Saccadic Eye Movements In Patients Research Articles

Intentional saccadic eye movements in patients with vestibular migraine

Objectives: Patients with vestibular migraine (VM) show a significant decrease in gray matter cortical regions associated with pain and vestibular processing, as revealed by head functional magnetic resonance imaging. We predict that these changes can be reflected in intentional saccadic eye movements. This study aims to establish whether there are abnormalities in intentional saccadic eye movements in patients with VM. Subjects and Methods: This is a retrospective study involving two groups of patients, including 39 patients in the VM group and 38 patients in the control group. The VM group and control group matched for age and gender were collected from Beijing Luhe Hospital affiliated with Capital Medical University, between June 2021 and May 2022. All patients received antisaccade (AS) and memory-guided saccade (MGS) tasks. Results: Compared with the control group, there were no significant differences in VM group in latency and gain of ASs. However, there were significant differences in the AS error rate between the two groups (right side 44% in VM and 32% in the control group; P = 0.041, left side 41% in VM and 29% in the control group; P = 0.011), with higher error rates observed in the VM group compared to the control group. Compared with the control group, there were no significant differences in the accuracy and final eye position gain of MGSs. However, there were significant differences in the valid saccade accurate percentage of MGS between the two groups (right side 59% in VM and 81% in the control group; P = 0.009, left side 59% in VM and 90% in the control group; P = 0.012), with lower accurate percentages observed in patients with VM compared to the normal control group. Furthermore, the latency of MGS between the two groups differed significantly (right side 677 ms in VM and 491.5 ms in the control group; P = 0.024, left side 670 ms in VM and 555 ms in the control group; P = 0.024), with longer latencies observed in patients with VM compared to normal control group. The results showed that VM disease duration had a positive correlation with the AS error rate (right: P =0.043, r = 0.326; left: P =0.000, r = 0.535). Conclusions: We found abnormalities in the AS and MGS tasks in patients with VM. The duration of VM is positively correlated with the AS error rate. Our study discovered that in addition to headache, dizziness, and autonomic symptoms, VM patients also exhibit impaired intentional saccadic eye movements, which may be related to reduced gray matter volume involved in pain and vestibular processing and cognitive impairment in VM patients.

Saccadic Eye Movements in Patients with Mild Cognitive Impairment: A Longitudinal Study

Saccadic eye movements are one of the sensitive and noninvasive methods to help monitor the cognitive course of mild cognitive impairment (MCI). The study aimed to evaluate both pro and anti-saccade longitudinally and the relationship between cognitive functions and eye movements in MCI subgroups and healthy controls (HCs) at a two-year follow-up. This study revealed that the anti-saccade anticipatory responses decreased in amnestic MCI (aMCI). Correct vertical pro-saccades increased in non-amnestic MCI (naMCI), while the express saccades decreased. Our study demonstrated that longer than two years of follow-up is necessary to monitor the course of MCI. Findings of the relationships between longitudinal changes of saccades and cognitive measurements demonstrated the usability of eye movements in evaluating the process of MCI.

Ocular myasthenia gravis saccades as a measure of extraocular muscle function.

It is important to understand the pathophysiology of ocular myasthenia gravis (OMG) to improve treatment. To use modern video-oculography to characterise saccadic eye movements in patients with OMG, including anti-AChR, anti-MuSK, anti-LRP4, and seronegative OMG. In total, 21 patients with OMG and five age-matched healthy control subjects underwent video-oculography. Participants performed a sequence of horizontal saccades (3 minutes each) at ±5°, ± 10°, and ±20°, followed by 3 minutes of saccades directed at randomly presented targets at ±5°, ± 10°, and ±15°. We recorded the direction, amplitude, duration, peak, and average velocity of each saccade for each task for each participant. Saccadic amplitude, duration, and average velocity were all lower in OMG patients than in control subjects (p<0.021). Saccadic amplitude and velocity decreased over time, but this decrease was similar in OMG patients and control subjects. Fixation drift and ocular disparity tended to be greater in OMG patients than in control subjects. Saccadic intrusions occurred more frequently in OMG patients than in control subjects (p<0.001). No significant effects of time or group by time on fixation drift or ocular disparity were found. Saccadic velocities in OMG patients differed from those in normal control subjects, which suggests that OMG affects fast-twitch fibres, although fast-twitch fibres were still able to generate "twitch" or "quiver" movements in the presence of even severe ophthalmoplegia. Slow-twitch muscle fibres involved in gaze holding were also affected, accounting for increased fixation drift following saccades. Our objective finding of increased fixation drift and a larger number of saccadic intrusions mirror our anecdotal experience of patients with OMG who report significant diplopia despite minimal ophthalmoplegia on examination. Such microsaccades may be a surrogate for compensation of a gaze-holding deficit in MG.

