A perceptual discrimination task results in greater facilitation of voluntary saccades in Parkinson's disease patients

Many studies have shown that Parkinson's disease (PD) affects not only the ability to generate voluntary saccades but also the ability to suppress reflexive saccades (hyper‐reflexivity). To further investigate these apparently contradictory effects of PD on the saccade system we adapted a well‐known dual‐task paradigm (Deubel, 2008) to measure saccades with and without a peripheral discrimination task. Previously we reported that the concurrent performance of a perceptual discrimination task abnormally reduced the latencies of reflexive saccades in PD. Here we report the effects of the concurrent discrimination task on the generation of voluntary saccades in a PD and a control group. As expected, when saccades were performed without the discrimination task the PD group made voluntary saccades with longer latencies and smaller gain than the control group. The concurrent performance of the perceptual discrimination task facilitated the initiation of voluntary saccades in both groups, but, surprisingly, this facilitatory effect was stronger in the PD group than in the control group. In addition, in the PD group voluntary saccades were abnormally facilitated by the peripheral symbol‐changes that occur during saccade planning in this paradigm. The results of this study may help to clarify apparently contradictory oculomotor abnormalities observed in PD.     

Further analysis of the control of voluntary saccadic eye movements in schizophrenic patients

Many schizophrenic patients reveal abnormalities in the antisaccade task. To better understand the nature of these abnormalities, in the present study we have assigned to schizophrenics the no-saccade task (subjects were required to remain fixated without being disturbed by a reflexive saccade) and memory-saccade task (subjects were required to look at a remembered target) in addition to the antisaccade and saccade tasks used previously. Many schizophrenics revealed higher error rates in the no-saccade task, and latencies of saccades to a memorized target were significantly longer than controls in the memory-saccade task. Peak velocities of saccades of large amplitudes in the memory-saccade and antisaccade tasks (but not in the saccade task) were significantly slower and durations of such saccades were longer than normal controls despite the similarity between the distributions of amplitudes of such saccades between the patients and controls. These results suggest that many schizophrenics have difficulty suppressing reflexive saccades and initiating and executing appropriate volitional saccades when the goal for the movements is known but not visible.     

Early event-related cortical activity originating in the frontal eye fields and inferior parietal lobe predicts the occurrence of correct and error saccades

Although the cortical circuitry underlying saccade execution has well been specified by neurophysiological and functional imaging studies, the temporal dynamics of cortical activity predicting the occurrence of voluntary or reflexive saccades in humans are largely unknown. Here, we examined electrophysiological activity preceding the onset of correct (i.e., voluntary) or error (i.e., reflexive) saccades in an oculomotor capture task. Participants executed saccades to lateralized visual targets while attempting to inhibit reflexive glances to abruptly appearing distracters. Since the visual display was identical for both types of saccades, different electrophysiological patterns preceding correct and error saccades could not be explained by low-level perceptual differences. Compared to correct saccades electrophysiological activity preceding error saccades showed significant differences of the scalp electric field and of voltage amplitudes at posterior electrodes. In addition, though error saccades had significantly shorter latency than correct saccades a prolonged topographic configuration of electric potentials prior to error saccades was found ～120-140 ms following target onset. In agreement with the known asymmetry in hemispheric dominance for spatial attention, distinct electrophysiological patterns were only found for leftward saccades. While error saccades were associated with stronger activity in the right Frontal Eye Field, correct saccades were preceded by stronger activity in the inferior parietal lobule. These findings suggest that selection of the saccade target in a conflicting situation is determined by early top-down biases originating in frontal and parietal cortical regions critical for spatial attention and saccade programming.     

