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Lopergolo D, Rosini F, Pretegiani E, Bargagli A, Serchi V, Rufa A. Autosomal recessive cerebellar ataxias: a diagnostic classification approach according to ocular features. Front Integr Neurosci 2024; 17:1275794. [PMID: 38390227 PMCID: PMC10883068 DOI: 10.3389/fnint.2023.1275794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/10/2023] [Indexed: 02/24/2024] Open
Abstract
Autosomal recessive cerebellar ataxias (ARCAs) are a heterogeneous group of neurodegenerative disorders affecting primarily the cerebellum and/or its afferent tracts, often accompanied by damage of other neurological or extra-neurological systems. Due to the overlap of clinical presentation among ARCAs and the variety of hereditary, acquired, and reversible etiologies that can determine cerebellar dysfunction, the differential diagnosis is challenging, but also urgent considering the ongoing development of promising target therapies. The examination of afferent and efferent visual system may provide neurophysiological and structural information related to cerebellar dysfunction and neurodegeneration thus allowing a possible diagnostic classification approach according to ocular features. While optic coherence tomography (OCT) is applied for the parametrization of the optic nerve and macular area, the eye movements analysis relies on a wide range of eye-tracker devices and the application of machine-learning techniques. We discuss the results of clinical and eye-tracking oculomotor examination, the OCT findings and some advancing of computer science in ARCAs thus providing evidence sustaining the identification of robust eye parameters as possible markers of ARCAs.
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Affiliation(s)
- Diego Lopergolo
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Francesca Rosini
- UOC Stroke Unit, Department of Emergenza-Urgenza, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Elena Pretegiani
- Unit of Neurology, Centre Hospitalier Universitaire Vaudoise Lausanne, Unit of Neurology and Cognitive Neurorehabilitation, Universitary Hospital of Fribourg, Fribourg, Switzerland
| | - Alessia Bargagli
- Evalab-Neurosense, Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Valeria Serchi
- Evalab-Neurosense, Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
- Evalab-Neurosense, Department of Medicine Surgery and Neuroscience, University of Siena, Siena, Italy
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2
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Lopergolo D, Bargagli A, Satolli S, Barghigiani M, Mignarri A, Musumeci O, Maria Santorelli F, Rufa A. Oculomotor features in SCA27B patients. Clin Neurophysiol 2024; 158:56-58. [PMID: 38176158 DOI: 10.1016/j.clinph.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Affiliation(s)
- Diego Lopergolo
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Alessia Bargagli
- Evalab-Neurosense, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Sara Satolli
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Melissa Barghigiani
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Andrea Mignarri
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Siena, Italy
| | - Olimpia Musumeci
- Unit of Neurology and Neuromuscular Disorders, Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - Filippo Maria Santorelli
- Molecular Medicine for Neurodegenerative and Neuromuscular Diseases Unit, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Alessandra Rufa
- Department of Medicine, Surgery, and Neurosciences, University of Siena, Siena, Italy; UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Siena, Italy; Evalab-Neurosense, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy.
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3
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Zaino D, Serchi V, Giannini F, Pucci B, Veneri G, Pretegiani E, Rosini F, Monti L, Rufa A. Different saccadic profile in bulbar versus spinal-onset amyotrophic lateral sclerosis. Brain 2023; 146:266-277. [PMID: 35136957 DOI: 10.1093/brain/awac050] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 12/21/2021] [Accepted: 01/16/2022] [Indexed: 01/11/2023] Open
Abstract
Two clinical phenotypes characterize the onset of amyotrophic lateral sclerosis (ALS): the spinal variant, with symptoms beginning in the limbs, and the bulbar variant, affecting firstly speech and swallowing. The two variants show some distinct features in the histopathology, localization and prognosis, but to which extent they really differ clinically and pathologically remains to be clarified. Recent neuropathological and neuroimaging studies have suggested a broader spreading of the neurodegenerative process in ALS, extending beyond the motor areas, toward other cortical and deep grey matter regions, many of which are involved in visual processing and saccadic control. Indeed, a wide range of eye movement deficits have been reported in ALS, but they have never been used to distinguish the two ALS variants. Since quantifying eye movements is a very sensitive and specific method for the study of brain networks, we compared different saccadic and visual search behaviours across spinal ALS patients (n = 12), bulbar ALS patients (n = 6) and healthy control subjects (n = 13), along with cognitive and MRI measures, with the aim to define more accurately the two patients subgroups and possibly clarify a different underlying neural impairment. We found separate profiles of visually-guided saccades between spinal (short saccades) and bulbar (slow saccades) ALS, which could result from the pathologic involvement of different pathways. We suggest an early involvement of the parieto-collicular-cerebellar network in spinal ALS and the fronto-brainstem circuit in bulbar ALS. Overall, our data confirm the diagnostic value of the eye movements analysis in ALS and add new insight on the involved neural networks.
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Affiliation(s)
- Domenica Zaino
- Eye tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy.,Neurology and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Valeria Serchi
- Eye tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Fabio Giannini
- Centre for Motor Neuron Diseases, Neurology and Neurophysiology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Barbara Pucci
- Neurology and Neurophysiology Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, 53100 Siena, Italy
| | - Giacomo Veneri
- Eye tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Elena Pretegiani
- Eye tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesca Rosini
- Eye tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Lucia Monti
- Unit of Neuroimaging and Neurointervention, Department of Neurological and Neurosensorial Sciences, AOUS, 53100, Siena, Italy
| | - Alessandra Rufa
- Eye tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
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Lopergolo D, Berti G, Mari F, Bertini E, Battisti C, Renieri A, Rufa A, Malandrini A. An atypical case of spastic paraplegia type 11 mimicking a GM2 gangliosidoses. J Neurol Sci 2021. [DOI: 10.1016/j.jns.2021.118254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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5
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Bargagli A, Fontanelli E, Zanca D, Castelli I, Rosini F, Maddii S, Di Donato I, Carluccio A, Battisti C, Tosi GM, Dotti MT, Rufa A. Neurophthalmologic and Orthoptic Ambulatory Assessments Reveal Ocular and Visual Changes in Patients With Early Alzheimer and Parkinson's Disease. Front Neurol 2020; 11:577362. [PMID: 33224092 PMCID: PMC7669827 DOI: 10.3389/fneur.2020.577362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Patients with Alzheimer's disease (AD) and Parkinson's disease (PD) develop a progressive decline of visual function. This condition aggravates overall cognitive and motor abilities, is a risk factor for developing hallucinations, and can have a significant influence on general quality of life. Visual problems are common complaints of patients with PD and AD in the early stages of the disease, but they also occur during normal aging, making it difficult to differentiate between normal and pathological conditions. In this respect, their real incidence has remained largely underestimated, and no rehabilitative approaches have been standardized. With the aim to increase awareness for ocular and visual disorders, we collected the main neurophthalmologic and orthoptic parameters, including optical coherence tomography (OCT), in six patients with a diagnosis of PD, six patients with a diagnosis of early AD, and eight control subjects in an easily assessable outpatient setting. We also evaluated the patient's ability to recognize changes in facial expression. Our study demonstrates that visual problems, including blurred vision, diplopia, reading discomfort, photophobia, and glare, are commonly reported in patients with PD and AD. Moreover, abnormal eye alignment and vergence insufficiency were documented in all patients during examination. Despite the small size of the sample, we demonstrated greater ganglion cell and retinal nerve fibers layer (RNFL) damage and a defect of facial emotion recognition in AD/PD patients with respect to a comparable group of normal elderly persons, with peculiarities depending upon the disease. Ocular defects or visual discomfort could be correctly evaluated in these patients and possibly corrected by means of lens, orthoptic exercises, and visual rehabilitation. Such a practical approach may help to ameliorate motor autonomy, reading ability, and may also reduce the risk of falls, with a positive impact in daily living activities.
