Movement Latency Research Articles

Oculomotor inhibition of return: Evidence against object-centered representation

ABSTRACTIntermixing central, directional arrow targets with the peripheral targets typically used in the Posnerian spatial cueing paradigm offers a useful diagnostic for ascertaining the relative contributions of output and input processes to oculomotor inhibition of return (IOR). Here, we use this diagnostic to determine whether object-based oculomotor IOR comprises output and/or input processes. One of two placeholder objects in peripheral vision was cued, then both objects rotated smoothly either 90 or 180 degrees around the circumference of an imaginary circle. After this movement, a saccade was made to the location marked by a peripheral onset target or indicated by the central arrow. In our first three experiments, whereas there was evidence for IOR when measured by central arrow or peripheral onset targets at cued locations, there was little trace of IOR at the cued object. We thereafter precisely replicated the seminal experiment for object-based oculomotor IOR (Abrams, R. A., & Dobkin, R. S. (1994). Inhibition of return: Effects of attentional cuing on eye movement latencies. Journal of Experimental Psychology: Human Perception and Performance, 20(3), 467–477; Experiment 4) but again found little evidence of an object-based IOR effect. Finally, we ran a paradigm with only peripheral targets and with motion and stationary trials randomly intermixed. Here we again showed IOR at the cued location but not at the cued object. Together, the findings suggest that object-based representation of oculomotor IOR is much more tenuous than implied by the literature.

No Evidence That Frontal Eye Field tDCS Affects Latency or Accuracy of Prosaccades.

Transcranial direct current stimulation (tDCS) may be used to directly affect neural activity from outside of the skull. However, its exact physiological mechanisms remain elusive, particularly when applied to new brain areas. The frontal eye field (FEF) has rarely been targeted with tDCS, even though it plays a crucial role in control of overt and covert spatial attention. Here, we investigate whether tDCS over the FEF can affect the latency and accuracy of saccadic eye movements. Twenty-six participants performed a prosaccade task in which they made eye movements to a sudden-onset eccentric visual target (lateral saccades). After each lateral saccade, they made an eye movement back to the center (center saccades). The task was administered before, during, and after anodal or cathodal tDCS over the FEF, in a randomized, double-blind, within-subject design. One previous study (Kanai et al., 2012) found that anodal tDCS over the FEF decreased the latency of saccades contralateral to the stimulated hemisphere. We did not find the same effect: neither anodal nor cathodal tDCS influenced the latency of lateral saccades. tDCS also did not affect accuracy of lateral saccades (saccade endpoint deviation and saccade endpoint variability). For center saccades, we found some differences between the anodal and cathodal sessions, but these were not consistent across analyses (latency, endpoint variability), or were already present before tDCS onset (endpoint deviation). We tried to improve on the design of Kanai et al. (2012) in several ways, including the tDCS duration and electrode montage, which could explain the discrepant results. Our findings add to a growing number of null results, which have sparked concerns that tDCS outcomes are highly variable. Future studies should aim to establish the boundary conditions for FEF-tDCS to be effective, in addition to increasing sample size and adding additional controls such as a sham condition. At present, we conclude that it is unclear whether eye movements or other aspects of spatial attention can be affected through tDCS of the frontal eye fields.

Motion Extrapolation for Eye Movements Predicts Perceived Motion-Induced Position Shifts.

Transmission delays in the nervous system pose challenges for the accurate localization of moving objects as the brain must rely on outdated information to determine their position in space. Acting effectively in the present requires that the brain compensates not only for the time lost in the transmission and processing of sensory information, but also for the expected time that will be spent preparing and executing motor programs. Failure to account for these delays will result in the mislocalization and mistargeting of moving objects. In the visuomotor system, where sensory and motor processes are tightly coupled, this predicts that the perceived position of an object should be related to the latency of saccadic eye movements aimed at it. Here we use the flash-grab effect, a mislocalization of briefly flashed stimuli in the direction of a reversing moving background, to induce shifts of perceived visual position in human observers (male and female). We find a linear relationship between saccade latency and perceived position shift, challenging the classic dissociation between "vision for action" and "vision for perception" for tasks of this kind and showing that oculomotor position representations are either shared with or tightly coupled to perceptual position representations. Altogether, we show that the visual system uses both the spatial and temporal characteristics of an upcoming saccade to localize visual objects for both action and perception.SIGNIFICANCE STATEMENT Accurately localizing moving objects is a computational challenge for the brain due to the inevitable delays that result from neural transmission. To solve this, the brain might implement motion extrapolation, predicting where an object ought to be at the present moment. Here, we use the flash-grab effect to induce perceptual position shifts and show that the latency of imminent saccades predicts the perceived position of the objects they target. This counterintuitive finding is important because it not only shows that motion extrapolation mechanisms indeed work to reduce the behavioral impact of neural transmission delays in the human brain, but also that these mechanisms are closely matched in the perceptual and oculomotor systems.