Dissociating cognitive deficits involved in voluntary eye movement dysfunctions in Parkinson's disease patients

In an attempt to distinguish and define the altered cognitive processes associated with Parkinson's disease (PD), we examine and try to dissociate the components of an effective voluntary saccade: (1) the planning and execution of a voluntary saccade; (2) the suppression of reflexive eye movements; and (3) the working memory processes required. We tested 14 PD patients (off their medications) and 11 control subjects on antisaccade (AS), delayed antisaccade (DAS), and remembered antisaccade (RAS) paradigms. The three tasks required identical responses, each task only differing in a single manipulation for direct comparison--a delay period was added in the DAS, and the target was removed during the delay period of the RAS--allowing us to study the specific cognitive processes involved in the execution of a voluntary saccade. Voluntary saccade response times were longer in the PD group compared to controls on all three tasks, suggesting difficulties in voluntary saccade execution. Furthermore, PD patients showed difficulty suppressing reflexive saccades (increased number of errors in the AS task and increased number of disinhibitions in the DAS task). Finally, our study did not show significant differences in either response time or error rate between the RAS and the DAS tasks for either control subjects or PD patients. In sum, we report evidence for voluntary saccade execution deficits together with problems inhibiting reflexive saccades in Parkinson's disease patients. These findings were correlated with each other and disease severity, suggesting that eye movement measurement may be a useful tool for studying higher cognitive function.     

Impairment of voluntary saccades and facilitation of reflexive saccades do not co-occur in Parkinson’s disease

Reflexive saccades (fast eye movements) and voluntary saccades activate overlapping parts of the oculomotor system. It is assumed that striatal dopamine depletion in Parkinson’s disease (PD) only affects the voluntary saccadic system and that the often-reported facilitation of the reflexive saccadic system in PD is secondary to impairment of the voluntary saccadic system. If this assumption is correct, facilitation of reflexive saccades should co-occur with impaired performance of voluntary saccades in patients with PD. We measured reflexive and voluntary saccades in a group of patients with PD (both “on” and “off” medication) and a matching group of control subjects. Interestingly, performance measures showed strong positive correlations across reflexive and voluntary saccades in the PD group. Our results suggest that facilitation of reflexive saccades does not co-occur with impairment of voluntary saccades and that PD may affect the parts of the oculomotor system which are common to reflexive and voluntary saccade generation.     

Hypometric primary saccades and increased variability in visually-guided saccades in Huntington's disease

Eye movement abnormalities can be distinctive and suggestive of a specific pathophysiology. To further investigate the deficits in the control of saccades in patients with Huntington's disease (HD), we investigated the ability of 11 HD patients and 11 matched controls to perform visually-guided saccades. We adopted reflexive saccade tasks involving predictable and unpredictable sequences, at different amplitudes of target step (10 degrees, 20 degrees, 30 degrees, 40 degrees ), as well as voluntary self-paced saccades. Prolongation of initiation was observed in the HD group as the target amplitude of predictable saccades increased. During the self-paced saccade task, the HD patients had increased intersaccadic intervals, performed fewer saccades in the allocated time and displayed an increased temporal variability in comparison to the controls. Furthermore, hypometric primary saccades, and an increased number of corrective saccades, were observed during both reflexive and voluntary saccades in the HD group. The delayed initiation of large saccades, deficits in voluntary, self-paced saccades, impaired saccadic accuracy and increased corrective saccades in HD, were interpreted in light of other ocular motor and limb studies, and appear to be due to damage to the fronto-striatal loop, including the supplementary eye fields, as well as possible brainstem and cerebellar involvement.     

Effects of stimulus predictability and interstimulus gap on saccades in Alzheimer's disease

