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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1999 Jun;66(6):746–753. doi: 10.1136/jnnp.66.6.746

Progressive bradykinesia and hypokinesia of ocular pursuit in Parkinson's disease

G Lekwuwa 1, G Barnes 1, C Collins 1, P Limousin 1
PMCID: PMC1736387  PMID: 10329748

Abstract

OBJECTIVES—Patients with Parkinson's disease characteristically have difficulty in sustaining repetitive motor actions. The purpose of this study was to establish if parkinsonian difficulty with sustaining repetitive limb movements also applies to smooth ocular pursuit and to identify any pursuit abnormalities characteristic of Parkinson's disease.
METHODS—Ocular pursuit in seven patients with moderate to severe bradykinesia predominant Parkinson's disease was compared with seven age matched controls. Predictive and non-predictive pursuit of constant velocity target ramps were examined. Subjects pursued intermittently illuminated 400/s ramps sweeping to the left or right with an exposure duration of 480 ms and average interval of 1.728 s between presentations. To examine for any temporal changes in peak eye velocity, eye displacement or anticipatory smooth pursuit the 124 s duration of each record was divided into four epochs (E1, E2, E3, E4), each lasting 31 s and containing 18 ramp stimuli. Three test conditions were examined in each subject: predictive (PRD1), non-predictive (NPD), and predictive (PRD2) in that order.
RESULTS—Both patients and controls initiated appropriate anticipatory pursuit before target onset in the PRD1 and PRD2 conditions that enhanced the response compared with the NPD condition. The distinctive findings in patients with Parkinson's disease were a reduction in response magnitude compared with controls and a progressive decline of response with stimulus repetition. The deficits were explained on the basis of easy fatiguability in Parkinson's disease.
CONCLUSIONS—Ocular pursuit shows distinct anticipatory movements in Parkinson's disease but peak velocity and displacement are reduced and progressively decline with repetition as found with limb movements.



