Evaluation of endocrine ophthalmopathy with saccadic eye movements

Summary Horizontal saccades were examined in 25 patients with hyperthyroidism and/or endocrine ophthalmopathy (EOP) using the infrared reflection method. With one exception none had restriction of horizontal eye movements. Conventional saccadic parameters were usually normal. A standardized test for muscle fatigue, however, gave pathological results in all but one of the patients with EOP, and also in three of seven patients with hyperthyroidism but no clinical EOP. In one of the latter the oculographic abnormality disappeared with treatment, while another developed clinical EOP. Performing a saccadic fatigue test seems to be useful for detecting early EOP and especially for monitoring its course.     

Disturbed smooth pursuit and saccadic eye movements in schizophrenia

Summary Smooth pursuit and saccadic eye movements of schizophrenic patients were examined. In a pendulum (0.5 Hz) tracking task schizophrenic inpatients had a slightly lower smooth pursuit gain than outpatients and controls, who showed no significant differences. The number of saccades, counter-saccades and velocity arrests occuring in a 20 s tracking epoque was the same in patients and controls, but patients made larger saccades. When tracking a stepping target by saccadic eye movements, schizophrenic inpatients, and to a lesser extent outpatients, exhibited longer reaction times than controls and had a higher incidence of non-fixation (saccades away from the target while the target is stationary). Schizophrenic patients also showed a significantly larger proportion of dysmetric saccades (undershooting the target). While similar changes of reaction time and non-fixation score were observed in manic-depressives and alcoholics, dysmetria was more often found in schizophrenics and possibly constitutes the expression of a specific impairment of attention.     

Fluctuations in tremor at rest and saccadic eye movements in subjects with Parkinsons disease

This study investigates the possible relationships between fluctuations in finger tremor amplitude and the performance of visual saccades. Saccadic eye movements were analyzed in five subjects with Parkinson's disease (PD) and five age-matched controls. Tremor was recorded by using a position laser system, and eye movements were recorded with an infrared reflectometry technique (Ober2). Tremor amplitude (root mean square) was significantly larger in the group of subjects with PD (2.87 ± 4.37 mm) than in the control group (0.017 ± 0.005 mm, U = 0, p < 0.01). In addition, subjects with PD showed more fluctuations in their tremor at rest (0.52 ± 0.98 mm versus 0.003 ± 0.006 mm, U = 1, p < 0.05). Latency, saccade error and percentage of predictive saccades were not significantly different between subjects with PD and control subjects. Average saccade amplitude was smaller in the group of subjects with PD (16.1 ± 2.31°) than in the control group (18.49 ± 3.62°, U = 1, p < 0.05). Spearman's rank correlation coefficient showed no direct relationship between saccade amplitude and changes in tremor amplitude at the time of each saccade but, in general, subjects with PD who had more fluctuations in their tremor at rest had also more fluctuations in their saccade error (Rho = 0.9). These results suggest that the mechanisms causing short-term fluctuations in tremor at rest do not directly influence the visual saccadic system.     

Impaired saccadic eye movements on stationary targets in patients with schizophrenia spectrum disorder

This study examined tracking eye movements on predetermined stationary targets in patients with schizophrenia spectrum disorder. The targets were 8 black points or 8 arabic-numbered points placed on the circumference of a circle. Self-paced eye movements during clockwise tracking of these points by 23 patients and 23 normal controls were recorded using an infrared eye-mark recorder. Eye movements were analyzed at two settings: firstly, when fixation point was defined as a point at which a gaze was held for at least 200-ms; and secondly, when held for at least 100-ms. The results indicated that at the 200-ms setting schizophrenic patients track with significantly fewer correct scores and more deviant scores than controls under black-point conditions. At the 100-ms setting, however, the correct scores of patients were not significantly different from those of controls, although patients displayed more aberrant paths than controls. The superfluous fixations in the patients improved significantly under numbered-point conditions, but patients still achieved lower correct scores than controls. Four of the 23 patients exhibited centering (aberrant path directed toward the center point), suggesting immature control of eye movements under black-point conditions, but not numbered-point conditions. These results suggest that some schizophrenic patients viewed the targets too quickly, and that they have impaired directed attention, which can be improved by cues, and may have impaired preprogramming of eye movements, which is not improved by external cues.     