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Affiliation(s)
| | | | - Dario Zanca
- Neurosense-EVAlab DSMCN Università di Siena, Siena, Italy
| | | | | | | | - Ilaria Di Donato
- UOC Neurologia e Malattie Neurometaboliche Università di Siena, Siena, Italy
| | | | - Carla Battisti
- UOC Neurologia e Malattie Neurometaboliche Università di Siena, Siena, Italy
| | - Gian M Tosi
- UOC Oculistica Università di Siena, Siena, Italy.,UOC Neurologia e Malattie Neurometaboliche Università di Siena, Siena, Italy
| | - Maria T Dotti
- UOC Neurologia e Malattie Neurometaboliche Università di Siena, Siena, Italy
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6
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Rosini F, Pretegiani E, Battisti C, Dotti MT, Federico A, Rufa A. Eye movement changes in autosomal dominant spinocerebellar ataxias. Neurol Sci 2020; 41:1719-1734. [PMID: 32130555 DOI: 10.1007/s10072-020-04318-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Accepted: 02/24/2020] [Indexed: 12/15/2022]
Abstract
Oculomotor abnormalities are common findings in spinocerebellar ataxias (SCAs), a clinically heterogeneous group of neurodegenerative disorders with an autosomal dominant pattern of inheritance. Usually, cerebellar impairment accounts for most of the eye movement changes encountered; as the disease progresses, the involvement of extracerebellar structures typically seen in later stages may modify the oculomotor progression. However, ocular movement changes are rarely specific. In this regard, some important exceptions include the prominent slowing of horizontal eye movements in SCA2 and, to a lesser extent, in SCA3, SCA4, and SCA28, or the executive deficit in SCA2 and SCA17. Here, we report the eye movement abnormalities and neurological pictures of SCAs through a review of the literature. Genetic and neuropathological/neuroimaging aspects are also briefly discussed. Overall, the findings reported indicate that oculomotor analysis could be of help in differential diagnosis among SCAs and contribute to clarify the role of brain structures, particularly the cerebellum, in oculomotor control.
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Affiliation(s)
- Francesca Rosini
- Department of Medicine Surgery and Neuroscience, Eye Tracking& Visual Application Lab EVALAB, Neurology and Neurometabolic Unit, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Elena Pretegiani
- Department of Medicine Surgery and Neuroscience, Eye Tracking& Visual Application Lab EVALAB, Neurology and Neurometabolic Unit, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Carla Battisti
- Department of Medicine, Surgery and Neuroscience, Neurology and Neurometabolic Unit, University of Siena, Siena, Italy
| | - Maria Teresa Dotti
- Department of Medicine, Surgery and Neuroscience, Neurology and Neurometabolic Unit, University of Siena, Siena, Italy
| | - Antonio Federico
- Department of Medicine, Surgery and Neuroscience, Neurology and Neurometabolic Unit, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Department of Medicine Surgery and Neuroscience, Eye Tracking& Visual Application Lab EVALAB, Neurology and Neurometabolic Unit, University of Siena, Viale Bracci 2, 53100, Siena, Italy.
- Department of Medicine, Surgery and Neuroscience, Neurology and Neurometabolic Unit, University of Siena, Siena, Italy.
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7
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Abstract
Eye movements are an essential part of human vision as they drive the fovea and, consequently, selective visual attention toward a region of interest in space. Free visual exploration is an inherently stochastic process depending on image statistics but also individual variability of cognitive and attentive state. We propose a theory of free visual exploration entirely formulated within the framework of physics and based on the general Principle of Least Action. Within this framework, differential laws describing eye movements emerge in accordance with bottom-up functional principles. In addition, we integrate top-down semantic information captured by deep convolutional neural networks pre-trained for the classification of common objects. To stress the model, we used a wide collection of images including basic features as well as high level semantic content. Results in a task of saliency prediction validate the theory.
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Affiliation(s)
- Dario Zanca
- University of Florence, Florence, Italy; University of Siena, Siena, Italy.
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8
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Piu P, Pretegiani E, Rosini F, Serchi V, Zaino D, Chiantini T, Rufa A. The cerebellum improves the precision of antisaccades by a latency-duration trade-off. Prog Brain Res 2019; 249:125-139. [PMID: 31325973 DOI: 10.1016/bs.pbr.2019.04.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The cerebellum adapts motor responses by controlling the gain of a movement, preserving its accuracy and by learning from endpoint errors. Adaptive behavior likely acts not only in the motor but also in the sensory, behavioral, and cognitive domains, thus supporting a role of cerebellum in monitoring complex brain performances. Here, we analyzed the relationship between saccade latency, duration and endpoint error of antisaccades in a group of 10 idiopathic cerebellar atrophy (ICA) patients compared to controls. The latency distribution was decomposed in a decision time and a residual time. Both groups showed a trade-off between duration and decision time, with a peak of entropy within the range of this trade-off where the information flow was maximized. In cerebellar patients, greater reductions of duration as the time of decision increased, were associated with a lower probability for a saccade to fall near the target, with a constant low entropy outside the optimal time window. We suggest a modulation of saccade duration, depending on the latency-related decision time (accumulation of sensory and motor evidences in favor of a goal-directed movement), normally adopted to perform efficient trajectories in goal-directed saccades. This process is impaired in cerebellar patients suggesting a role for the cerebellum in monitoring voluntary motor performance by controlling the movement onset until the ambiguity of planning is resolved.
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Affiliation(s)
- Pietro Piu
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Elena Pretegiani
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; Laboratory of Sensorimotor Research-NEI, NIH, DHHS, Bethesda, MD, United States
| | - Francesca Rosini
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Valeria Serchi
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Domenica Zaino
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Tommaso Chiantini
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Eye-tracking and Visual Application Lab (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy; Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
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9
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Piu P, Serchi V, Rosini F, Rufa A. A Cross-Recurrence Analysis of the Pupil Size Fluctuations in Steady Scotopic Conditions. Front Neurosci 2019; 13:407. [PMID: 31114474 PMCID: PMC6502958 DOI: 10.3389/fnins.2019.00407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 04/10/2019] [Indexed: 01/19/2023] Open
Abstract
Pupil size fluctuations during stationary scotopic conditions may convey information about the cortical state activity at rest. An important link between neuronal network state modulation and pupil fluctuations is the cholinergic and noradrenergic neuromodulatory tone, which is active at cortical level and in the peripheral terminals of the autonomic nervous system (ANS). This work aimed at studying the low- and high-frequency coupled oscillators in the autonomic spectrum (0–0.45 Hz) which, reportedly, drive the spontaneous pupillary fluctuations. To assess the interaction between the oscillators, we focused on the patterns of their trajectories in the phase-space. Firstly, the frequency spectrum of the pupil signal was determined by empirical mode decomposition. Secondly, cross-recurrence quantification analysis was used to unfold the non-linear dynamics. The global and local patterns of recurrence of the trajectories were estimated by two parameters: determinism and entropy. An elliptic region in the entropy-determinism plane (95% prediction area) yielded health-related values of entropy and determinism. We hypothesize that the data points inside the ellipse would likely represent balanced activity in the ANS. Interestingly, the Epworth Sleepiness Scale scores scaled up along with the entropy and determinism parameters. Although other non-linear methods like Short Time Fourier Transform and wavelets are usually applied for analyzing the pupillary oscillations, they rely on strong assumptions like the stationarity of the signal or the a priori knowledge of the shape of the single basis wave. Instead, the cross-recurrence analysis of the non-linear dynamics of the pupil size oscillations is an adaptable diagnostic tool for identifying the different weight of the autonomic nervous system components in the modulation of pupil size changes at rest in non-luminance conditions.
