Eye movement disorders are different in Parkin-linked and idiopathic early-onset PD
Department of Neurology, University of Lübeck, Lübeck, Germany. Neurology
(Impact Factor: 8.29).
07/2010; 75(2):125-8. DOI: 10.1212/WNL.0b013e3181e7ca6d
Parkin gene mutations are the most common cause of early-onset parkinsonism. Patients with Parkin mutations may be clinically indistinguishable from patients with idiopathic early-onset Parkinson disease (EOPD) without Parkin mutations. Eye movement disorders have been shown to differentiate parkinsonian syndromes, but have never been systematically studied in Parkin mutation carriers.
Eye movements were recorded in symptomatic (n = 9) and asymptomatic Parkin mutation carriers (n = 13), patients with idiopathic EOPD (n = 14), and age-matched control subjects (n = 27) during established oculomotor tasks.
Both patients with EOPD and symptomatic Parkin mutation carriers showed hypometric prosaccades toward visual stimuli, as well as deficits in suppressing reflexive saccades toward unintended targets (antisaccade task). When directing gaze toward memorized target positions, patients with EOPD exhibited hypometric saccades, whereas symptomatic Parkin mutation carriers showed normal saccades. In contrast to patients with EOPD, the symptomatic Parkin mutation carriers showed impaired tracking of a moving target (reduced smooth pursuit gain). The asymptomatic Parkin mutation carriers did not differ from healthy control subjects in any of the tasks.
Although clinically similarly affected, symptomatic Parkin mutation carriers and patients with idiopathic EOPD differed in several oculomotor tasks. This finding may point to distinct anatomic structures underlying either condition: dysfunctions of cortical areas involved in smooth pursuit (V5, frontal eye field) in Parkin-linked parkinsonism vs greater impairment of basal ganglia circuits in idiopathic Parkinson disease.
Available from: Jan Kassubek
- "Deterioration of dopaminergically mediated pathways in the basal ganglia in PD leads to overactive SC inhibition preventing the SC to trigger the brainstem saccadic generator. This may contribute to saccadic hypometria, as depicted in Figure 2, and slowed initiation of voluntary saccades  such as reduced number of rapid alternating self-paced saccades where subjects are asked to shift their gaze as fast and as accurately as possible between to stationary targets . In PD, deep brain stimulation of the subthalamic nucleus has "
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ABSTRACT: The evolution of the fovea centralis, the most central part of the retina and the area of the highest visual accuracy, requires humans to shift their gaze rapidly (saccades) to bring some object of interest within the visual field onto the fovea. In addition, humans are equipped with the ability to rotate the eye ball continuously in a highly predicting manner (smooth pursuit) to hold a moving target steadily upon the retina. The functional deficits in neurodegenerative movement disorders (e.g., Parkinsonian syndromes) involve the basal ganglia that are critical in all aspects of movement control. Moreover, neocortical structures, the cerebellum, and the midbrain may become affected by the pathological process. A broad spectrum of eye movement alterations may result, comprising smooth pursuit disturbance (e.g., interrupting saccades), saccadic dysfunction (e.g., hypometric saccades), and abnormal attempted fixation (e.g., pathological nystagmus and square wave jerks). On clinical grounds, videooculography is a sensitive noninvasive in vivo technique to classify oculomotion function alterations. Eye movements are a valuable window into the integrity of central nervous system structures and their changes in defined neurodegenerative conditions, that is, the oculomotor nuclei in the brainstem together with their directly activating supranuclear centers and the basal ganglia as well as cortical areas of higher cognitive control of attention.
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be implemented in commercial CAD software. Here we report the results of
the modeling procedure with a special concern for the noise performance
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Electron Devices for Microwave and Optoelectronic Applications, 2001 International Symposium on; 02/2001
Movement Disorders 11/2010; 25(15):2687-9. DOI:10.1002/mds.23352 · 5.68 Impact Factor
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