OBJECTIVES: Studies of saccadic eye movement impairment in Alzheimer's disease (AD) have largely focused on simple reflexive eye movements and the antisaccade task. The effects of manipulating stimulus timing have been little studied. METHODS: Fourteen patients with mild to severe AD and 11 age-matched controls were studied on the antisaccade task, while latencies on simultaneous, gap and predictable tasks were recorded from 11 patients and 11 controls. Dementia severity was assessed with the Mini-Mental State Examination. RESULTS: As a group, patients' latencies were significantly higher and more variable on the simultaneous and gap tasks. Predictable task performance was similar in mean but significantly more variable. Grossly anticipatory responses by patients were common on the predictable, simultaneous and gap tasks. Exclusion of these from subject means revealed that AD patients, when making target-driven saccades, demonstrated a gap effect of similar magnitude to normal subjects. Patients made significantly fewer correct antisaccades and significantly more reflexive errors not followed by a corrective antisaccade than did controls. CONCLUSIONS: The frequent presence of grossly anticipatory saccades may reflect dysfunction of fixation mechanisms possibly involving projections from frontal lobe to superior colliculus. The less frequently seen, marked prolongation of latency may reflect changes in posterior parietal mechanisms mediating reflexive saccade generation. The presence of the gap effect demonstrates a continued ability to benefit from externally controlled stimulus disengagement. Patients' ability to make appropriately timed saccades to targets of known locations was particularly impaired, but the target sequence itself was at least grossly correctly learned. Larger studies may be able to identify clinically distinct populations of AD patients.     

The influence of motor and cognitive impairment upon visually-guided saccades in Parkinson's disease

Studies of saccades in Parkinson's disease (PD) have seldom examined the influence of cognitive status, ranging from normal cognition, through mild cognitive impairment, to dementia. In a large and heterogeneous sample, we examined how motor and cognitive impairment was reflected in the performance of reflexive, visually-guided saccades. We examined 163 people with PD and 47 similar-aged controls. Ninety three of the PD group had normal cognition (PDN), 48 had mild cognitive impairment (PD-MCI), and 22 had dementia (PDD). Pseudo-random targets (amplitudes of 5, 10, 15 and 20 deg and inter-stimulus-intervals ranging from 550 to 1800 ms) were shown in 108 mixed randomised trials, incorporating gap, step, and overlap onset conditions. Analyses were conducted using multi-level regression modeling. Participants were first assessed by continuous measures (Unified PD Rating Scale motor score and the Montreal Cognitive Assessment). Prolonged latency was significantly related to both motor and cognitive impairment, with the cognitive effect being compounded by increasing age. Decreased saccade amplitude, meanwhile, was primarily related to motor impairment. When assessed by discrete cognitive categories, all of the PD groups showed reduced saccadic amplitude relative to controls. Saccadic latencies, meanwhile, were abnormally prolonged only in the PD-MCI and PDD groups (the control and PDN groups were similar to each other). Latency in the overlap task was particularly sensitive to increasing motor and cognitive impairment. We conclude that reflexive saccades in PD are subtly decreased in amplitude even early in the disease process. Prolonged saccade latency, meanwhile, tends to occur later in the disease process, in the presence of more substantial motor and cognitive impairment, and greater age. The progressive impairment of reflexive saccades, and the differential onset of amplitude and latency impairments, may make them a useful objective tool for assessing disease status.     

Inhibitory control and spatial working memory in Parkinson's disease.

Patients with Parkinson's disease (PD) have difficulty performing tasks relying on inhibitory control and working memory, functions of the prefrontal cortex. Eye movement paradigms can be used to investigate basic sensorimotor functions and higher order cognitive aspects of motor control. This study investigated inhibitory control and spatial working memory in the saccadic system of 13 individuals with mild-moderate PD and 13 age-matched controls. Tasks explored suppression of reflexive saccades during qualitatively different tasks, generation of express and anticipatory saccades, and the ability to respond to occasional, unpredictable ("oddball") targets that occurred during a sequence of well-learned, reciprocating saccades between horizontal targets. Spatial working memory was assessed using single and two-step (involving a visually guided saccade during the delay period) memory-guided tasks. Results for the PD group indicated an increased percentage of response selection errors during an oddball task, reduced suppression of inappropriate reflexive saccades during memory-guided tasks (but not during fixation or saccade-engagement tasks), and an increased percentage of express and anticipatory saccades. Spatial working memory was preserved in the PD group during single and two-step memory-guided tasks. These findings are consistent with dysfunction within fronto-striatal and prefrontal-collicular pathways influencing suppression and selection of eye movements.     