Post-stroke Movement Disorders: The Clinical, Neuroanatomic, and Demographic Portrait of 284 Published Cases

Abnormal movements are a relatively uncommon complication of strokes. Besides the known correlation between stroke location and certain movement disorders, there remain uncertainties about the collective effects of age and stroke mechanism on phenomenology, onset latency, and outcome of abnormal movements. We systematically reviewed all published cases and case series with adequate clinical-imaging correlations. A total of 284 cases were analyzed to evaluate the distribution of different movement disorders and their association with important cofactors. Posterolateral thalamus was the most common region affected (22.5%) and dystonia the most commonly reported movement disorder (23.2%). The most common disorders were parkinsonism (17.4%) and chorea (17.4%) after ischemic strokes and dystonia (45.5%) and tremor (19.7%) after hemorrhagic strokes. Strokes in the caudate and putamen were complicated by dystonia in one third of the cases; strokes in the globus pallidus were followed by parkinsonism in nearly 40%. Chorea was the earliest poststroke movement disorder, appearing within hours, whereas dystonia and tremor manifested several months after stroke. Hemorrhagic strokes were responsible for most delayed-onset movement disorders (>6 months) and were particularly overrepresented among younger individuals affected by dystonia. This evidence-mapping portrait of poststroke movement disorders will require validation or correction based on a prospective epidemiologic study. We hypothesize that selective network vulnerability and resilience may explain the differences observed in movement phenomenology and outcomes after stroke.

Short-term temporal memory in idiopathic and Parkin-associated Parkinson\u2019s disease

In a rapidly changing environment, we often know when to do something before we have to do it. This preparation in the temporal domain is based on a ‘perception’ of elapsed time and short-term memory of previous stimulation in a similar context. These functions could be perturbed in Parkinson’s disease. Therefore, we investigated their role in eye movement preparation in sporadic Parkinson’s disease and in a very infrequent variant affecting the Parkin gene. We used a simple oculomotor task where subjects had to orient to a visual target and movement latency was measured. We found that in spite of an increased average reaction time, the influence of elapsed time on movement preparation was similar in controls and the two groups of PD patients. However, short-term temporal memory of previous stimulation was severely affected in sporadic PD patients either ON or OFF dopaminergic therapy. We conclude that the two different contributions to temporal preparation could be dissociated. Moreover, a short-term temporal memory deficit might underlie temporal cognition deficits previously observed in PD.

Changes to online control and eye-hand coordination with healthy ageing

Goal directed movements are typically accompanied by a saccade to the target location. Online control plays an important part in correction of a reach, especially if the target or goal of the reach moves during the reach. While there are notable changes to visual processing and motor control with healthy ageing, there is limited evidence about how eye-hand coordination during online updating changes with healthy ageing. We sought to quantify differences between older and younger people for eye-hand coordination during online updating. Participants completed a double step reaching task implemented under time pressure. The target perturbation could occur 200, 400 and 600 ms into a reach. We measured eye position and hand position throughout the trials to investigate changes to saccade latency, movement latency, movement time, reach characteristics and eye-hand latency and accuracy. Both groups were able to update their reach in response to a target perturbation that occurred at 200 or 400 ms into the reach. All participants demonstrated incomplete online updating for the 600 ms perturbation time. Saccade latencies, measured from the first target presentation, were generally longer for older participants. Older participants had significantly increased movement times but there was no significant difference between groups for touch accuracy. We speculate that the longer movement times enable the use of new visual information about the target location for online updating towards the end of the movement. Interestingly, older participants also produced a greater proportion of secondary saccades within the target perturbation condition and had generally shorter eye-hand latencies. This is perhaps a compensatory mechanism as there was no significant group effect on final saccade accuracy. Overall, the pattern of results suggests that online control of movements may be qualitatively different in older participants.