Automatic and strategic volitional saccadic eye movements in psychotic patients

Summary Drug-free schizophrenics were compared with depressive psychotics and normal controls on two saccade initiation tasks which differed with respect to the type of stimulus that initiated a saccadic response. Strategic initiation (SIS) appears to use a route different from that in automatic initiation (AIS). The SIS task revealed slowed responding in psychiatrically ill patients if their cognition was impaired, but all groups responded similarly on the AIS task. Schizophrenics could be separated from depressed psychotics by their inability to utilize temporal redundancy to speed up saccade initiation on the SIS task. Neurophysiological evidence implicates specific impairments in the frontal eye field (FEF) and/or basal ganglia.This article was presented in part at the Symposium on Eye Movements and Psychopathology, Berlin, 23–24 June 1988     

The effect of oral ethanol consumption on eye movements in healthy volunteers

Horizontal and vertical eye movements were recorded and analysed with an infrared photoelectric technique in 12 healthy volunteers under various blood alcohol concentrations (0.0, 0.5, 1.0 g/kg body weight, [‰]). The predictive smooth-pursuit tracking and saccadic eye movements were studied in response to unpredictable target jumps and during scanning of a classical kitchen scene and a traffic scene. Smooth-pursuit eye movement gain value decreased dose-dependently and was compensated by an increased number of catch-up saccades. With increasing blood alcohol concentrations peak velocities of horizontal and vertical visually guided reflexive saccades decreased while their latencies to the target increased. At blood alcohol concentrations of 0.5‰ and 1.0‰ healthy volunteers showed significantly longer mean fixation durations and a lower total number of exploratory saccades when scanning both the classical kitchen scene and the traffic scene. Surprisingly, in both of these scanning tasks the total fixation duration or the relative number of exploratory saccades increased in those scene sectors in which exciting situations were presented. Additionally, the time interval needed to foveate these exciting areas for the first time increased, probably due to an attention deficit. In conclusion, these findings indicate that alcohol consumption impairs the velocity and initiation of saccadic and smooth-pursuit eye movements, but that subjects can nevertheless still recognize exciting and relevant areas of visual scenes. The significant increase in fixation time, however, does not allow scanning of the entire visual scene during an adequate period of time. Therefore the reduced visual exploration caused by alcohol reflects an impaired sensorimotor processing of active visual perception. Received: 1 December 1997 Received in revised form: 4 February 1998 Accepted: 16 February 1998     

帕金森病的眼球跟踪运动特点

目的 定量分析帕金森病(PD)患者眼球跟踪运动的特点,为评价PD患者的前庭功能提供依据.方法 选取30名健康人(对照组)和55例PD患者(PD组)作为受试者,PD组包括静止件震颤起病者31例(静止性震颤组),运动减少起病者23例(运动减少组),混合起病1例.对全部受试者进行眼震电图检杳.比较PD组和对照组跟踪运动增益值(gain,G)的差异,运动减少组和静止性震颤组跟踪运动的差异,PD患者双侧跟踪运动的非对称性和健康对照者的差异.结果 PD患者双侧跟踪运动的增益值(G左:0.79±0.10、G右:0.78±0.11)较对照组(G左:0.86±0.05、G右:0.85±0.06)明显降低(U=394.500、t=3.547,均P<0.01),运动减少组(G左:0.79±0.14、G右:0.75±0.14)与静止性震颤组(G左:0.79±0.06、G右:0.81±0.07)眼球跟踪运动增益值差异无统计学意义(t=-0.100、2.005,均P0.05).病例组左右两侧的跟踪运动非对称性(1.03±0.97)明显大于对照组(0.87±0.86,U=755.500,P<0.05).结论 PD患者眼球跟踪运动速度明显减慢,但不存在类型间的差异,两侧跟踪运动存在不对称性.     