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Affiliation(s)
- Pietro Piu
- Eye Tracking and Visual Application Lab, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Valeria Serchi
- Eye Tracking and Visual Application Lab, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Francesca Rosini
- Eye Tracking and Visual Application Lab, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.,Neurology and Neurometabolic Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Eye Tracking and Visual Application Lab, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.,Neurology and Neurometabolic Unit, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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10
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Koens LH, Tijssen MAJ, Lange F, Wolffenbuttel BHR, Rufa A, Zee DS, de Koning TJ. Eye movement disorders and neurological symptoms in late-onset inborn errors of metabolism. Mov Disord 2018; 33:1844-1856. [PMID: 30485556 PMCID: PMC6587951 DOI: 10.1002/mds.27484] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 08/03/2018] [Accepted: 08/06/2018] [Indexed: 11/06/2022] Open
Abstract
Inborn errors of metabolism in adults are still largely unexplored. Despite the fact that adult‐onset phenotypes have been known for many years, little attention is given to these disorders in neurological practice. The adult‐onset presentation differs from childhood‐onset phenotypes, often leading to considerable diagnostic delay. The identification of these patients at the earliest stage of disease is important, given that early treatment may prevent or lessen further brain damage. Neurological and psychiatric symptoms occur more frequently in adult forms. Abnormalities of eye movements are also common and can be the presenting sign. Eye movement disorders can be classified as central or peripheral. Central forms are frequently observed in lysosomal storage disorders, whereas peripheral forms are a key feature of mitochondrial disease. Furthermore, oculogyric crisis is an important feature in disorders affecting dopamine syntheses or transport. Ocular motor disorders are often not reported by the patient, and abnormalities can be easily overlooked in a general examination. In adults with unexplained psychiatric and neurological symptoms, a special focus on examination of eye movements can serve as a relatively simple clinical tool to detect a metabolic disorder. Eye movements can be easily quantified and analyzed with video‐oculography, making them a valuable biomarker for following the natural course of disease or the response to therapies. Here, we review, for the first time, eye movement disorders that can occur in inborn errors of metabolism, with a focus on late‐onset forms. We provide a step‐by‐step overview that will help clinicians to examine and interpret eye movement disorders. © 2018 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Lisette H Koens
- University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands
| | - Marina A J Tijssen
- University of Groningen, University Medical Center Groningen, Department of Neurology, Groningen, The Netherlands
| | - Fiete Lange
- University of Groningen, University Medical Center Groningen, Department of Clinical Neurophysiology, Groningen, The Netherlands
| | - Bruce H R Wolffenbuttel
- Department of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Alessandra Rufa
- Department of Medicine Surgery and Neurosciences, University of Siena, Eye tracking and Visual Application Lab (EVA Lab)-Neurology and Neurometabolic Unit, Siena, Italy
| | - David S Zee
- Department of Neuroscience, Department of Ophthalmology, The Johns Hopkins University, The Johns Hopkins Hospital, Department of Neurology, Department of Otolaryngology-Head and Neck Surgery, Baltimore, Maryland, USA
| | - Tom J de Koning
- University of Groningen, Division of Metabolic Diseases, University Medical Center Groningen, Groningen, The Netherlands.,University of Groningen, Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
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11
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Taglia I, Di Donato I, Bianchi S, Cerase A, Monti L, Marconi R, Orrico A, Rufa A, Federico A, Dotti MT. AARS2-related ovarioleukodystrophy: Clinical and neuroimaging features of three new cases. Acta Neurol Scand 2018; 138:278-283. [PMID: 29749055 DOI: 10.1111/ane.12954] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP), previously known as hereditary diffuse leukoencephalopathy with axonal spheroids (HDLS) or pigmentary orthochromatic leukodystrophy (POLD), is the most frequent non-vascular adult-onset leukoencephalopathy. It is caused by autosomal dominant mutations in CSF1R gene. Recently, also autosomal recessive mutations in AARS2 gene were found to be the cause of an adult-onset leukodystrophy with axonal spheroids. Our aim was to achieve a genetic diagnosis in a cohort of CSF1R-negative patients, performing a sequence analysis of AARS2 gene. MATERIAL AND METHODS AARS2 sequencing was performed in 38 CSF1R-negative patients with clinical and magnetic resonance imaging (MRI) findings of adult-onset leukoencephalopathy. RESULTS Three patients carrying AARS2 compound heterozygous mutations have been found. All patients were female with ovarian failure and leukoencephalopathy. In 2 patients, MRI findings were consistent with previous reports while the third patient showed focal white matter (WM) lesions in the centrum semiovale and the corpus callosum in the absence of extensive involvement and rarefaction of the WM. MRI spectroscopy showed the presence of increased lactate in 2 patients, thus linking AARS2-related leukoencephalopathy with other mitochondrial leukoencephalopathies with high levels of cerebral lactate. CONCLUSION We recommend screening for mutations in AARS2 gene in CSF1R-negative patients, also in the absence of a clear family history and peculiar MRI findings. Our results also suggest that findings of conventional MRI and MR spectroscopy may be useful in prompting the genetic screening.
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Affiliation(s)
- I. Taglia
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - I. Di Donato
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - S. Bianchi
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - A. Cerase
- Unit of Neuroradiology; Department of Neurosciences; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - L. Monti
- Unit of Neuroradiology; Department of Neurosciences; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - R. Marconi
- Unit of Neurology; Misericordia Hospital; Grosseto Italy
| | - A. Orrico
- Molecular Medicine; Azienda Ospedaliera Universitaria Senese; Siena Italy
| | - A. Rufa
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - A. Federico
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
| | - M. T. Dotti
- Department of Medicine, Surgery and Neurosciences; University of Siena; Siena Italy
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12
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Rufa A, Shaikh AG. Editorial: Ocular Motor and Vestibular Deficits in Neurometabolic, Neurogenetic, and Neurodegenerative Diseases. Front Neurol 2018; 9:567. [PMID: 30072945 PMCID: PMC6058526 DOI: 10.3389/fneur.2018.00567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/25/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Alessandra Rufa
- Department of Neurology, University of Siena, Siena, Italy
- *Correspondence: Alessandra Rufa
| | - Aasef G. Shaikh
- Daroff-Dell'Osso Ocular Motility Laboratory, Neurology Service, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States
- Department of Neurology, University Hospitals and Case Western Reserve University, Cleveland, OH, United States
- Aasef G. Shaikh
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13
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Pretegiani E, Piu P, Rosini F, Federighi P, Serchi V, Tumminelli G, Dotti MT, Federico A, Rufa A. Anti-Saccades in Cerebellar Ataxias Reveal a Contribution of the Cerebellum in Executive Functions. Front Neurol 2018; 9:274. [PMID: 29740392 PMCID: PMC5926529 DOI: 10.3389/fneur.2018.00274] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 04/06/2018] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVE Increasing evidence suggests a cerebellar contribution to modulate cognitive aspects of motor behavior and executive functions. Supporting findings come from studies on patients with neurodegenerative diseases, in which however, given the extent of the disease, the specific role of the cerebellum, could not be clearly isolated. Anti-saccades are considered a sensitive tool to test executive functions. The anti-saccade underlying neural network, consisting of different cortical areas and their downstream connections including the lateral cerebellum, has been largely clarified. To separate the role of the cerebellum with respect to other cortical structures in executive control, we compared the anti-saccade performances in two distinct cohorts of patients with cerebellar disorders (with and without cerebral cortical involvement). METHODS Eye movements during the execution of anti-saccades were recorded in 12 patients with spinocerebellar ataxia type 2 (a cortical-subcortical neurodegenerative disease), 10 patients with late onset cerebellar ataxia (an isolated cerebellar atrophy), and 34 matched controls. RESULTS In the anti-saccade task, besides dynamic changes already demonstrated in the pro-saccades of these patients, we found in both groups of cerebellar patients prolonged latency with larger variability than normal and increased directional error rate. Errors, however, were corrected by cerebellar patients as frequently as normal. No significant differences were found in patients with and without cortical involvement. CONCLUSION Our results indicate, in a large cohort of cerebellar patients, that the cerebellum plays a critical role in the regulation of executive motor control not only, as well known, by controlling the end of a movement, but also modulating its initiation and reducing reflexive responses that would perturb voluntary actions.
