Memory-guided saccadic eye movements: effects of cerebellar disease

Bilateral lesion of the cerebellar fastigial nucleus: Effects on smooth pursuit acceleration and non-reflexive visually-guided saccades

Background

“Central dizziness” due to acute bilateral midline cerebellar disease sparing the posterior vermis has specific oculomotor signs. The oculomotor region of the cerebellar fastigial nucleus (FOR) crucially controls the accuracy of horizontal visually-guided saccades and smooth pursuit eye movements. Bilateral FOR lesions elicit bilateral saccade hypermetria with preserved pursuit. It is unknown whether the initial acceleration of smooth pursuit is impaired in patients with bilateral FOR lesions.

Objective

We studied the effect of a cerebellar lesion affecting the deep cerebellar nuclei on the initial horizontal pursuit acceleration and investigated whether saccade dysmetria also affects other types of volitional saccades, i.e., memory-guided saccades and anti-saccades, which are not performed in immediate response to the visual target.

Methods

We recorded eye movements during a sinusoidal and step-ramp target motion paradigm as well as visually-guided saccades, memory-guided saccades, and anti-saccades in one patient with a circumscribed cerebellar hemorrhage and 18 healthy control subjects using a video-based eye tracker.

Results

The lesion comprised the FOR bilaterally but spared the posterior vermis. The initial pursuit acceleration was low but not significantly different from the healthy control subjects and sinusoidal pursuit was normal. Bilateral saccade hypermetria was not only seen with visually-guided saccades but also with anti-saccades and memory-guided saccades. The final eye position remained accurate.

Conclusion

We provide new insights into the contribution of the bilateral deep cerebellar nuclei on the initial acceleration of human smooth pursuit in midline cerebellar lesions. In line with experimental bilateral FOR lesion data in non-human primates, the initial pursuit acceleration in our patient was not significantly reduced, in contrast to the effects of unilateral experimental FOR lesions. Working memory and neural representation of target locations seem to remain unimpaired. Our data argue against an impaired common command feeding the circuits controlling saccadic and pursuit eye movements and support the hypothesis of independent influences on the neural processes generating both types of eye movements in the deep cerebellar nuclei.

Effects of cerebellar disease on sequences of rapid eye movements

Studying saccades can illuminate the more complex decision-making processes required for everyday movements. The double-step task, in which a target jumps to two successive locations before the subject has time to react, has proven a powerful research tool to investigate the brain's ability to program sequential responses. We asked how patients with a range of cerebellar disorders responded to the double-step task, specifically, whether the initial saccadic response made to a target is affected by the appearance of a second target jump. We also sought to determine whether cerebellar patients were able to make corrective saccades towards the remembered second target location if it were turned off soon after presentation. We tested saccades to randomly interleaved single- and double-step target jumps to eight locations on a circle. Patient's initial responses to double-step stimuli showed 50% more error than saccades to single target jumps, and often, they failed to make a saccade to the first target jump. The presence of a second target jump had similar, but smaller effects in control subjects (error increased by 18%). During memory-guided double-step trials, both patients and controls made corrective saccades in darkness to the remembered location of the second jump. We conclude that in cerebellar patients, the second target jump interferes with programming of the saccade to the first target jump of a double-step stimulus; this defect highlights patients' impaired ability to respond appropriately to sudden, conflicting changes in their environment. Conversely, since cerebellar patients can make corrective memory-guided saccades in darkness, they retain the ability to remember spatial locations, possibly due to non-retinal neural signals (corollary discharge) from cerebral hemispheric areas concerned with spatial localization.