Deficits in the initiation of eye movements in the absence of a visual target in adolescents with high functioning autism

BACKGROUND: We used ocular motor paradigms to examine whether or not saccades are impaired in individuals with high functioning autism (HFA). METHODS: We recorded eye movements in patients with HFA (n=11), and in normal adolescents (n=11) on anti-saccade, memory-guided saccade (MGS), predictive saccade and gap/overlap tasks. RESULTS: Compared with the normal subjects, patients with HFA had (1) a significantly higher percentage of directional errors on the anti-saccade task (63.2% versus 26.6%), (2) a significantly higher percentage of response suppression errors on a MGS task (60.3% versus 29.5%) and (3) a significantly lower percentage of predictive eye movements on a predictive saccade task. They also showed longer latencies on a MGS task and for all conditions tested on a gap/null/overlap task (fixation target extinguished before, simultaneously, or after the new peripheral target appeared). When the latencies during the gap condition were subtracted from the latencies in the overlap condition, there was no difference between patients and normals. CONCLUSIONS: Abnormalities in ocular motor function in patients with HFA provide preliminary evidence for involvement of a number of brain regions in HFA including the dorsolateral prefrontal cortex (dlPFC) and the frontal eye fields (FEFs) and possibly the basal ganglia and parietal lobes.     

帕金森病患者记忆扫视的特点

目的 研究帕金森病(PD)患者记忆扫视的特点,探讨记忆扫视对PD辅助诊断的价值.方法 选取53例早、中期PD患者作为PD组,同时选取36名年龄匹配的健康受试者作为对照组.对所有受试者进行记忆扫视检查和事件相关电位P300检查,并对检查结果进行比较;同时,对29例早期PD亚组患者的记忆扫视结果进行单独分析.结果 与健康受试者相比,PD组患者记忆扫视速度、初始增益明显降低,记忆扫视潜伏期明显延长,多余扫视和多阶模式扫视的发生率明显增多(U=124.000、37.000;均P＜0.0l),这些异常在早期PD患者亚组中已经非常明显;PD患者事件相关电位P300潜伏期[( 384.76±34.48) ms]较健康受试者[(352.42±24.99) ms]延长(t=-4.791,P＜0.01);多阶模式扫视的发生率对区分PD患者和健康受试者具有很好的敏感度(96.2％)和特异度(94.4％).结论 PD患者记忆扫视各项指标检查结果明显异常,可能是PD患者脑干扫视通路和额叶功能损害的反映.记忆扫视检查在PD的辅助诊断方面可能具有一定的应用价值.     

Insights to the schizophrenia continuum: A systematic review of saccadic eye movements in schizotypy and biological relatives of schizophrenia patients

Myles, J.B., S. Rossell, A. Phillipou, Thomas, E and C. Gurvich. A systematic review of saccadic eye movements across the schizophrenia continuum: Characterisation, pathophysiology and genetic associations. NEUROSCI BIOBEHAV REV 21(1) XXX–XXX, 2015.One of the cognitive hallmarks of schizophrenia is impaired eye movements, particularly for the antisaccade task. Less saccade research has been conducted in relation to the broader schizophrenia continuum, that is, people with high schizotypy or first-degree relatives of people with schizophrenia. This systematic review sought to identify, collate and appraise prosaccade, antisaccade and memory-guided saccade studies involving behavioural, neuroimaging and genetic data published between 1980 and September 2016 in individuals with high schizotypy and first-degree relatives. A systematic literature search was conducted, using Ovid MEDLINE, PsycINFO, PubMed and SCOPUS databases. Of 913 references screened, 18 schizotypy, 29 family studies and two schizotypy and relatives articles studies were eligible for inclusion. Antisaccade error rate was the most consistent deficit found for high schizotypy. Relatives had intermediate antisaccade error rates between patients and healthy controls. Results from the limited genetic and neuroimaging studies echoed schizophrenia findings. Confounds were also identified. It was concluded that future research is required to refine the saccade endophenotype and to expand genetic and neuroimaging research.     

