task, suggesting that the mechanisms driving voluntary and automatic saccade performance deteriorate at different rates in the aging brain, and therefore likely involves different neural substrates. Our data provide insight into deficits due to normal brain changes in aging as well as a baseline to evaluate deficits caused by neurological disorders common in this age range.

Neurophysiology and neuroanatomy of reflexive and volitional saccades: evidence from studies of humans

This review provides a summary of the contributions made by human functional neuroimaging studies to the understanding of neural correlates of saccadic control. The generation of simple visually guided saccades (redirections of gaze to a visual stimulus or pro-saccades) and more complex volitional saccades require similar basic neural circuitry with additional neural regions supporting requisite higher level processes. The saccadic system has been studied extensively in non-human (e.g., single-unit recordings) and human (e.g., lesions and neuroimaging) primates. Considerable knowledge of this system's functional neuroanatomy makes it useful for investigating models of cognitive control. The network involved in pro-saccade generation (by definition largely exogenously-driven) includes subcortical (striatum, thalamus, superior colliculus, and cerebellar vermis) and cortical (primary visual, extrastriate, and parietal cortices, and frontal and supplementary eye fields) structures. Activation in these regions is also observed during endogenously-driven voluntary saccades (e.g., anti-saccades, ocular motor delayed response or memory saccades, predictive tracking tasks and anticipatory saccades, and saccade sequencing), all of which require complex cognitive processes like inhibition and working memory. These additional requirements are supported by changes in neural activity in basic saccade circuitry and by recruitment of additional neural regions (such as prefrontal and anterior cingulate cortices). Activity in visual cortex is modulated as a function of task demands and may predict the type of saccade to be generated, perhaps via top-down control mechanisms. Neuroimaging studies suggest two foci of activation within FEF - medial and lateral - which may correspond to volitional and reflexive demands, respectively. Future research on saccade control could usefully (i) delineate important anatomical subdivisions that underlie functional differences, (ii) evaluate functional connectivity of anatomical regions supporting saccade generation using methods such as ICA and structural equation modeling, (iii) investigate how context affects behavior and brain activity, and (iv) use multi-modal neuroimaging to maximize spatial and temporal resolution.

A review on eye movement studies in childhood and adolescent psychiatry

The neural substrates of eye movement measures are largely known. Therefore, measurement of eye movements in psychiatric disorders may provide insight into the underlying neuropathology of these disorders. Visually guided saccades, antisaccades, memory guided saccades, and smooth pursuit eye movements will be reviewed in various childhood psychiatric disorders. The four aims of this review are (1) to give a thorough overview of eye movement studies in a wide array of psychiatric disorders occurring during childhood and adolescence (attention-deficit/hyperactivity disorder, oppositional deviant disorder and conduct disorder, autism spectrum disorders, reading disorder, childhood-onset schizophrenia, Tourette's syndrome, obsessive compulsive disorder, and anxiety and depression), (2) to discuss the specificity and overlap of eye movement findings across disorders and paradigms, (3) to discuss the developmental aspects of eye movement abnormalities in childhood and adolescence psychiatric disorders, and (4) to present suggestions for future research. In order to make this review of interest to a broad audience, attention will be given to the clinical manifestation of the disorders and the theoretical background of the eye movement paradigms.

Cerebellum volume and eyeblink conditioning in schizophrenia

Although accumulating evidence suggests that cerebellar abnormalities may be linked to the symptoms and course of schizophrenia, few studies have related structural and functional indices of cerebellar integrity. The present study examined the relationship between the volume of specific subregions of the cerebellum and cerebellar function, as measured by eyeblink conditioning (EBC). Nine individuals with schizophrenia and six healthy comparison participants completed structural magnetic resonance imaging of the brain and a delay EBC procedure. Volumetric measurements were taken for the whole brain, whole cerebellum, cerebellar anterior lobules I-V and posterior lobules VI-VII. The schizophrenia group had smaller cerebellar anterior lobes and exhibited impaired EBC relative to the comparison group. In the comparison group, larger anterior volume correlated with earlier conditioned response onset latencies and increased amplitudes of the unconditioned blink response during paired trials (i.e., when the conditioned and unconditioned stimuli co-occurred). The findings that smaller anterior cerebellar volumes and EBC impairments were associated with schizophrenia are consistent with non-human studies showing that anterior cerebellar abnormalities are associated with deficits in delay EBC. The lack of a significant correlation between indices of EBC and cerebellar volume within the schizophrenia group suggests an aberrant relationship between cerebellar structure and function.

Cortical mechanisms of retinal and extraretinal smooth pursuit eye movements to different target velocities

Smooth pursuit eye movements (SPEM) are used to maintain focus upon moving targets. The generation of SPEM velocity is controlled by retinal information and extraretinal signals. Although there is a wealth of studies investigating retinal and extraretinal SPEM control, the main questions regarding the cortical mechanisms involved in the processing of SPEM to different stimulus velocities are still unresolved. We applied an innovative event-related fMRI-design by presenting target ramps at different velocities (5, 10, 15, 20 degrees/s) with both continuous target presentation and intervals of target blanking. The stimulus parameters were integrated into the statistical model and eye movements were registered to confirm SPEM performance. Our results clearly demonstrate that in humans the oculomotor network (V5, frontal and supplementary eye fields, lateral intraparietal area) is engaged in the processing of retinal and extraretinal SPEM velocity. Within this network neural activity increases with increasing target velocity. During extraretinal SPEM, additional engagement of the dorsolateral prefrontal cortex, angular gyrus, parahippocampal gyrus and superior temporal gyrus occurs. These regions encode cognitive functions such as memory, attention and monitoring. The activation of the inferior parietal cortex seems to be related to the interaction between velocity and blanking thereby underlining its relevance for task switching and sensorimotor transformation.