A comparative study of sleep architecture in non-institutionalized senior citizens of Bengaluru city and normative data of sleep

Background: Sleep disturbances are particularly common among even the apparently healthy aging population, and its role as a cause or consequence of chronic illness makes it an issue worth addressing. Aims and Objectives: (i) To record and score the sleep architecture in familial senior citizens using polysomnography, (ii) to compare the score with the normative data provided by American Academy of Sleep Medicine for the same age group, and (iii) to compare the polysomnographic recordings of male and female subjects. Materials and Methods: The study was done on apparently healthy 30 non‑institutionalized senior citizens (15 males and 15 females) residing with their families in residential areas of Bengaluru city. Eligible subjects underwent overnight polysomnography. The recorded sleep parameters included total sleep time (TST), sleep latency (SL), rapid eye movement (REM) latency (RL), wake after sleep onset, sleep efficiency (SE), and stages N1%, N2%, N3%, and REM%. The data were manually scored, tabulated, and compared with normative data using the appropriate statistical tools. Results: On statistical analysis, TST was not significantly altered. The SL, RL, WASO, N1%, and N2% were significantly (P < 0.05) increased in the study group compared to normative data. SE, N1%, and N2% are significantly decreased compared to the normative data. Furthermore, males had longer RL and females had greater percentage of N1% compared to each other. Conclusion: The sleep architecture of the senior citizens under study is significantly deviate from the normative data and the causes for this may be altered circadian rhythm, nutritional, hormonal, or psychosocial factors.

Depressive symptoms account for differences between self‐reported versus polysomnographic assessment of sleep quality in women with myofascial TMD

Patients with temporomandibular disorder (TMD) report poor sleep quality on the Pittsburgh Sleep Quality Index (PSQI). However, polysomnographic (PSG) studies show meagre evidence of sleep disturbance on standard physiological measures. The present aim was to analyse self-reported sleep quality in TMD as a function of myofascial pain, PSG parameters and depressive symptomatology. PSQI scores from 124 women with myofascial TMD and 46 matched controls were hierarchically regressed onto TMD presence, ratings of pain intensity and pain-related disability, in-laboratory PSG variables and depressive symptoms (Symptoms Checklist-90). Relative to controls, TMD cases had higher PSQI scores, representing poorer subjective sleep and more depressive symptoms (both P < 0·001). Higher PSQI scores were strongly predicted by more depressive symptoms (P < 0·001, R2 = 26%). Of 19 PSG variables, two had modest contributions to higher PSQI scores: longer rapid eye movement latency in TMD cases (P = 0·01, R2 = 3%) and more awakenings in all participants (P = 0·03, R2 = 2%). After accounting for these factors, TMD presence and pain ratings were not significantly related to PSQI scores. These results show that reported poor sleep quality in TMD is better explained by depressive symptoms than by PSG-assessed sleep disturbances or myofascial pain. As TMD cases lacked typical PSG features of clinical depression, the results suggest a negative cognitive bias in TMD and caution against interpreting self-report sleep measures as accurate indicators of PSG sleep disturbance. Future investigations should take account of depressive symptomatology when interpreting reports of poor sleep.

Restoration of Sleep Architecture after Maxillomandibular Advancement: Success Beyond the Apnea–Hypopnea Index

While effects of maxillomandibular advancement (MMA) on respiratory parameters for patients with obstructive sleep apnea (OSA) are well described, effects on sleep architecture before and after MMA are not. A retrospective cohort analysis on sleep architecture was examined in 10 OSA patients who underwent MMA surgery between July 2013 and November 2014, and had prespecified complete polysomnography (PSG) datasets. Sleep stages were examined relative to a Western European population-based control group. All of the respiratory parameters improved significantly post MMA. Rapid eye movement (REM) latency decreased from 178.0±142.8 to 96.6±64.5min (P=0.035). %NREM (non-rapid eye movement)1 (P=0.045) and %WASO (wakefulness after sleep onset) (P=0.006) decreased, while %REM increased (P=0.002) after MMA. WASO decreased from 64.2±57min to 22.4±15.4min (P=0.017). Preoperatively, OSA subjects showed significantly lower sleep efficiency (P=0.016), sleep onset latency (P=0.015), and % REM (P<0.001) than the normative population dataset, while post MMA there was a significant decrease in %NREM1 sleep (P<0.001) and in %WASO (P<0.001). MMA results in a marked decrease in WASO and increase in REM, and to a lesser extent NREM sleep. Patients after MMA show values similar to population controls except for a lower WASO.