Visually stimulated saccadic eye movements in patients treated with lithium

Saccadic eye movements were stimulated with the aid of 11 light spot stimuli, 10 of which were arranged at 3 degrees, 6 degrees, 9 degrees, 12 degrees, and 15 degrees to the left and right of the central stimulus. The parameters average and maximal eye movement velocity and latency were precisely investigated. 19 patients averaging 6.6 years on lithium prophylaxis were compared with 23 healthy controls. Significant differences between the two groups could not be found at this level of function.     

眼针疗法结合电针治疗脑卒中眼外肌麻痹临床研究

目的探讨眼针疗法结合电针治疗脑卒中眼外肌麻痹的临床效果和安全性,为其治疗提供新思路。方法选取2012-06-2014-06 92例脑卒中后并发眼外肌麻痹的患者为研究对象,将其随机分为观察组和对照组各46例,2组患者均予常规西药治疗基础上,观察组应用眼针疗法结合电针针刺治疗,针刺1次/d;对照组应用单纯针刺疗法治疗,针刺1次/d;2周为一疗程;2周后,观察2组患者眼外肌麻痹的有效率和不良反应发生率等指标。结果治疗2周后,2组患者治疗有效率分别为93.48%、82.61%,无效率分别为6.52%、17.39%,观察组临床治疗总有效高于对照组,差异有统计学意义(P0.05);观察组4例出现不良反应,发生率为8.70%,对照组3例出现不良反应,发生率为6.52%,2组不良反应发生率差异无统计学意义(P0.05)。结论应用眼针疗法结合电针治疗脑卒中眼外肌麻痹临床效果确切,安全性好,值得临床推广应用。     

Diagnostic value of saccadic pursuit eye movement in screening for organic cerebral dysfunction

Summary In order to validate the results obtained in a preliminary investigation the saccadation of slow pursuit eye movements was examined in 19 patients with unilateral brain damage, in 25 patients with diffuse cerebral disease and in 26 neurotic patients.The diagnostic significance of saccadation was ascertained in detecting general cerebral dysfunction. By means of a discriminant function combining the parameters, number and size, of saccades more than 80% of the brain-damaged patients and controls could be identified correctly, but the side of the cerebral lesion could not be determined.

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Zusammenfassung Zur Validierung der Ergebnisse einer Voruntersuchung wurde die Sakkadierung der Augenfolgebewegungen bei 19 einseitig hirngeschädigten, 25 diffus hirnkranken und 26 neurotischen Patienten untersucht.Die diagnostische Valenz des Merkmals der Sakkadierung für den Nachweis cerebraler Funktionsbeeinträchtigungen wurde bestätigt. Mit Hilfe einer Diskriminanzfunktion, die sowohl die Anzahl als auch die Größe der Sakkaden berücksichtigt, konnten mehr als 80% der Hirnkranken und der neurotischen Kontrollpatienten identifiziert werden. Zur Feststellung der Seite der cerebralen Läsion eignet sich das Merkmal nicht.

     

Atrio-ventricular block requiring pacemaker in patients with late onset Pompe disease

Enzyme replacement therapy consistently improves cardiac function in infantile and juvenile onset patients with Pompe disease and cardiomyopathy, but is apparently not effective in preventing rhythm disorders, an emerging cardiac phenotype in long term survivors. In patients with late onset Pompe disease cardiomyopathy is an exceptional finding while heart rhythm disorders seem to be more frequent. We retrospectively identified, among a cohort of 131 French late onset Pompe disease patients, four patients with severe atrio-ventricular blocks requiring pacemaker implantation. These patients had no other risk factors for cardiovascular diseases or cardiomyopathy. In one patient the atrioventricular block was discovered while still asymptomatic. Cardiac conduction defects are relatively rare in late onset Pompe disease and may occur even in absence of cardiac symptoms or EKG abnormalities. However because of the possible life-threatening complications associated with these conduction defects, cardiac follow-up in patients with late onset Pompe disease should include periodical Holter-EKG monitoring.     