Reflexive, symbolic, and affective contributions to eye movements during task switching: response selection

Active vision is a dynamic process involving the flexible coordination of different gaze strategies to achieve behavioral goals. Although many complex behaviors rely on an ability to efficiently switch between gaze-control strategies, few studies to date have examined mechanisms of task level oculomotor control in detail. Here, we report five experiments in which subjects alternated between conflicting stimulus-saccade mappings within a block of trials. The first experiment showed that there is no performance cost associated with switching between pro and anti saccades. However, follow-up experiments demonstrate that whenever subjects alternate between arbitrary stimulus-saccade mappings, latency costs are apparent on the first trial after a task change. More detailed analysis of switch costs showed that latencies were particularly elevated for saccades directed toward the same location that had been the target for a saccade on the preceeding trial. This saccade "inhibition of return" effect was most marked when unexpected error feedbacks cued task switches, suggesting that saccade selection processes are modulated by reward. We conclude that there are two systems for saccade control that differ in their characteristics following a task switch. The "reflexive" control system can be enabled/disabled in advance of saccade execution without incurring any performance cost. Switch costs are only observed when two or more arbitrary stimulus-saccade mappings have to be coordinated by a "symbolic" control system.     

Pre-saccadic perceptual facilitation can occur without covert orienting of attention

The pre-motor theory of attention suggests that the mechanisms involved in target selection for eye movements are the same as those for spatial attention shifts. The pre-saccadic facilitation of perceptual discrimination at the location of a saccadic goal (paradigm of Deubel and Schneider, 1996) has been considered as an argument for this theory. We compared letter discrimination performance in a saccade (overt attention - pre-saccadic facilitation) and a fixation (covert attention) task in a patient with right posterior parietal damage and 4 controls.In the overt attention condition, the patient was instructed by a central cue to make a saccade to a target located at a peripheral location. During the saccade latency (in a period of time of 250 msec following the presentation of the cue), a letter was presented at the target location. Accuracy of leftward saccades was impaired compared to rightward saccades. To evaluate letter discrimination performance in this saccade task (i.e., the presence of pre-saccadic facilitation), we selected only those leftward saccades that were equivalent in accuracy (and latency) to the rightward ones. Within these selected trials, the patient was able to discriminate letters equally well in both visual fields. In contrast, he performed at chance level during the fixation task (covert attention condition) for letters presented at the same peripheral location with the same timing with respect to the cue presentation. The patient could thus discriminate the letter presented at 8° of visual eccentricity while he was preparing a saccade, whereas he was unable to perceive the letter in the fixation task.Remarkably, in the left visual field, letter discrimination was impossible even when a letter was presented as close as 2.5° of visual eccentricity in the fixation task. Altogether, these results suggest that pre-saccadic perceptual facilitation does not rely on the same processes as those of covert attention, as tested by fixation task. Instead, we propose that pre-saccadic perceptual facilitation results from a form of attention specific to action, which could correspond to a pre-saccadic remapping process.     