Detection of Oculomotor Dysmetria From Mobile Phone Video of the Horizontal Saccades Task Using Signal Processing and Machine Learning Approaches.

Eye movement assessments have the potential to help in diagnosis and tracking of neurological disorders. Cerebellar ataxias cause profound and characteristic abnormalities in smooth pursuit, saccades, and fixation. Oculomotor dysmetria (i.e., hypermetric and hypometric saccades) is a common finding in individuals with cerebellar ataxia. In this study, we evaluated a scalable approach for detecting and quantifying oculomotor dysmetria. Eye movement data were extracted from iPhone video recordings of the horizontal saccade task (a standard clinical task in ataxia) and combined with signal processing and machine learning approaches to quantify saccade abnormalities. Entropy-based measures of eye movements during saccades were significantly different in 72 individuals with ataxia with dysmetria compared with 80 ataxia and Parkinson's participants without dysmetria. A template matching-based analysis demonstrated that saccadic eye movements in patients without dysmetria were more similar to the ideal template of saccades. A support vector machine was then used to train and test the ability of multiple signal processing features in combination to distinguish individuals with and without oculomotor dysmetria. The model achieved 78% accuracy (sensitivity= 80% and specificity= 76%). These results show that the combination of signal processing and machine learning approaches applied to iPhone video of saccades, allow for extraction of information pertaining to oculomotor dysmetria in ataxia. Overall, this inexpensive and scalable approach for capturing important oculomotor information may be a useful component of a screening tool for ataxia and could allow frequent at-home assessments of oculomotor function in natural history studies and clinical trials.

Saccadic Eye Movements in Young-Onset Parkinson’s Disease - A BOLD fMRI Study

ABSTRACTThe objective of the present study was to understand control of saccadic eye movements in patients with young onset Parkinson’s disease (YOPD) where onset of disease symptoms appears early in life (<40 years of age). Functional magnetic resonance imaging (fMRI) was performed in patients with YOPD and control subjects while they performed saccadic tasks, which consisted of a reflexive task and another task that required inhibitory control of eye movements (Go-NoGo task). Functional imaging related to saccadic eye movements in this group of patients has not been widely reported. A 1.5T MR scanner was used for structural and functional imaging. Analysis of blood-oxygen-level-dependent (BOLD) fMRI was performed using Statistical Parametric Mapping (SPM) software and compared in patients and controls. In patients with YOPD greater activation was seen significantly in the middle frontal gyrus, medial frontal gyrus, angular gyrus, cingulate gyrus, precuneus and cerebellum, when compared with the control group, during the saccadic tasks. Gap and overlap protocols revealed differential activation patterns. The abnormal activation during reflexive saccades was observed in the overlap condition, while during Go-NoGo saccades in the gap condition. The results suggest that impaired circuitry in patients with YOPD results in recruitment of more cortical areas. This increased frontal and parietal cortical activity possibly reflects compensatory mechanisms for impaired cognitive and saccadic circuitry.