Dissecting patterns of preparatory activity in the frontal eye fields during pursuit target selection.

We investigated the composition of preparatory activity of frontal eye field (FEF) neurons in monkeys performing a pursuit target selection task. In response to the orthogonal motion of a large and a small reward target, monkeys initiated pursuit biased toward the direction of large reward target motion. FEF neurons exhibited robust preparatory activity preceding movement initiation in this task. Preparatory activity consisted of two components, ramping activity that was constant across target selection conditions, and a flat offset in firing rates that signaled the target selection condition. Ramping activity accounted for 50% of the variance in the preparatory activity and was linked most strongly, on a trial-by-trial basis, to pursuit eye movement latency rather than to its direction or gain. The offset in firing rates that discriminated target selection conditions accounted for 25% of the variance in the preparatory activity and was commensurate with a winner-take-all representation, signaling the direction of large reward target motion rather than a representation that matched the parameters of the upcoming movement. These offer new insights into the role that the frontal eye fields play in target selection and pursuit control. They show that preparatory activity in the FEF signals more strongly when to move rather than where or how to move and suggest that structures outside the FEF augment its contributions to the target selection process.NEW & NOTEWORTHY We used the smooth eye movement pursuit system to link between patterns of preparatory activity in the frontal eye fields and movement during a target selection task. The dominant pattern was a ramping signal that did not discriminate between selection conditions and was linked, on trial-by-trial basis, to movement latency. A weaker pattern was composed of a constant signal that discriminated between selection conditions but was only weakly linked to the movement parameters.

Context effects on smooth pursuit and manual interception of a disappearing target.

In our natural environment, we interact with moving objects that are surrounded by richly textured, dynamic visual contexts. Yet most laboratory studies on vision and movement show visual objects in front of uniform gray backgrounds. Context effects on eye movements have been widely studied, but it is less well known how visual contexts affect hand movements. Here we ask whether eye and hand movements integrate motion signals from target and context similarly or differently, and whether context effects on eye and hand change over time. We developed a track-intercept task requiring participants to track the initial launch of a moving object ("ball") with smooth pursuit eye movements. The ball disappeared after a brief presentation, and participants had to intercept it in a designated "hit zone." In two experiments (n = 18 human observers each), the ball was shown in front of a uniform or a textured background that either was stationary or moved along with the target. Eye and hand movement latencies and speeds were similarly affected by the visual context, but eye and hand interception (eye position at time of interception, and hand interception timing error) did not differ significantly between context conditions. Eye and hand interception timing errors were strongly correlated on a trial-by-trial basis across all context conditions, highlighting the close relation between these responses in manual interception tasks. Our results indicate that visual contexts similarly affect eye and hand movements but that these effects may be short-lasting, affecting movement trajectories more than movement end points.NEW & NOTEWORTHY In a novel track-intercept paradigm, human observers tracked a briefly shown object moving across a textured, dynamic context and intercepted it with their finger after it had disappeared. Context motion significantly affected eye and hand movement latency and speed, but not interception accuracy; eye and hand position at interception were correlated on a trial-by-trial basis. Visual context effects may be short-lasting, affecting movement trajectories more than movement end points.

Target-distractor synchrony affects performance in a novel motor task for studying action selection.

The study of action selection in humans can present challenges of task design since our actions are usually defined by many degrees of freedom and therefore occupy a large action-space. While saccadic eye-movement offers a more constrained paradigm for investigating action selection, the study of reach-and-grasp in upper limbs has often been defined by more complex scenarios, not easily interpretable in terms of such selection. Here we present a novel motor behaviour task which addresses this by limiting the action space to a single degree of freedom in which subjects have to track (using a stylus) a vertical coloured target line displayed on a tablet computer, whilst ignoring a similarly oriented distractor line in a different colour. We ran this task with 55 subjects and showed that, in agreement with previous studies, the presence of the distractor generally increases the movement latency and directional error rate. Further, we used two distractor conditions according to whether the distractor’s location changes asynchronously or synchronously with the location of the target. We found that the asynchronous distractor yielded poorer performance than its synchronous counterpart, with significantly higher movement latencies and higher error rates. We interpret these results in an action selection framework with two actions (move left or right) and competing ‘action requests’ offered by the target and distractor. As such, the results provide insights into action selection performance in humans and supply data for directly constraining future computational models therein.