Screening for late-onset Pompe disease in Finland

Pompe disease (glycogen storage disease type II) is caused by autosomal recessive mutations in GAA gene. The estimated frequency of late-onset Pompe disease is around 1:60,000. However, only two infantile and one late-onset Pompe patients have been reported in Finland with a population of 5 million. We screened for late-onset Pompe disease in a cohort of undetermined myopathy patients with proximal muscle weakness and/or elevated serum creatine kinase values. Acid α-glucosidase (GAA) activity in dried blood spots was measured and clinical data collected in 108 patients. Four patients had low normal GAA activity; all the others had activities well within the normal range. Re-analyses of these patients did not reveal new Pompe patients. Our findings suggest that Pompe disease is extremely rare in Finland. Finland is an example of an isolated population with enrichment of certain mutations for genetic disorders and low occurrence of some autosomal recessive diseases.     

精神分裂症患者及其一级亲属探究性眼球轨迹运动的研究

目的 探讨精神分裂症患者及其一级亲属的眼球轨迹运动在生物遗传学上的意义。方法 应用眼球轨迹运动标记记录仪,对６４例精神分裂症患者（症状显著２６例,症状缓解３８例）及其２６例一级亲属、３５名正常人进行测试。经判别式分析获正分者为精神分裂症性障碍,获负分者为非精神分裂症性障碍,并以眼球轨迹运动的有关参数作分析指标。结果 显著组患者判别式分析平均获２．０７６分,缓解组患者获２．５７１分,一级亲属且平均获     

Analogies solving by individuals with and without intellectual disability: Different cognitive patterns as indicated by eye movements

Eighteen adults with intellectual disability (ID) and 20 children with typical development (TD) matched for cognitive level, participated in this study. Participants solved perceptual and conceptual analogies (from the Conceptual and Perceptual Analogical Modifiability Test—CPAM) while having their eye movements monitored. As predicted, the overall percent of correct answers was significantly higher for the TD group compared to that of the ID group. Comparison of the eye movement pattern of each group while solving the analogies revealed that in addition to the quantitative difference between the groups, there is a qualitative difference in the process of solving the analogies. The difference in the scanning pattern between the TD and the ID groups is interpreted as a reflection of two different types of strategies, Constructive matching and Response elimination, respectively.     

Severe distal muscle involvement and mild sensory neuropathy in a boy with infantile onset Pompe disease treated with enzyme replacement therapy for 6 years

Enzyme replacement therapy in infantile onset Pompe disease has led to a new phenotype with features not known in the pre-enzyme replacement therapy era. We investigated the origin of a rapidly emerging and severe weakness of the foot dorsiflexors in a 7-year-old boy after 6.5 years of enzyme replacement therapy. Electroneurography yielded normal findings except low compound muscle action potentials of the extensor digitorum brevis muscles after stimulation of the peroneal nerves. Electromyography of the tibial muscle demonstrated a myopathic pattern. Tibial muscle, sural nerve, and skin biopsy showed a myopathy with empty and glycogen containing vacuoles, a mild loss of myelinated and unmyelinated axons, and a moderately reduced intraepidermal nerve fiber density. These findings provide evidence for a severe distal muscle involvement and a mild sensory neuropathy evolving during the course of disease after long-term enzyme replacement therapy, thereby expanding the new emerging phenotype of infantile onset Pompe disease.     

Top-down and bottom-up effects in pure alexia: evidence from eye movements

The eye movements of a patient with pure alexia, GJ, were recorded as he read sentences in order to explore the roles of top-down and bottom-up information during letter-by-letter reading. Specifically, the effects of word frequency and word predictability were examined. Additional analyses examined the interaction of these effects with the lower level influences of word length and letter confusability. The results indicate that GJ is sensitive to all four of these variables in sentence reading. These findings support an interactive account of reading where letter-by-letter readers use both bottom-up and top-down information to decode words. Due to the disrupted bottom-up processes caused by damage to the Visual Word Form Area or the input connections to it, pure alexic patients rely more heavily on intact top-down information in reading.