Eye movement impairments in Parkinsons disease: possible role of extradopaminergic mechanismsReport as inadecuate




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BMC Neurology

, 12:5

First Online: 29 February 2012Received: 13 September 2011Accepted: 29 February 2012

Abstract

BackgroundThe basal ganglia BG are thought to play an important role in the control of eye movements. Accordingly, the broad variety of subtle oculomotor alterations that has been described in Parkinson-s disease PD are generally attributed to the dysfunction of the BG dopaminergic system. However, the present study suggest that dopamine substitution is much less effective in improving oculomotor performance than it is in restoring skeletomotor abilities.

MethodsWe investigated reactive, visually guided saccades RS, smooth pursuit eye movements SPEM, and rapidly left-right alternating voluntary gaze shifts AVGS by video-oculography in 34 PD patients receiving oral dopaminergic medication PD-DA, 14 patients with deep brain stimulation of the nucleus subthalamicus DBS-STN, and 23 control subjects CTL;In addition, we performed a thorough review of recent literature according therapeuthic effects on oculomotor performance in PD by switching deep brain stimulation off and on in the PD-DBS patients, we achieved swift changes between their therapeutic states without the delays of dopamine withdrawal. In addition, participants underwent neuropsychological testing.

ResultsPatients exhibited the well known deficits such as increased saccade latency, reduced SPEM gain, and reduced frequency and amplitude of AVGS. Across patients none of the investigated oculomotor parameters correlated with UPDRS III whereas there was a negative correlation between SPEM gain and susceptibility to interference Stroop score. Of the observed deficiencies, DBS-STN slightly improved AVGS frequency but neither AVGS amplitude nor SPEM or RS performance.

ConclusionsWe conclude that the impairment of SPEM in PD results from a cortical, conceivably non-dopaminergic dysfunction, whereas patients- difficulty to rapidly execute AVGS might be related to their BG dysfunction.

KeywordsDeep brain stimulation Parkinson-s Disease Oculomotor function Neurophysiology Eye movement Neurodegeneration Electronic supplementary materialThe online version of this article doi:10.1186-1471-2377-12-5 contains supplementary material, which is available to authorized users.

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Author: Elmar H Pinkhardt - Reinhart Jürgens - Dorothée Lulé - Johanna Heimrath - Albert C Ludolph - Wolfgang Becker - Jan Kas

Source: https://link.springer.com/







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