Perception of coarticulation in listeners with cochlear implants and other spectrally degraded conditions

Hearing loss can lead to not only decreased overall word recognition, but also poor access to cues that help us identify words more quickly in context. One such cue is coarticulation, or the overlap of articulatory gestures in neighboring sounds, which is utilized by listeners to more quickly an upcoming word. This study measures benefit of coarticulation when the incoming speech signal is spectrally degraded, as with the use of a cochlear implant or other degradation. In a visual world eye-tracking paradigm, listeners looked to four pictures of named objects while listening to speech stimuli in which the vowel preceding a target word contained natural cooperating coarticulation cues, conflicting cues (for a different word), or neutral cues (no coarticulation). The benefit of coarticulation was measured as reduction of latency of eye movements elicited by the cooperating cue compared to neutral cues, or the increase in latency resulting from conflicting cues; both situations would show evidence of sensitivity to coarticulation. Preliminary results suggest that coarticulation perception is partially robust to degradation for normal-hearing listeners but is highly variable/deficient in cochlear implant listeners, suggesting a disadvantage in the speed of word recognition that would not be evident in conventional word recognition scores.

Sleep disturbance in mild cognitive impairment: a systematic review of objective measures.

Sleep disturbance frequently occurs in patients with mild cognitive impairment (MCI) and appears to be involved in the cellular and molecular mechanisms of cognitive decline. The aim of this systematic review is to clarify whether patients with MCI demonstrate alterations in certain sleep parameters: total sleep time (TST), sleep efficiency (SE), sleep latency (SL), rapid eye movement latency (REML), percent of rapid eye movement (REM%), arousal index (AI), wake after sleep onset (WASO), slow-wave sleep (SWS), periodic leg movement in sleep (PLMS), and cyclic alternating pattern (CAP) through polysomnography (PSG) and actigraphy. Databases including PubMed, Web of Science, Embase, ScienceDirect, Cochrane, CBM, CNKI, Wanfang Data, and VIP were searched up to January 2016 to collect literature on the correlation between sleep disturbance and MCI as assessed by objective measures. Meta-analysis was conducted using the Review Manager 5.3 software. A total of ten case-control studies involving 225 MCI patients and 235 healthy elders (HE) were deemed eligible and included in our meta-analysis. Every type of sleep disturbance was present in our studies with significant differences in the MCI subtypes. Compared with HE, overall MCI patients as a group expressed more SL and less SE; MCI patients showed less TST and SE and more SL and CAP; patients with amnestic mild cognitive impairment (aMCI) had less AI; patients with non-amnestic mild cognitive impairment (naMCI) had more TST and less AI. Patients with naMCI expressed more AI than those with aMCI. The results indicate that MCI patients might experience more serious sleep disturbance and that different MCI subtypes have different patterns of sleep disturbance.

Depressive Symptoms Are Associated With Objectively Measured Sleep Parameters in Kidney Transplant Recipients.

Both depression and sleep complaints are very prevalent among kidney transplant (kTx) recipients. However, details of the complex relationship between sleep and depression in this population are not well documented. Thus, we investigated the association between depressive symptoms and sleep macrostructure parameters among prevalent kTx recipients. Ninety-five kTx recipients participated in the study (54 males, mean ± standard devation age 51 ± 13 years, body mass index 26 ± 4 kg/m2, estimated glomerular filtration rate 53 ± 19 ml/min/1.73 m2). Symptoms of depression were assessed by the Center for Epidemiologic Studies - Depression Scale (CES-D). After 1-night polysomnography each recording was visually scored and sleep macrostructure was analyzed. The CES-D score was significantly associated with the amount of stage 2 sleep (r = 0.20, P < .05), rapid eye movement (REM) latency (r = 0.21, P < .05) and REM percentage (r = -0.24, P < .05), but not with the amount of slow wave sleep (r = -0.12, P > .05). In multivariable linear regression models the CES-D score was independently associated with the amount of stage 2 sleep (β: 0.205; confidence interval: 0.001-0.409; P = .05) and REM latency (β: 0.234; confidence interval: 0.001-0.468; P = .05) after adjustment for potential confounders. Depressive symptoms among kTx recipients are associated with increased amount of stage 2 sleep and prolonged REM latency. Further studies are needed to confirm our findings and understand potential clinical implications.