Two Cases of Myasthenia Gravis Showing Fatigibility Presenting with Decreased Gain of Smooth Pursuit

Myasthenia gravis (MG) is an autoimmune disease caused by autoantibodies to the acetylcholine receptors of the neuromuscular junction characterized by weakness and abnormal fatigability of the muscles. Therefore, the diagnosis of MG depends on the recognition of this distinctive pattern of fatigable weakness. Previous studies presented the diagnostic efficacy of saccadic eye movements in patients with ocular MG. We here in report 2 patients of ocular MG showing the fatigue effects during repetitive sustained smooth pursuit, and the effects of the administration of edrophonium on myasthenic smooth pursuit. Changes in smooth pursuits reflecting peripheral and secondary central mechanisms were demonstrated. Keywords: Myasthenia gravis; Video-oculography; Smooth pursuit; Fatigibility 중심 단어: ì¤‘ì¦ê·¼ë¬´ë ¥ì¦, 비디오안구운동검사, ì›í™œì¶”ì¢ ìš´ë™, 근피로도

Saccadic dysfunction in patients with hypoxic-ischemic encephalopathy.

Electrophysiological monitoring of saccadic eye movements in patients with hypoxic-ischemic encephalopathy (HIE) was carried out. Externally guided saccades (prosaccades) were recorded using a patented hardware-software complex for studying the subject's physical activity. Recordings were performed in two independent experimental procedures- for saccades separately and when they were in coordination with the motion of head and hand. In both cases statistically significant differences in latent periods and durations of saccadic eye movements were noticed in HIE patients in comparison with healthy subjects of the same age group (p<0.05). Jerking and deviation of eyes after fixing the gaze on a target were often present in HIE participants. In some cases saccades of patients were asymmetrical among themselves. We found HIE induced changes in the parameters of autosaccades as well, expressed through the instability of gaze fixation periods, sometimes asymmetric eye movements, slow gaze shift from one target to another and disturbance of gaze stabilization (as jerking of the eyeballs during the saccadic period).

Reduced saccadic velocity and pupillary width in young onset Parkinson’s disease

BackgroundPatients with Young onset Parkinson disease patients (YODP) are individuals with motor complications identical to late onset Parkinson’s disease (PD) but onset in early age. YOPD is a specific subgroup of PD and their performance on saccadic eye movements is not well established. This study evaluated saccadic eye movements in patients with YOPD (< 40 years at onset of illness). MethodsEye movements were recorded during saccadic eye movement tasks, induced by presentation of a visual target and reflexive saccadic task was administered. ResultsYOPD patients showed reduced saccadic velocity on reflexive saccadic task (Gap task) as compared to their age matched healthy controls. Additionally, pupil width in gap period and at saccade onset was measured. Pupil width was significantly smaller in patients with YOPD as compared to control subjects. ConclusionsReduced saccadic velocity implies that Parkinson’s disease affects saccadic circuitry in patients with YOPD reflecting impaired circuitry at the brainstem level. The reduced pupillary response in gap condition is attributed to deficits in motor preparedness in patients compared to controls.

Opposite effects of l-dopa and DBS-STN on saccadic eye movements in advanced Parkinson's disease

ObjectiveTo assess the effects of l-dopa and deep brain stimulation of the subthalamic nucleus (DBS-STN) on saccadic eye movements in patients with Parkinson's disease (PD). MethodsVisually and internally guided horizontal saccades were evaluated using a saccadometer in 64 patients with advanced PD and 48 healthy controls. Forty-four pharmacologically treated patients were assessed in their “med-off” (OFF) and “med-on” (ON) status, whereas 20 DBS-STN treated patients were assessed in their “med-off, stim-off” (OFF) and “med-off, stim-on” (ON) status. ResultsIn all PD patients the saccades in the OFF status were delayed, slower and smaller (p<0.01) than in controls. In pharmacologically treated patients all studied parameters showed tendency to worsen in the ON status as compared to the OFF status. In contrast, activating DBS-STN showed tendency to improve all studied parameters. Comparison of the studied saccade parameters between the ON status of DBS-STN treated patients, ON status of the pharmacologically treated patients and the controls showed that 73% of these parameters in the DBS-STN treated patients were similar as in the controls. While in the pharmacologically treated patients only 26% of these parameters were similar as in the controls. ConclusionThis prospective study comparing the influence of l-dopa and DBS-STN on saccades in advanced PD showed contrasting results between these two treatments; the majority of the studied parameters in patients on DBS-STN were similar as in the controls.