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Affiliation(s)
- Elena Pretegiani
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- Laboratory of Sensorimotor Research, National Eye Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
| | - Pietro Piu
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Francesca Rosini
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Pamela Federighi
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- Department of Business and Law, University of Siena, Siena, Italy
| | - Valeria Serchi
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Gemma Tumminelli
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Teresa Dotti
- Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Antonio Federico
- Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Eye-Tracking and Visual Application Laboratory (EVALab), Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
- Neurological and Neurometabolic Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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14
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Federighi P, Ramat S, Rosini F, Pretegiani E, Federico A, Rufa A. Characteristic Eye Movements in Ataxia-Telangiectasia-Like Disorder: An Explanatory Hypothesis. Front Neurol 2017; 8:596. [PMID: 29170652 PMCID: PMC5684103 DOI: 10.3389/fneur.2017.00596] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 10/24/2017] [Indexed: 01/23/2023] Open
Abstract
Objective To investigate cerebellar dysfunctions and quantitatively characterize specific oculomotor changes in ataxia-telangiectasia-like disorder (ATLD), a rare autosomal recessive disease caused by mutations in the MRE11 gene. Additionally, to further elucidate the pathophysiology of cerebellar damage in the ataxia-telangiectasia (AT) spectrum disorders. Methods Saccade dynamics, metrics, and visual fixation deficits were investigated in two Italian adult siblings with genetically confirmed ATLD. Visually guided saccades were compared with those of 40 healthy subjects. Steady fixation was tested in primary and eccentric positions. Quantitative characterization of saccade parameters, saccadic intrusions (SI), and nystagmus was performed. Results Patients showed abnormally hypermetric and fast horizontal saccades to the left and greater inaccuracy than healthy subjects in all saccadic eye movements. Eye movement abnormalities included slow eye movements that preceded the initial saccade. Horizontal and vertical spontaneous jerk nystagmus, gaze-evoked, and rebound nystagmus were evident. Fixation was interrupted by large square-wave jerk SI and macrosaccadic oscillations. Conclusion Slow eye movements accompanying saccades, SI, and cerebellar nystagmus are frequently seen in AT patients, additionally our ATLD patients showed the presence of fast and hypermetric saccades suggesting damage of granule cell-parallel fiber-Purkinje cell synapses of the cerebellar vermis. A dual pathogenetic mechanism involving neurodevelopmental and neurodegenerative changes is hypothesized to explain the peculiar phenotype of this disease.
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Affiliation(s)
- Pamela Federighi
- Eye Tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Stefano Ramat
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Francesca Rosini
- Eye Tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Elena Pretegiani
- Laboratory of Sensorimotor Research, National Eye Institute, National Institutes of Health, Bethesda, MD, United States
| | - Antonio Federico
- UOC Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Eye Tracking and Visual Application Lab (EVA Lab), Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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15
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Pretegiani E, Rosini F, Federico A, Optican LM, Rufa A. Eye movements in genetic parkinsonisms affecting the α-synuclein, PARK9, and manganese network. Clin Neurophysiol 2017; 128:2450-2453. [PMID: 29096219 DOI: 10.1016/j.clinph.2017.09.107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 09/23/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Elena Pretegiani
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, MD, USA.
| | - Francesca Rosini
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Antonio Federico
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Lance M Optican
- Laboratory of Sensorimotor Research, National Eye Institute, NIH, Bethesda, MD, USA
| | - Alessandra Rufa
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
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16
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Pretegiani E, Rosini F, Rufa A, Gallus G, Cardaioli E, Da Pozzo P, Bianchi S, Serchi V, Collura M, Franceschini R, Bianchi Marzoli S, Dotti M, Federico A. Genotype-phenotype and OCT correlations in Autosomal Dominant Optic Atrophy related to OPA1 gene mutations: Report of 13 Italian families. J Neurol Sci 2017; 382:29-35. [DOI: 10.1016/j.jns.2017.09.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 09/09/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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17
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Tirelli L, Rosini F, Rufa A, Garosi G, Cerase A, Federico A, De Luca A. Clinical and MRI improvement in a case of progressive multifocal leukoencephalopathy. Neurol Sci 2017; 38:1517-1519. [PMID: 28421302 DOI: 10.1007/s10072-017-2914-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 03/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Letizia Tirelli
- Department of Medical, Surgical and Neurological Sciences, UO Clinical Neurology and Neurometabolic Diseases, University of Siena, Siena, Italy
| | - Francesca Rosini
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, UO Clinical Neurology and Neurometabolic Diseases, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, UO Clinical Neurology and Neurometabolic Diseases, University of Siena, Siena, Italy.
| | - Guido Garosi
- Nephrology and Dialysis Unit, Department of Internal and Specialty Medicine, Azienda Ospedaliera Universitaria Senese, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Alfonso Cerase
- Unit NINT Neuroimaging and Neurointervention, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico "Santa Maria alle Scotte", Siena, Italy
| | - Antonio Federico
- Department of Medical, Surgical and Neurological Sciences, UO Clinical Neurology and Neurometabolic Diseases, University of Siena, Siena, Italy
| | - Andrea De Luca
- Department of Internal and Specialty Medicine, University Division of Infectious Diseases, University of Siena, Siena, Italy
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18
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Rosini F, Pretegiani E, Mignarri A, Optican LM, Serchi V, De Stefano N, Battaglini M, Monti L, Dotti MT, Federico A, Rufa A. The role of dentate nuclei in human oculomotor control: insights from cerebrotendinous xanthomatosis. J Physiol 2017; 595:3607-3620. [PMID: 28168705 DOI: 10.1113/jp273670] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 01/20/2017] [Indexed: 12/26/2022] Open
Abstract
KEY POINTS A cerebellar dentate nuclei (DN) contribution to volitional oculomotor control has recently been hypothesized but not fully understood. Cerebrotendinous xanthomatosis (CTX) is a rare neurometabolic disease typically characterized by DN damage. In this study, we compared the ocular movement characteristics of two sets of CTX patients, with and without brain MRI evidence of DN involvement, with a set of healthy subjects. Our results suggest that DN participate in voluntary behaviour, such as the execution of antisaccades, and moreover are involved in controlling the precision of the ocular movement. The saccadic abnormalities related to DN involvement were independent of global and regional brain atrophy. Our study confirms the relevant role of DN in voluntary aspects of oculomotion and delineates specific saccadic abnormalities that could be used to detect the involvement of DN in other cerebellar disorders. ABSTRACT It is well known that the medial cerebellum controls saccadic speed and accuracy. In contrast, the role of the lateral cerebellum (cerebellar hemispheres and dentate nuclei, DN) is less well understood. Cerebrotendinous xanthomatosis (CTX) is a lipid storage disorder due to mutations in CYP27A1, typically characterized by DN damage. CTX thus provides a unique opportunity to study DN in human oculomotor control. We analysed horizontal and vertical visually guided saccades and horizontal antisaccades of 19 CTX patients. Results were related to the presence/absence of DN involvement and compared with those of healthy subjects. To evaluate the contribution of other areas, abnormal saccadic parameters were compared with global and regional brain volumes. CTX patients executed normally accurate saccades with normal main sequence relationships, indicating that the brainstem and medial cerebellar structures were functionally spared. Patients with CTX executed more frequent multistep saccades and directional errors during the antisaccade task than controls. CTX patients with DN damage showed less precise saccades with longer latencies, and more frequent directional errors, usually not followed by corrections, than either controls or patients without DN involvement. These saccadic abnormalities related to DN involvement but were independent of global and regional brain atrophy. We hypothesize that two different cerebellar networks contribute to the metrics of a movement: the medial cerebellar structures determine accuracy, whereas the lateral cerebellar structures control precision. The lateral cerebellum (hemispheres and DN) also participates in modulating goal directed gaze behaviour, by prioritizing volitional over reflexive movements.