Evaluating Large Saccades in Patients with Brain-Stem or Cerebellar Disorders

Clinicians conventionally test saccades at the bedside by noting the accuracy, initiation time, and speed of large movements, with the patient's head stationary. Partly for methodological reasons, laboratory analysis of saccades has mainly focused on movements of 20 degrees or less. By measuring the velocity waveform of large saccades, it is possible to examine more closely the way in which brain stem and cerebellum guide the eye to the target. Large saccades made by healthy humans show a positively skewed velocity profile. Slow saccades made by patients with brain-stem disorders show a prolonged plateau of low velocity. Some patients with cerebellar disorders may show increased acceleration and deceleration of saccades. Each of these velocity waveforms can be modeled by changing the parameters that describe medium-lead burst neuron firing. In certain other brain-stem and cerebellar disorders, transient decelerations or premature terminations of saccades occur; such velocity waveforms cannot be modeled solely by changing the parameters that describe burst neuron firing. Instead, it is necessary to postulate dysfunction of the mechanism that normally inhibits pontine omnipause neurons, thereby permitting burst neurons to discharge until the saccade is completed. Analysis of large, abnormal saccades calls for application of novel techniques to identify the beginning and end of the saccadic pulse command.

Control of saccadic eye movements and combined eye/head gaze shifts by the medio-posterior cerebellum

The cerebellar areas involved in the control of saccades have recently been identified in the medio-posterior cerebellum (MPC). Unit activity recordings, experimental lesions and electrical microstimulation of this region in cats and monkeys have provided a considerable amount of data and allowed the development of new computational models. In this paper, we review these data and concepts about cerebellar function, discuss their importance and limitations and suggest future directions for research. The anatomical data indicate that the MPC has more than one site of action in the visuo-oculomotor system. In contrast, most models emphasize the role of cerebellar connections with immediate pre-oculomotor circuits in the reticular formation, and only one recent model also incorporates the ascending projections of the MPC to the superior colliculus. A major challenge for future studies, in continuation with this initial attempt, is to determine whether the various cerebellar output pathways correspond to distinct contributions to the control of saccadic eye movements. Also, a series of recent studies in the cat have indicated a more general role of the MPC in the control of orienting movements in space, calling for an increasing effort to the study of the MPC in the production of head-unrestrained saccadic gaze shifts.

Generative character of perception: a neural architecture for sensorimotor anticipation

The basic idea of our anticipatory approach to perception is to avoid the common separation of perception and generation of behavior and to fuse both aspects into a consistent neural process. Our approach tries to explain the phenomenon of perception, in particular, of perception at the level of sensorimotor intelligence, from a behavior-oriented point of view. Perception is assumed to be a generative process of anticipating the course of events resulting from alternative sequences of hypothetically executed actions. By means of this sensorimotor anticipation, it is possible to characterize a visual scenery immediately in categories of behavior, i.e. by a set of actions which describe possible methods of interaction with the objects in the environment. Thus, the competence to perceive a complex situation can be understood as the capability to anticipate the course of events caused by different action sequences. Starting from an abstract description of anticipatory perception and the essential biological evidence for internal simulation, we present two biologically motivated computational models that are able to anticipate and evaluate hypothetically sensorimotor sequences. Both models consider functional aspects of those cortical and subcortical systems that are assumed to be involved in the process of sensory prediction and sensorimotor control. Our first approach, the Model for Anticipation based on Sensory IMagination (MASIM), realizes a sequential search in sensorimotor space using a simple model of lateral cerebellum as sensory predictor. We demonstrate the efficiency of this model approach in the light of visually guided local navigation behaviors of a mobile system. The second approach, the Model for Anticipation based on Cortical Representations (MACOR), is actually still at a conceptual level of realization. We postulate that this model allows a completely parallel search at the neocortical level using assemblies of spiking neurons for grouping, separation, and selection of sensorimotor sequences. Both models are intended as general schemes for anticipation based perception at the level of sensorimotor intelligence.

Neuropharmacologic aspects of the ocular motor system and the treatment of abnormal eye movements

Neuropharmacology is aiding our understanding of the control of eye movements in at least three ways. First, neurotransmitters have been identified in the pathways that coordinate gaze. Second, the technique of pharmacologic inactivation has provided a powerful method to determine the contributions of populations of neurons to specific behaviors, such as steady gaze holding. Finally, the results of basic neuropharmacologic studies have been used to identify candidate drugs for therapeutic trials of abnormal eye movements.