Asymmetric influences of pointing on saccade latency in hemi-Parkinson's disease

The objective of this study was to investigate whether eye-hand coupling was preserved or not in PD. We studied predictive saccade performance during hand pointing in six Parkinson's disease (PD) patients with asymmetrical motor signs compared to nine age-matched healthy subjects. The motor responses (saccades and hand pointing) were elicited under open loop conditions (without vision of the hand), by a visual target stepping at a predictable location (10 degrees right and left from the centre) and time. The subjects had to simultaneously move the eyes and point with the finger to the visual target alternating at one of three fixed frequencies (0.25, 0.5 and 1 Hz), for 30 cycles. This task was performed in two sessions balanced over the subjects: one session of ocular saccades only and another session of combined ocular saccades and manual pointing. In the PD group, motor performance was perturbed particularly in terms of increased latencies of hand movements. Interestingly, during pointing, associated predictive saccade disorders were tightly related to the defects of the pointing hand. Indeed, with respect to the latency of predictive saccades alone, the predictive saccade latency during hand pointing significantly decreased in the control group and in the PD group when using the non-affected hand. In contrast, for the PD group when using the affected hand, the saccade latency was increased from the latency values of predictive saccades induced without pointing. Moreover, in the control and in the PD groups, the correlation between eye and hand latencies was highly significant, suggesting an intact eye-hand coupling. No saccadic amplitude disorders were found in either condition. These results demonstrate that eye-hand coupling is preserved in PD, as revealed by the possible beneficial or adverse effects on the ocular saccades, respectively, of the less- or more-affected hand motor responses. This eye-hand coupling mechanism likely involves regions other than the nigro-striatal pathways affected in PD.     

Cerebral control of saccades and neuropsychological test results after head injury

Abnormalities in the control of saccades have been described in patients with cerebral pathology.(1, 2) We assessed control of visually guided, reflexive and volitional saccades in 16 patients suffering severe traumatic brain injury and 12 controls and related the results to deficits on neuropsychological tests of speed of information processing and goal directed behaviour. All saccadic latencies were prolonged. Suppression of inappropriate saccades was impaired on volitional saccade tests which proved to be more sensitive in identifying impairment of goal directed behaviour than the neuropsychological test results. Patients' self-paced saccade rate was lower than controls' and correlated with performance on several visually mediated neuropsychological test results. Patients' visually guided, reflexive saccades were hypometric; this hypometria correlated with both visual and non-visual neuropsychological test results and with post-traumatic amnesia duration. Hypometria in reflexive saccades may reflect diffuse brain injury. Re-examination after 12 months revealed that the control of volitional saccades improved but there was no improvement in the visually guided reflexive saccade measures. The volitional saccade tests may be useful in documenting both impairment and subsequent recovery.     

Impaired action control in schizophrenia: the role of volitional saccade initiation

Schizophrenia patients show prefrontal cortex dysfunctions of neurodevelopmental origin, but the cognitive implications of these dysfunctions are not yet understood. This study used experimental variations of oculomotor tasks to evaluate the relative roles of volitional action initiation and the inhibition of reflexive behavior. Thirty schizophrenia patients and 30 control participants performed standard prosaccades (SP), standard antisaccades (SA), delayed prosaccades (DP), and delayed antisaccades (DA). The delayed tasks allowed separating the inhibition of erroneous prosaccades and the initiation of volitional saccades, which coincide in the SA task. Arrow-cued (AC) saccades were used to evaluate initiation without any inhibitory component. Erroneous prosaccades were less frequent in the delayed tasks than in the SA task. Error rates were generally larger in schizophrenia patients than in control participants, but the deficit was smaller in the delayed tasks than in the SA task. Correct saccade latencies of schizophrenia patients were normal in the SP task, but not on conditions of volitional saccade initiation (all other tasks). Volitional saccade latencies were positively correlated with error rates in the schizophrenia group. These results confirm that schizophrenia patients have a specific deficit in initiating volitional action, which may also contribute to the increased error rates.     

Premature saccades: A detailed physiological analysis

ObjectivePremature saccades (PSs) are those made with latencies too short for the direction and amplitude to be specifically programmed. We sought to determine the minimum latency needed to establish accurate direction and amplitude, and observed what occurs when saccades are launched before this minimum latency.MethodsIn Experiment 1, 249 normal subjects performed the gap saccade task with horizontal targets. In Experiment 2, 28 normal subjects performed the gap saccade task with the targets placed in eight directions. In Experiment 3, 38 normal subjects, 49 patients with Parkinson’s disease (PD), and 10 patients with spinocerebellar degeneration (SCD) performed the gap saccade task with horizontal targets.ResultsIn Experiment 1, it took 100 ms to accurately establish saccade amplitudes and directions. In Experiment 2, however, the latencies needed for accurate amplitude and direction establishment were both approximately 150 ms. In Experiment 3, the frequencies of PSs in patients with PD and SCD were lower than those of normal subjects.ConclusionsThe saccade amplitudes and directions are determined simultaneously, 100–150 ms after target presentation. PSs may result from prediction of the oncoming target direction or latent saccade activities in the superior colliculus.SignificanceSaccade direction and amplitude are determined simultaneously.     