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Affiliation(s)
- Francesca Rosini
- Eye tracking and Visual Application Lab (EVA Lab) - Neurology and Neurometabolic Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | | | - Andrea Mignarri
- Neurology and Neurometabolic Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | | | - Valeria Serchi
- Eye tracking and Visual Application Lab (EVA Lab) - Neurology and Neurometabolic Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | - Nicola De Stefano
- Quantitative Neuroimaging Laboratory, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | - Marco Battaglini
- Quantitative Neuroimaging Laboratory, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | - Lucia Monti
- Unit NINT, Neuroimaging and Neurointervention, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - Maria T Dotti
- Neurology and Neurometabolic Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | - Antonio Federico
- Neurology and Neurometabolic Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
| | - Alessandra Rufa
- Eye tracking and Visual Application Lab (EVA Lab) - Neurology and Neurometabolic Unit, Department of Medical and Surgical Sciences and Neurosciences, University of Siena, Italy
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19
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Di Donato I, Bianchi S, De Stefano N, Dichgans M, Dotti MT, Duering M, Jouvent E, Korczyn AD, Lesnik-Oberstein SAJ, Malandrini A, Markus HS, Pantoni L, Penco S, Rufa A, Sinanović O, Stojanov D, Federico A. Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) as a model of small vessel disease: update on clinical, diagnostic, and management aspects. BMC Med 2017; 15:41. [PMID: 28231783 PMCID: PMC5324276 DOI: 10.1186/s12916-017-0778-8] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/03/2017] [Indexed: 12/11/2022] Open
Abstract
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common and best known monogenic small vessel disease. Here, we review the clinical, neuroimaging, neuropathological, genetic, and therapeutic aspects based on the most relevant articles published between 1994 and 2016 and on the personal experience of the authors, all directly involved in CADASIL research and care. We conclude with some suggestions that may help in the clinical practice and management of these patients.
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Affiliation(s)
- Ilaria Di Donato
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Silvia Bianchi
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Maria Teresa Dotti
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Marco Duering
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-University LMU, Munich, Germany
| | - Eric Jouvent
- Université Paris Diderot, Sorbonne Paris Cité, UMR-S 1161 INSERM, F-75205, Paris, France.,Department of Neurology, AP-HP, Lariboisière Hospital, F-75475, Paris, France.,DHU NeuroVasc Sorbonne Paris Cité, Paris, France
| | - Amos D Korczyn
- Department of Neurology, Tel Aviv University, Ramat Aviv, 69978, Israel
| | - Saskia A J Lesnik-Oberstein
- Department of Clinical Genetics, K5-R Leiden University Medical Center, PO Box 9600, 2300 RC, Leiden, The Netherlands
| | - Alessandro Malandrini
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Hugh S Markus
- Stroke Research Group, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Leonardo Pantoni
- NEUROFARBA Department, Neuroscience section, Largo Brambilla 3, 50134, Florence, Italy
| | - Silvana Penco
- Medical Genetic Unit, Department of Laboratory Medicine, Niguarda Hospital, Milan, Italy
| | - Alessandra Rufa
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy
| | - Osman Sinanović
- Department of Neurology, University Clinical Center Tuzla, School of Medicine University of Tuzla, 75000, Tuzla, Bosnia and Herzegovina
| | - Dragan Stojanov
- Faculty of Medicine, University of Nis, Bul. Dr. Zorana Djindjica 81, Nis, 18000, Serbia
| | - Antonio Federico
- Department of Medicine, Surgery and Neurosciences, Medical School, University of Siena, Viale Bracci 2, 53100, Siena, Italy.
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20
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Da Pozzo P, Cardaioli E, Rubegni A, Gallus GN, Malandrini A, Rufa A, Battisti C, Carluccio MA, Rocchi R, Giannini F, Bianchi A, Mancuso M, Siciliano G, Dotti MT, Federico A. Novel POLG mutations and variable clinical phenotypes in 13 Italian patients. Neurol Sci 2017; 38:563-570. [DOI: 10.1007/s10072-016-2734-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 10/07/2016] [Indexed: 11/29/2022]
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21
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Rosini F, Serchi V, Tirelli L, Di Toro Mammarella L, Pucci B, Federico A, Rufa A. Progression of oculomotor deficit in a patient with posterior cortical atrophy. J Neurol Sci 2016; 372:459-463. [PMID: 27816183 DOI: 10.1016/j.jns.2016.10.049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 10/26/2016] [Accepted: 10/28/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Francesca Rosini
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy
| | - Valeria Serchi
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy
| | - Letizia Tirelli
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy
| | - Lara Di Toro Mammarella
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy
| | - Barbara Pucci
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy
| | - Antonio Federico
- Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy
| | - Alessandra Rufa
- Eye Tracking and Visual Application Lab (EVALab), Department of Medical, Surgical and Neurological Sciences, University of Siena, Policlinico Santa Maria alle Scotte, viale Bracci 2, 53100 Siena, Italy.
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22
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Boggio E, Pancrazi L, Gennaro M, Lo Rizzo C, Mari F, Meloni I, Ariani F, Panighini A, Novelli E, Biagioni M, Strettoi E, Hayek J, Rufa A, Pizzorusso T, Renieri A, Costa M. Visual impairment in FOXG1-mutated individuals and mice. Neuroscience 2016; 324:496-508. [DOI: 10.1016/j.neuroscience.2016.03.027] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 03/01/2016] [Accepted: 03/08/2016] [Indexed: 01/01/2023]
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23
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Pretegiani E, Rosini F, Federighi P, Cerase A, Dotti MT, Rufa A. Pendular nystagmus, palatal tremor and progressive ataxia in GM2-gangliosidosis. Eur J Neurol 2015; 22:e67-9. [PMID: 25916337 DOI: 10.1111/ene.12661] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Accepted: 11/28/2014] [Indexed: 11/28/2022]
Affiliation(s)
- E Pretegiani
- Laboratory of Sensorimotor Research, National Eye Institute, National Institutes of Health, Bethesda, MD, USA; Department of Medical, Surgical, and Neurological Sciences, University of Siena, Siena, Italy
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24
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Di Giovanni M, Poggiani A, Bianchi S, Rosini F, Rufa A, Federico A. Adult Alexander disease with de novo c.1193C>T heterozygous variant in GFAP gene. Neurol Sci 2015; 37:143-145. [PMID: 26396075 DOI: 10.1007/s10072-015-2378-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/31/2015] [Indexed: 11/27/2022]
Affiliation(s)
- M Di Giovanni
- Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy
| | - A Poggiani
- Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy
| | - S Bianchi
- Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy
| | - F Rosini
- Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy.,Eye Tracking and Visual Application Lab (EVALab), University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy
| | - A Rufa
- Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy.,Eye Tracking and Visual Application Lab (EVALab), University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy
| | - A Federico
- Unit of Clinical Neurology and Neurometabolic Diseases, Department of Medicine, Surgery and Neurosciences, University of Siena, Viale Bracci 2, Policlinico Santa Maria alle Scotte, 53100, Siena, Italy.
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25
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Tumminelli G, Di Donato I, Guida V, Rufa A, De Luca A, Federico A. Oculodentodigital Dysplasia with Massive Brain Calcification and a New Mutation of GJA1 Gene. J Alzheimers Dis 2015; 49:27-30. [DOI: 10.3233/jad-150424] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- Gemma Tumminelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Ilaria Di Donato
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Valentina Guida
- IRCCS-Casa Sollievo della Sofferenza, Mendel Institute, Rome, Italy
| | - Alessandra Rufa
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | | | - Antonio Federico
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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Da Pozzo P, Rubegni A, Rufa A, Cardaioli E, Taglia I, Gallus GN, Malandrini A, Federico A. Sporadic PEO caused by a novel POLG variation and a Twinkle mutation: digenic inheritance? Neurol Sci 2015; 36:1713-5. [PMID: 26050231 DOI: 10.1007/s10072-015-2247-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 05/11/2015] [Indexed: 11/28/2022]
Abstract
Progressive external ophthalmoplegia (PEO) with multiple deletions of mitochondrial DNA (mtDNA) is associated with several mutations in nuclear genes. They include POLG, POLG2, ANT1, C10orf2/Twinkle, and OPA1. However, digenic inheritance in mitochondrial disorders has been documented in a few cases over the years. Here we describe an 80-year-old man with sporadic PEO associated with mtDNA deletions. Sequencing of the POLG revealed a novel heterozygous mutation (c.2831A>G; p.Glu944Gly), predicted in silico as damaging, in the patient who also carried a heterozygous mutation in C10orf2/Twinkle (c.1142T>C; p.Leu381Pro). This case provides a second report of a PEO with different mutations in the POLG and C10orf2/Twinkle genes, supporting the hypothesis that the PEO phenotype can be determined by the co-existence of two abnormalities in separate genes, both involved in the maintenance and stability of mtDNA. Finally, this study expands the spectrum of POLG mutations and highlights the need to sequence the whole set of nuclear genes associated with PEO and multiple mtDNA deletions.