Disrupted Eye Movements in Preperimetric Primary Open-Angle Glaucoma.

Primary open-angle glaucoma (POAG) can be associated with abnormal ocular motor behavior, possibly as a compensatory strategy following visual field loss. The aim of this study was to explore the characteristics of saccadic eye movements in patients with early-stage POAG without any detectable glaucomatous visual field loss (i.e., preperimetric POAG). Binocular eye movements were explored in 16 patients with bilateral preperimetric POAG and 16 age-matched healthy controls in a cross-sectional, observational study. Visually guided horizontal prosaccades (5°, 10°, 15°, and 20° amplitude) and antisaccades (12° amplitude) were measured using infrared oculography. The latency, average and peak velocities, amplitude and gain of prosaccades as well as the percentage of errors in the antisaccades task were compared between groups. POAG patients exhibited a reduced average velocity of saccades compared to controls across all amplitudes of peripheral visual target presentation (P = 0.03). Saccades performed by POAG patients were hypometric, and with reduced amplitude (P = 0.007) and gain (P = 0.01) compared to controls. On average, POAG patients displayed more antisaccade errors (40.6%), as compared to controls (23.4%; P = 0.04). Here, we show that patients with POAG without detectable glaucomatous visual field loss exhibit altered saccadic eye movements. These abnormalities may indicate disordered cortical and subcortical saccadic regulation, either on the basis of subthreshold visual impairment, or as a result of wider disease-associated neurodegeneration. Additional studies, controlling for glaucoma medications, are required to delineate the neural basis of eye movement abnormalities associated with POAG.

Saccadic eye movements in juvenile variant of Huntington disease

Background and purposeHuntington disease (HD) is a neurodegenerative disease leading to involuntary movements, cognitive and behavior decline. The juvenile variant of HD (JHD) manifests in people younger than 21 and is characterized by a different clinical presentation, i.e. rigidity and bradykinesia. Rapid eye movements were not extensively studied in patients with JHD. Aims of our study were to describe the saccadic eye movements in JHD patients and to find a correlation between the saccade abnormalities, severity of the disease and cognitive and behavior deterioration. Materials and methodsWe studied 10 patients with JHD and 10 healthy subjects. Reflexive and volitional saccades were assessed with the Saccadometer Advanced. The battery of cognitive and behavior tests was performed as well. ResultsWe found a prolonged latency, slowness and decreased velocity of reflexive and voluntary saccades and reduced amplitude of voluntary saccades. Moreover, patients with JHD executed a significantly lower number of volitional saccades and made more incorrect cued saccades than controls. We noted a significant correlation between prolonged latency of reflexive saccades with gap task and disease severity and significant inverse correlation between prolonged latency of reflexive saccades with overlap task, an increased number of incorrect saccades made on a cue and impairment in working memory. ConclusionAbnormalities of saccade eye movements in patients with JHD were similar to those reported in patients with HD. Our findings did not confirm abnormalities previously reported in patients with early onset HD. Abnormal saccade parameters correlated also with a disease severity and cognitive deterioration.

P01-105 Saccadic eye movements in dementia, major depression and healthy controls - relationship with cognitive functions

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog.Results:Saccadic latency and number of saccadic intrusions were significantly (p&lt; 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p&lt; 0.01) or number of saccadic intrusions (r = -0.80, p&lt; 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p&lt; 0.01) and intrusions (r = 0.74, p&lt; 0.01).There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9).Conclusions:It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.