Preserved search asymmetry in the detection of fearful faces among neutral faces in individuals with Williams syndrome revealed by measurement of both manual responses and eye tracking

BackgroundIndividuals with Williams syndrome (WS) exhibit an atypical social phenotype termed hypersociability. One theory accounting for hypersociability presumes an atypical function of the amygdala, which processes fear-related information. However, evidence is lacking regarding the detection mechanisms of fearful faces for individuals with WS. Here, we introduce a visual search paradigm to elucidate the mechanisms for detecting fearful faces by evaluating the search asymmetry; the reaction time when both the target and distractors were swapped was asymmetrical.MethodsEye movements reflect subtle atypical attentional properties, whereas, manual responses are unable to capture atypical attentional profiles toward faces in individuals with WS. Therefore, we measured both eye movements and manual responses of individuals with WS and typically developed children and adults in visual searching for a fearful face among neutral faces or a neutral face among fearful faces. Two task measures, namely reaction time and performance accuracy, were analyzed for each stimulus as well as gaze behavior and the initial fixation onset latency.ResultsOverall, reaction times in the WS group and the mentally age-matched control group were significantly longer than those in the chronologically age-matched group. We observed a search asymmetry effect in all groups: when a neutral target facial expression was presented among fearful faces, the reaction times were significantly prolonged in comparison with when a fearful target facial expression was displayed among neutral distractor faces. Furthermore, the first fixation onset latency of eye movement toward a target facial expression showed a similar tendency for manual responses.ConclusionsAlthough overall responses in detecting fearful faces for individuals with WS are slower than those for control groups, search asymmetry was observed. Therefore, cognitive mechanisms underlying the detection of fearful faces seem to be typical in individuals with WS. This finding is discussed with reference to the amygdala account explaining hypersociability in individuals with WS.

Intergroup Contact and Outgroup Humanization: Is the Causal Relationship Uni- or Bidirectional?

The attribution of uniquely human characteristics to the outgroup may favor the search for contact with outgroup members and, vice versa, contact experiences may improve humanity attributions to the outgroup. To explore this bidirectional relationship, two studies were performed. In Study 1, humanity perceptions were manipulated using subliminal conditioning. Two experimental conditions were created. In the humanization condition, the unconditioned stimuli (US) were uniquely human words; in the dehumanization condition, the US were non-uniquely human and animal words. In both conditions, conditioned stimuli were typical outgroup faces. An approach/avoidance technique (the manikin task) was used to measure the willingness to have contact with outgroup members. Findings showed that in the humanization condition participants were faster in approaching than in avoiding outgroup members: closeness to the outgroup was preferred to distance. Latencies of approach and avoidance movements were not different in the dehumanization condition. In Study 2, contact was manipulated using the manikin task. One approach (contact) condition and two control conditions were created. The attribution of uniquely human traits to the outgroup was stronger in the contact than in the no-contact conditions. Furthermore, the effect of contact on humanity attributions was mediated by increased trust toward the outgroup. Thus, findings demonstrate the bidirectionality of the relationship between contact and humanity attributions. Practical implications of findings are discussed.

Optimizing power efficiency for 3D stacked GPU-in-memory architecture

With the prevalence of data-centric computing, the key to achieving energy efficiency is to reduce the latency and energy cost of data movement. Near data processing (NDP) is a such technique which, instead of moving data around, moves computing closer to where data is stored. The emerging 3D stacked memory brings such opportunities for achieving both high power-efficiency as well as less data movement overheads. In this paper, we exploit power efficient NDP architectures using the 3D stacked memory. We integrate the programmable GPU streaming multiprocessors into the NDP architectures, in order to fully exploit the bandwidth provided by 3D stacked memory. In addition, we study the tradeoffs between area, performance and power of the NDP components, especially the NoC designs. Our experimental results show that, compared to traditional architectures, the proposed GPU based NDP architectures can achieve up to 43.8% reduction in EDP and 41.9% improvement in power efficiency in terms of performance-per-Watt.

Acute impairment of saccadic eye movements is associated with delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.