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Selected References

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  1. Alexander G. E., DeLong M. R., Strick P. L. Parallel organization of functionally segregated circuits linking basal ganglia and cortex. Annu Rev Neurosci. 1986;9:357–381. doi: 10.1146/annurev.ne.09.030186.002041. [DOI] [PubMed] [Google Scholar]
  2. Barnes G. R. A procedure for the analysis of nystagmus and other eye movements. Aviat Space Environ Med. 1982 Jul;53(7):676–682. [PubMed] [Google Scholar]
  3. Barnes G. R., Asselman P. T. The mechanism of prediction in human smooth pursuit eye movements. J Physiol. 1991 Aug;439:439–461. doi: 10.1113/jphysiol.1991.sp018675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bronstein A. M., Kennard C. Predictive ocular motor control in Parkinson's disease. Brain. 1985 Dec;108(Pt 4):925–940. doi: 10.1093/brain/108.4.925. [DOI] [PubMed] [Google Scholar]
  5. Flowers K. A., Downing A. C. Predictive control of eye movements in Parkinson disease. Ann Neurol. 1978 Jul;4(1):63–66. doi: 10.1002/ana.410040112. [DOI] [PubMed] [Google Scholar]
  6. Flowers K. Lack of prediction in the motor behaviour of Parkinsonism. Brain. 1978 Mar;101(1):35–52. doi: 10.1093/brain/101.1.35. [DOI] [PubMed] [Google Scholar]
  7. Flowers K. Some frequency response characteristics of Parkinsonism on pursuit tracking. Brain. 1978 Mar;101(1):19–34. doi: 10.1093/brain/101.1.19. [DOI] [PubMed] [Google Scholar]
  8. Friedman J., Friedman H. Fatigue in Parkinson's disease. Neurology. 1993 Oct;43(10):2016–2018. doi: 10.1212/wnl.43.10.2016. [DOI] [PubMed] [Google Scholar]
  9. Georgiou N., Iansek R., Bradshaw J. L., Phillips J. G., Mattingley J. B., Bradshaw J. A. An evaluation of the role of internal cues in the pathogenesis of parkinsonian hypokinesia. Brain. 1993 Dec;116(Pt 6):1575–1587. doi: 10.1093/brain/116.6.1575. [DOI] [PubMed] [Google Scholar]
  10. Gibson J. M., Pimlott R., Kennard C. Ocular motor and manual tracking in Parkinson's disease and the effect of treatment. J Neurol Neurosurg Psychiatry. 1987 Jul;50(7):853–860. doi: 10.1136/jnnp.50.7.853. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Hikosaka O. Role of basal ganglia in saccades. Rev Neurol (Paris) 1989;145(8-9):580–586. [PubMed] [Google Scholar]
  12. Jones G. M., DeJong J. D. Dynamic characteristics of saccadic eye movements in Parkinson's disease. Exp Neurol. 1971 Apr;31(1):17–31. doi: 10.1016/0014-4886(71)90173-7. [DOI] [PubMed] [Google Scholar]
  13. Kennard C., Lueck C. J. Oculomotor abnormalities in diseases of the basal ganglia. Rev Neurol (Paris) 1989;145(8-9):587–595. [PubMed] [Google Scholar]
  14. Langston J. W., Widner H., Goetz C. G., Brooks D., Fahn S., Freeman T., Watts R. Core assessment program for intracerebral transplantations (CAPIT). Mov Disord. 1992;7(1):2–13. doi: 10.1002/mds.870070103. [DOI] [PubMed] [Google Scholar]
  15. Lekwuwa G. U., Barnes G. R. Cerebral control of eye movements. II. Timing of anticipatory eye movements, predictive pursuit and phase errors in focal cerebral lesions. Brain. 1996 Apr;119(Pt 2):491–505. doi: 10.1093/brain/119.2.491. [DOI] [PubMed] [Google Scholar]
  16. Lueck C. J., Tanyeri S., Crawford T. J., Henderson L., Kennard C. Antisaccades and remembered saccades in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1990 Apr;53(4):284–288. doi: 10.1136/jnnp.53.4.284. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Marsden C. D. Which motor disorder in Parkinson's disease indicates the true motor function of the basal ganglia? Ciba Found Symp. 1984;107:225–241. doi: 10.1002/9780470720882.ch12. [DOI] [PubMed] [Google Scholar]
  18. Martin K. E., Phillips J. G., Iansek R., Bradshaw J. L. Inaccuracy and instability of sequential movements in Parkinson's disease. Exp Brain Res. 1994;102(1):131–140. doi: 10.1007/BF00232445. [DOI] [PubMed] [Google Scholar]
  19. Rascol O., Clanet M., Montastruc J. L., Simonetta M., Soulier-Esteve M. J., Doyon B., Rascol A. Abnormal ocular movements in Parkinson's disease. Evidence for involvement of dopaminergic systems. Brain. 1989 Oct;112(Pt 5):1193–1214. doi: 10.1093/brain/112.5.1193. [DOI] [PubMed] [Google Scholar]
  20. Rottach K. G., Riley D. E., DiScenna A. O., Zivotofsky A. Z., Leigh R. J. Dynamic properties of horizontal and vertical eye movements in parkinsonian syndromes. Ann Neurol. 1996 Mar;39(3):368–377. doi: 10.1002/ana.410390314. [DOI] [PubMed] [Google Scholar]
  21. Sharpe J. A., Fletcher W. A., Lang A. E., Zackon D. H. Smooth pursuit during dose-related on-off fluctuations in Parkinson's disease. Neurology. 1987 Aug;37(8):1389–1392. doi: 10.1212/wnl.37.8.1389. [DOI] [PubMed] [Google Scholar]
  22. Ventre J., Zee D. S., Papageorgiou H., Reich S. Abnormalities of predictive saccades in hemi-Parkinson's disease. Brain. 1992 Aug;115(Pt 4):1147–1165. doi: 10.1093/brain/115.4.1147. [DOI] [PubMed] [Google Scholar]
  23. Vidailhet M., Rivaud S., Gouider-Khouja N., Pillon B., Bonnet A. M., Gaymard B., Agid Y., Pierrot-Deseilligny C. Eye movements in parkinsonian syndromes. Ann Neurol. 1994 Apr;35(4):420–426. doi: 10.1002/ana.410350408. [DOI] [PubMed] [Google Scholar]
  24. Waterston J. A., Barnes G. R., Grealy M. A., Collins S. Abnormalities of smooth eye and head movement control in Parkinson's disease. Ann Neurol. 1996 Jun;39(6):749–760. doi: 10.1002/ana.410390611. [DOI] [PubMed] [Google Scholar]
  25. White O. B., Saint-Cyr J. A., Tomlinson R. D., Sharpe J. A. Ocular motor deficits in Parkinson's disease. II. Control of the saccadic and smooth pursuit systems. Brain. 1983 Sep;106(Pt 3):571–587. doi: 10.1093/brain/106.3.571. [DOI] [PubMed] [Google Scholar]
  26. van Hilten J. J., Hoogland G., van der Velde E. A., Middelkoop H. A., Kerkhof G. A., Roos R. A. Diurnal effects of motor activity and fatigue in Parkinson's disease. J Neurol Neurosurg Psychiatry. 1993 Aug;56(8):874–877. doi: 10.1136/jnnp.56.8.874. [DOI] [PMC free article] [PubMed] [Google Scholar]

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