PW08-01 Saccadic eye movements in dementia, major depression and healthy controls - relationship with cognitive functions

We compared horizontal saccadic eye movements in patients with dementia (n=18), and age-matched patients with major depression (n=18) or healthy controls (n=18). Cognitive functions were evaluated using Mini-Mental-State-Examination (MMSE) and ADAS-cog.Results:Saccadic latency and number of saccadic intrusions were significantly (p&lt; 0.001) higher in patients with dementia relative to healthy controls and depressed patients. There were significant correlations between MMSE total score and latency (r = -0.78, p&lt; 0.01) or number of saccadic intrusions (r = -0.80, p&lt; 0.001) in the demential group. In addition, both saccadic parameters were significantly associated with ADAS-cog total score of patients with dementia, whereas the subscale “orientation” showed the strongest correlation with latency (r = 0.71, p&lt; 0.01) and intrusions (r = 0.74, p&lt; 0.01).There were no significant differences in saccadic eye movements between healthy controls and patients with major depression as a whole, or a subgroup of depressed patients with the worst cognitive performance (n=9).Conclusions:It seems that disturbances in horizontal saccadic eye movements in patients with dementia are related to the degree of cognitive deficits in these patients. On the other hand, the lack of alterations in horizontal saccadic eye movements in depressed patients despite poor cognitive performance indicates different mechanism.

Saccadic Eye Movement Velocity Measured with the Infrared Reflection and Search Coil Eye-Tracking Systems in Patients with Thyroid-Associated Ophthalmopathy

Background Assessment of changes in saccade velocity may be useful in the early detection of thyroid-associated ophthalmopathy (TAO). Two eye-tracking systems were used to measure the velocity of saccadic eye movements in patients with TAO. Method Fourteen patients with active TAO and 14 healthy controls were enrolled for recordings with two eye-tracking systems: the magnetic scleral search coil (MSC; Skalar Medical) and the infrared reflection systems (IR; Orbit XY-1000). The MSC is generally considered the “gold standard” method for tracking of rapid eye movements. The IR system uses novel computer technology and is based on sampling of reflected infrared light from the surface of the eyes. Main sequence plots constructed from the recorded saccadic peak velocity and amplitude were analyzed for differences between patients and healthy controls. Results There were no significant differences between patients with TAO and healthy controls in the constructed main sequence plots of maximum velocity (VMAX) and the slope constant (C). Conclusions Main sequence analysis of saccadic eye movements was not useful for detecting TAO in this experimental setting with either of the two eye-tracking methods. This is hypothesized to be due to compensation for the early orbital changes in TAO by neural adaptation of the saccades in the brain stem. The contradictory results between this and previous studies cannot be easily explained. We assume that there is a large heterogeneity in the saccadic eye movement performance in both the normal population and the TAO-population. Also, differences in the study design may cause dissimilar outcomes and hence incoherent conclusions. A non-invasive recording system that is able to generate a minimum amount of intra- and inter-individual variability and a study design where normal variability can be reduced to a minimum may be useful for future identification of early eye muscle changes in TAO.

Propofol–remifentanil-based anaesthesia vs. sevoflurane–fentanyl-based anaesthesia for immediate postoperative ophthalmic evaluation following strabismus surgery

Following strabismus surgery, immediate postoperative ophthalmic evaluation may be desired. Thus, an anaesthetic technique allowing rapid recovery of ocular motility is required. Saccadic eye movements is a biophysical monitor of ocular motility and may be used to assess recovery from anaesthesia. The aim of this study is to compare the time to the recovery of saccadic eye movements in patients, following one of two anaesthetic techniques: Propofol-remifentanil-based anaesthesia vs. sevoflurane-fentanyl-based anaesthesia. Fifty adult patients undergoing strabismus surgery were randomly assigned to one of two groups: patients in Group R received induction and maintenance of anaesthesia with propofol and remifentanil, while patients in Group S received induction of anaesthesia with propofol and fentanyl and maintenance of anaesthesia with sevoflurane. Recovery from anaesthesia was measured from the time all anaesthetics were turned off and was assessed every 2 min. Recovery time was attained when patients were able to generate brisk saccadic eye movements. At recovery time, the ophthalmic evaluation was started. The mean recovery time of saccadic eye movements was significantly shorter in the Group R when compared to the Group S (12.1 +/- 4.3 min vs. 21.5 +/- 4.7 min, respectively, P < 0.0001). More patients in Group S experienced nausea and vomiting postoperatively as compared to Group R (9/25 vs. 2/25, respectively, P = 0.037). Propofol-remifentanil-based anaesthesia may be a useful technique in strabismus surgery when immediate postoperative ophthalmic evaluation is desired. When compared to sevoflurane maintenance of anaesthesia, it allows for a more rapid recovery from anaesthesia as judged by recovery of saccadic eye movements and a decreased incidence of postoperative nausea and vomiting.