Effect of intention and visual fixation disengagement on prosaccades in Parkinson's disease patients

In a previous study, we postulated a divergence in reflexive versus voluntary saccade behavior in Parkinson's disease (PD) patients and hypothesized a fronto-striatal dysfunction. The voluntary saccade tasks included antisaccades (AS) and remembered saccades (RemS). However, multiple cognitive processes are involved in AS and RemS and the procedures lack a visual target. The present study had two main objectives. Firstly, we wanted to extend our previous findings of disturbed AS and RemS to other intentional (endogenous, "voluntary") saccades but now with a visible target. Therefore, an intentional prosaccade (IpS) task was used. Secondly, we investigated whether there is a different saccade behavior in PD patients and controls in conditions where the central fixation stimulus is extinguished shortly before the onset of the peripheral target (the so called gap condition) to assess the role of disengagement of visual fixation. With respect to the first objective, the present study found a clear dissociation between the performances of PD patients on reflexive saccade (RS) versus IpS tasks. Patients did not differ from controls in latency or error rate of RS. However, in the IpS task, latency was longer and error rate was higher in PD patients. Thus, the present study provides evidence that PD patients are deficient in intentional saccade tasks independent from the fact whether a target is visible or not. As to the second objective, saccades of PD patients did show a shorter latency in the gap than in the no gap condition. This suggests that the gap effect is not dominantly dependent on nigro-collicular neuronal circuits that are affected in PD. In the patients, the gap effect was reliable in the RS task, but not in the IpS condition. These discordant gap findings might suggest modulation of selected neuronal circuits involved in early sensorimotor processing. The present findings do not to support the hypothesis that impaired saccade behavior in PD patients is merely dependent on the presence or the absence of visual fixation and suggests a higher order psychomotor dysfunction, presumably of intentional nature. The dorsolateral prefrontal cortex might correspond to the premotor cognitive dysfunction site. However, an additional involvement of the frontal eye field can not be excluded from the present study.     

Voluntary control of saccadic and smooth-pursuit eye movements in children with learning disorders

Eye movement is crucial to humans in allowing them to aim the foveae at objects of interest. We examined the voluntary control of saccadic and smooth-pursuit eye movements in 18 subjects with learning disorders (LDs) (aged 8–16) and 22 normal controls (aged 7–15). The subjects were assigned visually guided, memory-guided, and anti-saccade tasks, and smooth-pursuit eye movements (SPEM). Although, the LD subjects showed normal results in the visually guided saccade task, they showed more errors in the memory-guided saccade task (e.g. they were unable to stop themselves reflexively looking at the cue) and longer latencies, even when they performed correctly. They also showed longer latencies than the controls in the anti-saccade task. These results suggest that they find it difficult to voluntarily suppress reflexive saccades and initiate voluntary saccades when a target is invisible. In SPEM using step-ramp stimuli, the LD subjects showed lower open- and closed-loop gains. These results suggest disturbances of both acceleration of eye movement in the initial state and maintenance of velocity in minimizing retinal slip in the steady state. Recent anatomical studies in LD subjects have suggested abnormalities in the structure of certain brain areas such as the frontal cortex. Frontal eye movement-related areas such as the frontal eye fields and supplementary eye fields may be involved in these disturbances of voluntary control of eye movement in LDs.     