OBJECTIVE Delayed cerebral ischemia (DCI) causing cerebral infarction remains a significant cause of morbidity and mortality following aneurysmal subarachnoid hemorrhage (aSAH). Early brain injury in the first 72 hours following rupture is likely to play a key role in the pathophysiology underlying DCI but remains difficult to quantify objectively. Current diagnostic modalities are based on the concept of vasoconstriction causing cerebral ischemia and infarction and are either invasive or have a steep learning curve and user variability. The authors sought to determine whether saccadic eye movements are impaired following aSAH and whether this measurement in the acute period is associated with the likelihood of developing DCI. METHODS As part of a prospective, observational cohort study, 24 male and female patients (mean age 53 years old, range 31-70 years old) were recruited. Inclusion criteria included presentation with World Federation of Neurosurgical Societies (WFNS) Grades 1 or 2 ("good grade") aSAH on admission and endovascular treatment within 72 hours of aneurysmal rupture. DCI and DCI-related cerebral infarction were defined according to consensus guidelines. Saccadometry data were collected at 3 time points in patients: in the first 72 hours, between Days 5 and 10, and at 3 months after aSAH. Data from 10 healthy controls was collected on 1 occasion for comparison. RESULTS Age-adjusted saccadic latency in patients was significantly prolonged in the first 72 hours following aSAH when compared with controls (188.7 msec [95% CI 176.9-202.2 msec] vs 160.7 msec [95% CI 145.6-179.4 msec], respectively; p = 0.0054, t-test). By 3 months after aSAH, there was no significant difference in median saccadic latency compared with controls (188.7 msec [95% CI 176.9-202.2 msec] vs 180.0 msec [95% CI 165.1-197.8 msec], respectively; p = 0.4175, t-test). Patients diagnosed with cerebral infarction due to DCI had a significantly higher age-adjusted saccadic latency in the first 72 hours than those without infarction (240.6 msec [95% CI 216.7-270.3 msec] vs 204.1 msec [95% CI 190.7-219.5 msec], respectively; p = 0.0157, t-test). This difference was more pronounced during Days 5-10 following aSAH, the peak incidence for DCI (303.7 msec [95% CI 266.7-352.7 msec] vs 207.6 msec [95% CI 193.7-223.6 msec], respectively; p < 0.0001, t-test). A binary generalized linear model showed that latency in the first 72 hours was the only significant predictor of cerebral infarction (p = 0.0185). CONCLUSIONS This is the first study to use saccadometry to measure the saccadic latency of eye movements in patients with aSAH during the acute period following aneurysm rupture. The results showed that median saccadic latency is associated with the risk of developing cerebral infarction due to DCI and may act as a potential objective biomarker to guide the need for intensive care admission and treatment. Future studies will look to formally validate saccadic latency as a biomarker of DCI in a larger cohort and assess whether the addition of saccades improves current clinical models for predicting patients at risk.

P.2.b.062 - Efficacy of lurasidone in the treatment of major depression with mixed features: the value of early improvement as a predictor of short-term response during treatment of bipolar depression with lurasidone

Sleep profile in bipolar disorder has received little attention in comparison to sleep studies in major depressive disorders. Specific sleep abnormalities especially in REM sleep parameters have been detected in depression. The current study aimed at investigating whether bipolar disorder shares the same polysomnographic (PSG) changes or not.All night polysomnographic assessments were made for 20 patients diagnosed to have hypomania, in addition to 20 patients with major depression and 20 healthy matched controls. All participants were examined using Standardized Sleep Questionnaire, SCID-I for psychiatric diagnosis, based on DSM-IV criteria, YMRS (for hypomanic patients), HAMD (for major depression patients), and all-night polysomnography (for all subjects).The two patient groups differed significantly from controls in their sleep profile, especially regarding sleep continuity measures, Short REML (Rapid Eye Movement Latency), with increased REMD (Rapid Eye Movement sleep density). High similarity was found in EEG sleep profile of the two patient groups, though the changes were more robust in patients with depressionA relatively small sample size, the absence of follow up assessment, lack of consideration of other variables like body mass index, nicotine and caffeine intake.Similarity in EEG sleep profile between Bipolar disorder patients and patients with major depression suggests a common biological origin for both conditions, with the difference being “quantitative” rather than “qualitative”. This quantitative difference in sleep efficiency and SWS (Slow wave sleep), being higher in hypomania, might explain the rather “refreshing” nature of sleep in hypomanic patients, compared to depression.