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Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies.
Brain. 2005 Jun; 128(Pt 6):1267-76.B

Abstract

Neurodegeneration in Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) affect cortical and subcortical networks involved in saccade generation. We therefore expected impairments in saccade performance in both disorders. In order to improve the pathophysiological understanding and to investigate the usefulness of saccades for differential diagnosis, saccades were tested in age- and education-matched patients with PDD (n = 20) and DLB (n = 20), Alzheimer's disease (n = 22) and Parkinson's disease (n = 24), and controls (n = 24). Reflexive (gap, overlap) and complex saccades (prediction, decision and antisaccade) were tested with electro-oculography. PDD and DLB patients had similar impairment in all tasks (P > 0.05, not significant). Compared with controls, they were impaired in both reflexive saccade execution (gap and overlap latencies, P < 0.0001; gains, P < 0.004) and complex saccade performance (target prediction, P < 0.0001; error decisions, P < 0.003; error antisaccades: P < 0.0001). Patients with Alzheimer's disease were only impaired in complex saccade performance (Alzheimer's disease versus controls, target prediction P < 0.001, error decisions P < 0.0001, error antisaccades P < 0.0001), but not reflexive saccade execution (for all, P > 0.05). Patients with Parkinson's disease had, compared with controls, similar complex saccade performance (for all, P > 0.05) and only minimal impairment in reflexive tasks, i.e. hypometric gain in the gap task (P = 0.04). Impaired saccade execution in reflexive tasks allowed discrimination between DLB versus Alzheimer's disease (sensitivity > or =60%, specificity > or =77%) and between PDD versus Parkinson's disease (sensitivity > or =60%, specificity > or =88%) when +/-1.5 standard deviations was used for group discrimination. We conclude that impairments in reflexive saccades may be helpful for differential diagnosis and are minimal when either cortical (Alzheimer's disease) or nigrostriatal neurodegeneration (Parkinson's disease) exists solely; however, they become prominent with combined cortical and subcortical neurodegeneration in PDD and DLB. The similarities in saccade performance in PDD and DLB underline the overlap between these conditions and underscore differences from Alzheimer's disease and Parkinson's disease.

Authors+Show Affiliations

Institute for Ageing and Health, Wolfson Research Centre, Newcastle General Hospital, Newcastle upon Tyne, UK. u.p.mosimann@ncl.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15774501

Citation

Mosimann, Urs P., et al. "Saccadic Eye Movement Changes in Parkinson's Disease Dementia and Dementia With Lewy Bodies." Brain : a Journal of Neurology, vol. 128, no. Pt 6, 2005, pp. 1267-76.
Mosimann UP, Müri RM, Burn DJ, et al. Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies. Brain. 2005;128(Pt 6):1267-76.
Mosimann, U. P., Müri, R. M., Burn, D. J., Felblinger, J., O'Brien, J. T., & McKeith, I. G. (2005). Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies. Brain : a Journal of Neurology, 128(Pt 6), 1267-76.
Mosimann UP, et al. Saccadic Eye Movement Changes in Parkinson's Disease Dementia and Dementia With Lewy Bodies. Brain. 2005;128(Pt 6):1267-76. PubMed PMID: 15774501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies. AU - Mosimann,Urs P, AU - Müri,René M, AU - Burn,David J, AU - Felblinger,Jacques, AU - O'Brien,John T, AU - McKeith,Ian G, Y1 - 2005/03/17/ PY - 2005/3/19/pubmed PY - 2005/9/15/medline PY - 2005/3/19/entrez SP - 1267 EP - 76 JF - Brain : a journal of neurology JO - Brain VL - 128 IS - Pt 6 N2 - Neurodegeneration in Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB) affect cortical and subcortical networks involved in saccade generation. We therefore expected impairments in saccade performance in both disorders. In order to improve the pathophysiological understanding and to investigate the usefulness of saccades for differential diagnosis, saccades were tested in age- and education-matched patients with PDD (n = 20) and DLB (n = 20), Alzheimer's disease (n = 22) and Parkinson's disease (n = 24), and controls (n = 24). Reflexive (gap, overlap) and complex saccades (prediction, decision and antisaccade) were tested with electro-oculography. PDD and DLB patients had similar impairment in all tasks (P > 0.05, not significant). Compared with controls, they were impaired in both reflexive saccade execution (gap and overlap latencies, P < 0.0001; gains, P < 0.004) and complex saccade performance (target prediction, P < 0.0001; error decisions, P < 0.003; error antisaccades: P < 0.0001). Patients with Alzheimer's disease were only impaired in complex saccade performance (Alzheimer's disease versus controls, target prediction P < 0.001, error decisions P < 0.0001, error antisaccades P < 0.0001), but not reflexive saccade execution (for all, P > 0.05). Patients with Parkinson's disease had, compared with controls, similar complex saccade performance (for all, P > 0.05) and only minimal impairment in reflexive tasks, i.e. hypometric gain in the gap task (P = 0.04). Impaired saccade execution in reflexive tasks allowed discrimination between DLB versus Alzheimer's disease (sensitivity > or =60%, specificity > or =77%) and between PDD versus Parkinson's disease (sensitivity > or =60%, specificity > or =88%) when +/-1.5 standard deviations was used for group discrimination. We conclude that impairments in reflexive saccades may be helpful for differential diagnosis and are minimal when either cortical (Alzheimer's disease) or nigrostriatal neurodegeneration (Parkinson's disease) exists solely; however, they become prominent with combined cortical and subcortical neurodegeneration in PDD and DLB. The similarities in saccade performance in PDD and DLB underline the overlap between these conditions and underscore differences from Alzheimer's disease and Parkinson's disease. SN - 1460-2156 UR - https://www.unboundmedicine.com/medline/citation/15774501/Saccadic_eye_movement_changes_in_Parkinson's_disease_dementia_and_dementia_with_Lewy_bodies_ L2 - https://academic.oup.com/brain/article-lookup/doi/10.1093/brain/awh484 DB - PRIME DP - Unbound Medicine ER -