Reflexive and Voluntary Saccades in Parkinson's Disease

To evaluate the characteristics of saccadic eye movements in patients with Parkinson's disease(PD). Eye movements of 14 patients with moderate to advanced PD and 12 age-matched controls were recorded with an infrared system. Two kinds of saccade tasks were used: saccade tasks for eliciting reflexive saccades(visually guided saccades in the gap condition) and saccade tasks for eliciting volitional saccades(visually guided saccades, saccades in overlap condition, memory-guided saccades, and anti-saccades). Latency, accuracy, peak velocity, and other parameters of saccades were evaluated. Visually guided saccades and saccades in the gap condition were slightly hypometric in PD patients. Saccades in the short-term overlap condition were not impaired in PD patients. Increased mean latencies and decreased degrees of accuracy of memory-guided saccades, and increased error rates of the memory-guided saccade task were marked in PD patients. Error rates in the anti-saccade task were not increased in PD but the mean saccadic latencies were slightly increased. Reflexive saccades are preserved in PD, whereas memory-guided saccades are markedly impaired. But anti-saccades in a task for eliciting in volitional saccades are not impaired in PD.

The effects of antipsychotic medication on saccadic eye movement abnormalities in Huntington's disease

1. 1. The study was a prospective open trial done to determine the effect of antipsychotic medication on saccadic eye movements in patients with Huntington's disease (HD). The authors tested 16 outpatients with HD, 8 of whom were drug free and 8 of whom were on antipsychotic medication. We also tested 24 healthy control subjects. 2. 2. The antisaccade task was used to investigate the voluntary control of saccadic eye movements. Antisaccade latencies and error rates were used as outcome measures. Both HD patient groups showed significantly more antisaccade abnormalities than controls and the rate of abnormalities was very similar between the drug-free and medicated patient groups. 3. 3. The results suggest that these abnormalities are related to underlying neuropathology rather than effects of medication. Either specific dysfunction of the dorsolateral prefrontal cortex or of the subcortical circuit connecting this cortical area to the superior colliculus via the striatum are likely to be responsible for the generation of such antisaccade eye movement abnormalities.

P477 Saccadic eye movements in patients with schizophrenic disorders

P477 Saccadic eye movements in patients with schizophrenic disorders

Smooth pursuit eye movements and saccadic eye movements in patients with delusional disorder.

This study used eye movement tests to examine whether frontal lobe dysfunction is present in delusional disorder. Smooth pursuit and voluntary saccadic eye movements of 15 delusional patients, 40 schizophrenic patients, and 40 normal subjects were recorded and analyzed statistically. The schizophrenic patients differed significantly from the normal subjects in some smooth pursuit eye movement characteristics, whereas both the schizophrenic and the delusional patients showed more saccades than the normal subjects during the smooth pursuit test. The delusional patients and normal subjects differed significantly in some voluntary saccadic eye movement characteristics. The data support the idea of a biological dysfunction in eye tracking in delusional disorder.

Regional cerebral blood flow during sinusoidal pursuit, fixation and saccadic eye movements in patients with schizophrenia and normal controls

Regional cerebral blood flow during sinusoidal pursuit, fixation and saccadic eye movements in patients with schizophrenia and normal controls