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Affiliation(s)
- Paola Da Pozzo
- Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy
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Brooks G, Dolphin M, Rufa A. Who provides physical therapy in the United States? An analysis using data from the 2011 Medical Expenditure Panel Survey. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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28
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Formichi P, Radi E, Giorgi E, Gallus GN, Brunetti J, Battisti C, Rufa A, Dotti MT, Franceschini R, Bracci L, Federico A. Analysis of opa1 isoforms expression and apoptosis regulation in autosomal dominant optic atrophy (ADOA) patients with mutations in the opa1 gene. J Neurol Sci 2015; 351:99-108. [DOI: 10.1016/j.jns.2015.02.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 02/26/2015] [Accepted: 02/27/2015] [Indexed: 11/29/2022]
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Vinciguerra C, Federighi P, Rosini F, Pretegiani E, Cardaioli E, Dotti MT, Sicurelli F, Federico A, Rufa A. Eye movement changes in mitochondrial neurogastrointestinal encephalomyopathy (MNGIE). J Neurol Sci 2015; 350:107-9. [PMID: 25656101 DOI: 10.1016/j.jns.2015.01.031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 10/24/2022]
Affiliation(s)
- Claudia Vinciguerra
- Eye-tracking and Visual Application Lab (EVALab), University of Siena, Italy; Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Pamela Federighi
- Eye-tracking and Visual Application Lab (EVALab), University of Siena, Italy
| | - Francesca Rosini
- Eye-tracking and Visual Application Lab (EVALab), University of Siena, Italy; Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Elena Pretegiani
- Eye-tracking and Visual Application Lab (EVALab), University of Siena, Italy; Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Elena Cardaioli
- Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Maria T Dotti
- Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Francesco Sicurelli
- Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Antonio Federico
- Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy
| | - Alessandra Rufa
- Eye-tracking and Visual Application Lab (EVALab), University of Siena, Italy; Neurometabolic Unit Department of Medicine, Surgery and Neurosciences, University of Siena, Italy.
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Rosini F, Rufa A, Monti L, Tirelli L, Federico A. Adult-onset phenylketonuria revealed by acute reversible dementia, prosopagnosia and parkinsonism. J Neurol 2014; 261:2446-8. [DOI: 10.1007/s00415-014-7492-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 10/24/2022]
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Stan C, Astefanoaei C, Pretegiani E, Optican L, Creanga D, Rufa A, Cristescu CP. Nonlinear analysis of saccade speed fluctuations during combined action and perception tasks. J Neurosci Methods 2014; 232:102-9. [PMID: 24854830 DOI: 10.1016/j.jneumeth.2014.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/09/2014] [Accepted: 05/12/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Saccades are rapid eye movements used to gather information about a scene which requires both action and perception. These are usually studied separately, so that how perception influences action is not well understood. In a dual task, where the subject looks at a target and reports a decision, subtle changes in the saccades might be caused by action-perception interactions. Studying saccades might provide insight into how brain pathways for action and for perception interact. NEW METHOD We applied two complementary methods, multifractal detrended fluctuation analysis and Lempel-Ziv complexity index to eye peak speed recorded in two experiments, a pure action task and a combined action-perception task. RESULTS Multifractality strength is significantly different in the two experiments, showing smaller values for dual decision task saccades compared to simple-task saccades. The normalized Lempel-Ziv complexity index behaves similarly i.e. is significantly smaller in the decision saccade task than in the simple task. COMPARISON WITH EXISTING METHODS Compared to the usual statistical and linear approaches, these analyses emphasize the character of the dynamics involved in the fluctuations and offer a sensitive tool for quantitative evaluation of the multifractal features and of the complexity measure in the saccades peak speeds when different brain circuits are involved. CONCLUSION Our results prove that the peak speed fluctuations have multifractal characteristics with lower magnitude for the multifractality strength and for the complexity index when two neural pathways are simultaneously activated, demonstrating the nonlinear interaction in the brain pathways for action and perception.
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Affiliation(s)
- C Stan
- Department of Physics, Politehnica University of Bucharest, 313 Spl. Independentei, RO 060042, Romania.
| | - C Astefanoaei
- Physics Department, University Alexandru Ioan Cuza, 11 Blvd. Carol I., Iasi, Romania.
| | - E Pretegiani
- Eye-tracking & Visual Application Lab EVALab, Department of Medicine Surgery and Neuroscience, University of Siena, Siena 53100, Italy.
| | - L Optican
- Laboratory of Sensorimotor Research, IRP, National Eye Institute, DHHS, Bethesda, MD 20892, USA.
| | - D Creanga
- Physics Department, University Alexandru Ioan Cuza, 11 Blvd. Carol I., Iasi, Romania.
| | - A Rufa
- Eye-tracking & Visual Application Lab EVALab, Department of Medicine Surgery and Neuroscience, University of Siena, Siena 53100, Italy.
| | - C P Cristescu
- Department of Physics, Politehnica University of Bucharest, 313 Spl. Independentei, RO 060042, Romania.
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Veneri G, Pretegiani E, Fargnoli F, Rosini F, Vinciguerra C, Federighi P, Federico A, Rufa A. Spatial ranking strategy and enhanced peripheral vision discrimination optimize performance and efficiency of visual sequential search. Eur J Neurosci 2014; 40:2833-41. [PMID: 24893753 DOI: 10.1111/ejn.12639] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 04/17/2014] [Accepted: 04/25/2014] [Indexed: 11/27/2022]
Abstract
Visual sequential search might use a peripheral spatial ranking of the scene to put the next target of the sequence in the correct order. This strategy, indeed, might enhance the discriminative capacity of the human peripheral vision and spare neural resources associated with foveation. However, it is not known how exactly the peripheral vision sustains sequential search and whether the sparing of neural resources has a cost in terms of performance. To elucidate these issues, we compared strategy and performance during an alpha-numeric sequential task where peripheral vision was modulated in three different conditions: normal, blurred, or obscured. If spatial ranking is applied to increase the peripheral discrimination, its use as a strategy in visual sequencing should differ according to the degree of discriminative information that can be obtained from the periphery. Moreover, if this strategy spares neural resources without impairing the performance, its use should be associated with better performance. We found that spatial ranking was applied when peripheral vision was fully available, reducing the number and time of explorative fixations. When the periphery was obscured, explorative fixations were numerous and sparse; when the periphery was blurred, explorative fixations were longer and often located close to the items. Performance was significantly improved by this strategy. Our results demonstrated that spatial ranking is an efficient strategy adopted by the brain in visual sequencing to highlight peripheral detection and discrimination; it reduces the neural cost by avoiding unnecessary foveations, and promotes sequential search by facilitating the onset of a new saccade.