Initiation and inhibitory control of saccades with the progression of Parkinson's disease - changes in three major drives converging on the superior colliculus

The cardinal pathophysiology of Parkinson's disease (PD) is considered to be the increase in the activities of basal ganglia (BG) output nuclei, which excessively inhibits the thalamus and superior colliculus (SC) and causes preferential impairment of internal over external movements. Here we recorded saccade performance in 66 patients with PD and 87 age-matched controls, and studied how the abnormality changed with disease progression. PD patients were impaired not only in memory guided saccades, but also in visually guided saccades, beginning in the relatively early stages of the disease. On the other hand, they were impaired in suppressing reflexive saccades (saccades to cue). All these changes deteriorated with disease progression. The frequency of reflexive saccades showed a negative correlation with the latency of visually guided saccades and Unified Parkinson's Disease Rating Scale motor subscores reflecting dopaminergic function. We suggest that three major drives converging on SC determine the saccade abnormalities in PD. The impairment in visually and memory guided saccades may be caused by the excessive inhibition of the SC due to the increased BG output and the decreased activity of the frontal cortex-BG circuit. The impaired suppression of reflexive saccades may be explained if the excessive inhibition of SC is “leaky.” Changes in saccade parameters suggest that frontal cortex-BG circuit activity decreases with disease progression, whereas SC inhibition stays relatively mild in comparison throughout the course of the disease. Finally, SC disinhibition due to leaky suppression may represent functional compensation from neural structures outside BG, leading to hyper-reflexivity of saccades and milder clinical symptoms.     

Effects of cerebellar infarcts on cortical processing of saccades

The objective of the present study was to investigate cerebellar influences on cortical components of saccadic eye movement programming in human subjects. In 24 patients with a localized cerebellar lesion, saccadic eye movements were recorded in different reflexive (step, gap, overlap) and intentional (anti, memory, short memory sequences) tasks and compared to 23 healthy controls. The cerebellar lesions led to impairments in different saccade parameters. Cerebellar patients tended to show hypermetria and increased latencies compared to the control group. In particular, they executed significantly more erroneous saccades specifically in the memory task (suppression errors) but not in the anti task (pro-saccade errors). Moreover, while reproducing short sequences of saccades from memory, patients with cerebellar infarcts made more errors with regard to the sequence order than controls. The influence of cerebellar hemispheric lesions on the saccade latency, the task-specific lesion effects on the frequency of suppression errors, and the effects on the number of order errors suggest that the cerebellum is involved in cortical processes such as target selection and sequence reproduction.     

Neuropsychological and clinical correlates of antisaccade task performance in schizophrenia

OBJECTIVES: To elucidate pathophysiologic mechanisms involved in abnormal antisaccade task performance in schizophrenia by investigating a possible relationship among antisaccade task performance, neuropsychological test results, and symptomatology in a group of young patients with recent-onset schizophrenia; to compare the effects of olanzapine and risperidone on antisaccades and reflexive saccades. BACKGROUND: Patients with schizophrenia consistently perform worse than controls on the antisaccade task in which the subject is required to inhibit a reflexive saccade to a suddenly appearing visual target and look in the opposite direction. METHODS: In 37 young (mean age 21 years), medicated patients with recent-onset schizophrenia the authors assessed antisaccades, reflexive saccades, neuropsychological test performance, and symptomatology. A subgroup of 18 patients was treated with olanzapine, and 15 patients were treated with risperidone. Reflexive-saccade and antisaccade task results were compared with those obtained in 13 control subjects. RESULTS: The antisaccade error rate was significantly higher in the patients than in the control subjects. In the patients, poor working memory function was related to increased antisaccade error rate. Severity of disorganization symptoms at intake was related to prolonged mean latency of the correct antisaccades. Patients on risperidone had a prolonged mean latency in the reflexive saccade task compared with patients using olanzapine. CONCLUSIONS: Abnormal antisaccade task performance is already present in early schizophrenia and may reflect working memory dysfunction. In future studies, medication effects should be considered in interpreting eye movement test results of patients with schizophrenia.