Cortical grey matter volume and sensorimotor gating in schizophrenia

Prepulse inhibition (PPI) of the startle response, a cross-species measure of sensorimotor gating, provides a valuable tool to study the known inability of a large proportion of individuals with schizophrenia to effectively screen out irrelevant sensory input. The cortico-striato-pallido-thalamic circuitry is thought to be responsible for modulation of PPI in experimental animals. The involvement of this circuitry in human PPI is supported by observations of deficient PPI in a number of neuropsychiatric disorders that are characterised by abnormalities at some level in this circuitry, and findings of recent functional neuroimaging studies in healthy participants. The current study sought to investigate the structural neural correlates of PPI in a sample of 42 stable male outpatients with schizophrenia. Participants underwent magnetic resonance imaging (MRI) at 1.5T and were assessed (off-line) on acoustic PPI using electromyographic recordings of the orbicularis oculi muscle beneath the right eye. Optimised volumetric voxel-based morphometry implemented in SPM2 was used to investigate the relationship of PPI (prepulse onset-to-pulse onset interval 120msec) to regional grey matter (GM) volumes. Significant positive correlations were obtained between PPI and GM volume in the dorsolateral prefrontal, middle frontal and the orbital/medial prefrontal cortices. Our findings are consistent with (a) previous suggestions of susceptibility of PPI to cognitive processes controlled in a 'top down' manner by the cortex and (b) the hypothesis that compromised neural resources in the frontal cortex contribute to reduced PPI in schizophrenia.

Decomposing the neural correlates of antisaccade eye movements using event-related FMRI

The antisaccade task is a model of the conflict between an unwanted reflexive response (which must be inhibited) and a complex volitional response (which must be generated). The present experiment aimed to investigate separately the neural correlates of these cognitive components using a delayed saccade paradigm to dissociate saccade inhibition from generation. Seventeen healthy volunteers completed event-related functional magnetic resonance imaging at 1.5 T during saccades to and away from a peripheral visual target (prosaccades and antisaccades, respectively). Saccades were requested in response to an auditory go signal on average 12 s after peripheral target appearance. It was found that the right supramarginal gyrus showed significantly greater activation during the inhibition phase than the generation phase of the paradigm for both antisaccade and prosaccade trials, suggesting a role in saccade inhibition or stimulus detection. On the other hand, the right lateral frontal eye field and bilateral intraparietal sulcus showed evidence of selective involvement in antisaccade generation. Ventrolateral and dorsolateral prefrontal cortices showed comparable levels of activation in both phases of the task. These areas likely fulfill a more general supervisory role in the volitional control of eye movements, such as stimulus appraisal, task set, and decision making.

The antisaccade task as a research tool in psychopathology: a critical review

The antisaccade task is a measure of volitional control of behavior sensitive to fronto-striatal dysfunction. Here we outline important issues concerning antisaccade methodology, consider recent evidence of the cognitive processes and neural mechanisms involved in task performance, and review how the task has been applied to study psychopathology. We conclude that the task yields reliable and sensitive measures of the processes involved in resolving the conflict between volitional and reflexive behavioral responses, a key cognitive deficit relevant to a number of neuropsychiatric conditions. Additionally, antisaccade deficits may reflect genetic liability for schizophrenia. Finally, the ease and accuracy with which the task can be administered, combined with its sensitivity to fronto-striatal dysfunction and the availability of suitable control conditions, may make it a useful benchmark tool for studies of potential cognitive enhancers.

Attentional versus motor inhibition in adults with attention-deficit/hyperactivity disorder

Faulty inhibition is theorized to be a central feature in attention-deficit/hyperactivity disorder (ADHD), but it remains unclear whether inhibitory impairments encompass both motoric and attentional domains. Further, characterization of inhibitory deficits in adults with ADHD is needed. We experimentally assessed adults who met diagnostic criteria for ADHD and a subgroup who had partially remitted. Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) subtype effects were also examined. Motoric inhibition was assessed with the antisaccade task, and attentional inhibition was assessed with the attentional blink (AB) task. Antisaccade results replicated prior findings of extended latencies and increased anticipatory saccades in ADHD. Errors, however, appeared to be epiphenomenal to ADHD as they were absent when symptoms had partially remitted. Anticipatory saccades appeared as potential core problems that remained even when symptoms had improved. Differential response patterns were found for predominantly inattentive and combined subtypes, with the latter showing increasing anticipatory movements with increasing fixation time. In the AB task, ADHD groups committed more errors but showed no convincing evidence of an abnormal blink. These results demonstrate clear effects on motoric inhibition but not attentional inhibition in adults with ADHD.