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Affiliation(s)
- Giacomo Veneri
- Eye Tracking and Visual Application EVALab, Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, Siena, 53100, Italy
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Bianchi S, Di Palma C, Gallus GN, Taglia I, Poggiani A, Rosini F, Rufa A, Muresanu DF, Cerase A, Dotti MT, Federico A. Two novel HTRA1 mutations in a European CARASIL patient. Neurology 2014; 82:898-900. [PMID: 24500651 DOI: 10.1212/wnl.0000000000000202] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Silvia Bianchi
- From the Department of Medical, Surgical and Neurological Sciences (S.B., C.D.P., G.N.G., I.T., A.P, F.R., A.R., M.T.D., A.F.), University of Siena, Siena, Italy; Department of Neurology (D.F.M.), University of Medicine and Pharmacy "Iuliu Hatieganu," Cluj-Napoca, Romania; and Neuroimaging and Neurointervention Unit (A.C.), Azienda Ospedaliera Universitaria Senese, Policlinico "Santa Maria alle Scotte," Siena, Italy
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Palmeri S, Rufa A, Pucci B, Santarnecchi E, Malandrini A, Stromillo ML, Mandalà M, Rosini F, De Stefano N, Federico A. Clinical course of two Italian siblings with ataxia-telangiectasia-like disorder. Cerebellum 2014; 12:596-9. [PMID: 23436002 DOI: 10.1007/s12311-013-0460-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Ataxia-telangiectasia-like disorder (ATLD) due to mutations in the MRE11 gene is a very rare autosomal recessive disease, described so far in only 20 patients. Little is known about the onset of the first symptoms or the clinical course of the disease. The present report contributes to the diagnosis of ATLD and its prognosis at onset. We report 30 years of clinical and ophthalmic observations and the results of quantitative magnetic resonance (MR), MR spectroscopy (proton magnetic resonance spectroscopic imaging) and neuropsychological assessment in the first Italian siblings identified with ATLD. Although the disease had early onset and the clinical picture was initially severe, suggesting ataxia-telangiectasia, neurological impairment, ocular motor apraxia and neuropsychological tests showed very slow deterioration in adult age. The patients developed eye and head motor strategies to compensate ocular motor apraxia. MR measurements and MR spectroscopy disclosed widespread neuronal and axonal involvement. ATLD should be considered in patients with ocular apraxia and ataxia in infancy. The long follow-up provided insights into clinical outcome, with functional neuroimaging studies shedding light on the pathogenetic mechanisms of this rare disease.
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Battisti C, Di Donato I, Bianchi S, Monti L, Formichi P, Rufa A, Taglia I, Cerase A, Dotti MT, Federico A. Hereditary diffuse leukoencephalopathy with axonal spheroids: three patients with stroke-like presentation carrying new mutations in the CSF1R gene. J Neurol 2014; 261:768-72. [DOI: 10.1007/s00415-014-7257-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 01/15/2014] [Accepted: 01/17/2014] [Indexed: 11/29/2022]
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36
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Aştefănoaei C, Creangă D, Pretegiani E, Optican LM, Rufa A. DYNAMICAL COMPLEXITY ANALYSIS OF SACCADIC EYE MOVEMENTS IN TWO DIFFERENT PSYCHOLOGICAL CONDITIONS. Rom Rep Phys 2014; 66:1038-1055. [PMID: 25698890 PMCID: PMC4331081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Saccadic eye movements of a normal subject were assessed through semi-quantitative analysis algorithms based on linear and non-linear test application in order to highlight the dynamics type characterizing saccadic neural system behavior. These movements were recorded during a simple visually-guided saccade test and one with a cognitive load involving button pressing to show a decision. Following the application of specific computational tests, chaotic dynamical trend dominancy was mostly revealed with some differences between the two saccade recording conditions: auto-correlation time was increased from 170 to 240 by cognitive task superposition and the Hurst exponent was enhanced from 0.52 to 0.76, denoting more persistence in the dynamics of saccadic system during increased neural activity related to cognitive task.
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Affiliation(s)
- C. Aştefănoaei
- University “Alexandru Ioan Cuza”, Faculty of Physics, Laboratory of Biophysics & Medical Physics, 11 Bd. Carol I, 700506, Iasi, Romania
| | - D. Creangă
- University “Alexandru Ioan Cuza”, Faculty of Physics, Laboratory of Biophysics & Medical Physics, 11 Bd. Carol I, 700506, Iasi, Romania
| | - E. Pretegiani
- University of Siena, Department of Medicine Surgery and Neuroscience, Eye-tracking &Visual Application Lab EVALab, Siena 53100, Italy
| | - L. M. Optican
- National Eye Institute, Laboratory of Sensorimotor Research, Bethesda, MD, 20892, USA
| | - A. Rufa
- University of Siena, Department of Medicine Surgery and Neuroscience, Eye-tracking &Visual Application Lab EVALab, Siena 53100, Italy
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37
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Vinciguerra C, Rufa A, Bianchi S, Sperduto A, De Santis M, Malandrini A, Dotti MT, Federico A. Homozygosity and severity of phenotypic presentation in a CADASIL family. Neurol Sci 2013; 35:91-3. [DOI: 10.1007/s10072-013-1580-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 11/08/2013] [Indexed: 11/24/2022]
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38
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Rosini F, Pretegiani E, Guideri F, Cerase A, Rufa A. Eight and a Half Syndrome with Hemiparesis and Hemihypesthesia: The Nine Syndrome? J Stroke Cerebrovasc Dis 2013; 22:e637-8. [DOI: 10.1016/j.jstrokecerebrovasdis.2013.01.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Accepted: 01/28/2013] [Indexed: 10/27/2022] Open
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39
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Cerase A, Vallone IM, Rufa A, Leonini S. Pseudo-intraventricular hemorrhage from a deep calcarine fissure. Surg Radiol Anat 2013; 36:601-3. [PMID: 24173013 DOI: 10.1007/s00276-013-1226-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 10/19/2013] [Indexed: 11/24/2022]
Abstract
Evidence of areas of increased attenuation density within lateral ventricles at computed tomography (CT) of the brain is a finding of acute or subacute intraventricular hemorrhage. The purpose of this case report is to describe a 14-year-old female who presented with an episode of complicated migraine. Brain CT showed an area of high attenuation density (35 Hounsfield Units) in the trigone and occipital horn of the right lateral ventricle, mimicking a blood-fluid level from subacute intraventricular hemorrhage. Magnetic resonance imaging (MRI) of the brain showed that this resulted from gray matter lining a deep calcarine fissure. A deep calcarine fissure may mimic intraventricular hemorrhage at CT. Correct CT and MRI interpretation allows to avoid invasive diagnostic tests including lumbar puncture or intra-arterial catheter angiography.
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Affiliation(s)
- Alfonso Cerase
- Unit NINT Neuroimaging and Neurointervention, Department of Neurological and Sensorineural Sciences, Azienda Ospedaliera Universitaria Senese, Policlinico "Santa Maria alle Scotte", Viale Mario Bracci, 16, 53100, Siena, Italy,
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40
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Di Donato I, Bianchi S, Taglia I, Gallus G, Stabile C, Battisti C, Rufa A, Dotti M, Federico A. Three new mutations in CSF1R gene in 3 Italian patients with hereditary diffuse leukoencephalopathy with axonal spheroids. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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41
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Bianchi S, Rufa A, Vinciguerra C, Gallus G, Dotti M, Federico A. Homozygosity for P.Cys183ser mutation in Notch3 gene may influence the severity of clinical presentation? Report of an Italian family. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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42
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Lucii G, Rosini F, Federighi P, Pretegiani E, Giannini F, Federico A, Rufa A. Oculomotor changes in multiple system atrophy: Clinical, MRI and laboratory features in eight patients. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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43
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Rosini F, Cerase A, Pretegiani E, Lucii G, Federighi P, Federico A, Rufa A. Photophobia and bilateral pulvinar involvement in non-alcoholic Wernicke’s encephalopathy. Neurol Sci 2013; 34:1867-9. [DOI: 10.1007/s10072-013-1338-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 02/16/2013] [Indexed: 10/27/2022]
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44
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Bianchi S, Di Palma C, Gallus G, Taglia I, Poggiani A, Rosini F, Cerase A, Rufa A, Muresanu D, Dotti M, Federico A. Two new heterozygous mutations of Htra1 gene in a Caucasian patient affected by CARASIL. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.2286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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45
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Rosini F, Federighi P, Pretegiani E, Piu P, Leigh RJ, Serra A, Federico A, Rufa A. Ocular-motor profile and effects of memantine in a familial form of adult cerebellar ataxia with slow saccades and square wave saccadic intrusions. PLoS One 2013; 8:e69522. [PMID: 23894498 PMCID: PMC3718679 DOI: 10.1371/journal.pone.0069522] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 06/11/2013] [Indexed: 11/18/2022] Open
Abstract
Fixation instability due to saccadic intrusions is a feature of autosomal recessive spinocerebellar ataxias, and includes square wave intrusions (SWI) and macrosaccadic oscillations (MSO). A recent report suggested that the non-competitive antagonist of NMDA receptors, memantine, could decrease MSO and improve fixation in patients with spinocerebellar ataxia with saccadic intrusions (SCASI). We similarly tested two sisters, respectively of 58 and 60 years, with an unrecognized form of recessive, adult-onset cerebellar ataxia, peripheral neuropathy and slow saccades, who showed prominent SWI and also complained with difficulty in reading. We tested horizontal visually guided saccades (10°–18°) and three minutes of steady fixation in each patient and in thirty healthy controls. Both patients showed a significant reduction of peak and mean velocity compared with control subjects. Large SWI interrupting steady fixation were prominent during steady fixation and especially following visually guided saccades. Eye movements were recorded before and during the treatment with memantine, 20 mg/daily for 6 months. The treatment with memantine reduced both the magnitude and frequency of SWI (the former significantly), but did not modified neurological conditions or saccade parameters. Thus, our report suggests that memantine may have some general suppressive effect on saccadic intrusions, including both SWI and MSO, thereby restoring the capacity of reading and visual attention in these and in other recessive forms of ataxia, including Friedreich’s, in which saccadic intrusions are prominent.
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Affiliation(s)
- Francesca Rosini
- Eye tracking and Visual Application Lab (EVA Lab), Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Pamela Federighi
- Eye tracking and Visual Application Lab (EVA Lab), Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Elena Pretegiani
- Eye tracking and Visual Application Lab (EVA Lab), Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Pietro Piu
- Eye tracking and Visual Application Lab (EVA Lab), Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - R. John Leigh
- Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Alessandro Serra
- Veterans Affairs Medical Center, Case Western Reserve University, Cleveland, Ohio, United States of America
| | - Antonio Federico
- Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Alessandra Rufa
- Eye tracking and Visual Application Lab (EVA Lab), Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
- * E-mail:
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Mignarri A, Chini E, Rufa A, Rocchi R, Federico A, Dotti MT. Lithium neurotoxicity mimicking rapidly progressive dementia. J Neurol 2013; 260:1152-4. [PMID: 23306658 DOI: 10.1007/s00415-012-6820-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 12/10/2012] [Accepted: 12/22/2012] [Indexed: 12/24/2022]
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Aştefănoaei C, Pretegiani E, Optican L, Creangă D, Rufa A. EYE MOVEMENT RECORDING AND NONLINEAR DYNAMICS ANALYSIS - THE CASE OF SACCADES. Rom J Biophys 2013; 23:81-92. [PMID: 25698889 PMCID: PMC4331077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Evidence of a chaotic behavioral trend in eye movement dynamics was examined in the case of a saccadic temporal series collected from a healthy human subject. Saccades are highvelocity eye movements of very short duration, their recording being relatively accessible, so that the resulting data series could be studied computationally for understanding the neural processing in a motor system. The aim of this study was to assess the complexity degree in the eye movement dynamics. To do this we analyzed the saccadic temporal series recorded with an infrared camera eye tracker from a healthy human subject in a special experimental arrangement which provides continuous records of eye position, both saccades (eye shifting movements) and fixations (focusing over regions of interest, with rapid, small fluctuations). The semi-quantitative approach used in this paper in studying the eye functioning from the viewpoint of non-linear dynamics was accomplished by some computational tests (power spectrum, portrait in the state space and its fractal dimension, Hurst exponent and largest Lyapunov exponent) derived from chaos theory. A high complexity dynamical trend was found. Lyapunov largest exponent test suggested bi-stability of cellular membrane resting potential during saccadic experiment.
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Affiliation(s)
- Corina Aştefănoaei
- Laboratory of Biophysics & Medical Physics, Faculty of Physics, “Alexandru Ioan Cuza” University, 11, Carol I Blvd., 700506, Iași, Romania
| | - Elena Pretegiani
- Eye-tracking & Visual Application Lab EVALab, Department of Medicine Surgery and Neuroscience, University of Siena, Siena 53100, Italy
| | - L.M. Optican
- Laboratory of Sensorimotor Research, National Eye Institute, Bethesda, MD, 20892, USA
| | - Dorina Creangă
- Laboratory of Biophysics & Medical Physics, Faculty of Physics, “Alexandru Ioan Cuza” University, 11, Carol I Blvd., 700506, Iași, Romania
| | - Alessandra Rufa
- Eye-tracking & Visual Application Lab EVALab, Department of Medicine Surgery and Neuroscience, University of Siena, Siena 53100, Italy
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Veneri G, Pretegiani E, Rosini F, Federighi P, Federico A, Rufa A. Evaluating the human ongoing visual search performance by eye tracking application and sequencing tests. Comput Methods Programs Biomed 2012; 107:468-477. [PMID: 21453982 DOI: 10.1016/j.cmpb.2011.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Revised: 12/12/2010] [Accepted: 02/09/2011] [Indexed: 05/30/2023]
Abstract
Human visual search is an everyday activity that enables humans to explore the real world. Given the visual input, during a visual search, it is necessary to select some aspects of input to shift the gaze to next target. The aim of the study is to develop a mathematical method able to evaluate the visual selection process during the execution of a high cognitively demanding task such as the trial making test part B (TMT). The TMT is a neuro-psychological instrument where numbers and letters should be connected to each other in numeric and alphabetic order. We adapted the TMT to an eye-tracking version, and we used a vector model, the "eight pointed star" (8PS), to discover how selection (fixations) guides next exploration (saccades) and how human top-down factors interact with bottom-up saliency. The results reported a trend to move away from the last fixations correlated to the number of distracters and the execution performance.
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Affiliation(s)
- Giacomo Veneri
- Eye Tracking & Vision Applications Lab, Department of Neurological Neurosurgical and Behavioral Science, University of Siena, Viale Bracci 2, Siena, Italy.
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Salsano E, Umeh C, Rufa A, Pareyson D, Zee DS. Vertical supranuclear gaze palsy in Niemann-Pick type C disease. Neurol Sci 2012; 33:1225-32. [PMID: 22810120 DOI: 10.1007/s10072-012-1155-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 07/03/2012] [Indexed: 11/28/2022]
Abstract
Vertical supranuclear gaze palsy (VSGP) is a key clinical feature in patients with Niemann-Pick type C disease (NP-C), a rare, autosomal recessive, neuro-visceral disorder caused by mutations in either the NPC1 or NPC2 gene. VSGP is present in approximately 65 % of the cases and is, with gelastic cataplexy, an important risk indicator for NP-C. VSGP in NP-C is characterized by a paralysis of vertical saccades, especially downward, with the slow vertical eye movement systems (smooth pursuit and the vestibulo-ocular reflex) spared in the early phase of the disease. This dissociation is caused by a selective vulnerability of the neurons in the rostral interstitial nuclei of the medial longitudinal fasciculus (riMLF) in NP-C. Here we discuss VSGP in NP-C and how clinicians can best elicit this sign.
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Affiliation(s)
- Ettore Salsano
- Department of Clinical Neurosciences, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11, 20133, Milano, Italy.
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Federighi P, Ramat S, Zee D, Leigh R, Piu P, Rufa A. Dynamic Properties of Saccades Identify Forms of Spinocerebellar Ataxia (S48.005). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s48.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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