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Lexical processes and eye movements in neglect dyslexia.

Neglect dyslexia is a disturbance in the allocation of spatial attention over a letter string following unilateral brain damage. Patients with this condition may fail to read letters on the contralesional side of an orthographic string. In some of these cases, reading is better with words than with non-words. This word superiority effect has received a variety of explanations that differ, among other things, with regard to the spatial distribution of attention across the letter string during reading. The primary goal of the present study was to explore the interaction between attention and lexical processes by recording eye movements in a patient (F.C.) with severe left neglect dyslexia who was required to read isolated word and non-word stimuli of various length. F.C.'s ocular exploration of orthographic stimuli was highly sensitive to the lexical status of the letter string. We found that: (1) the location to which F.C. directed his initial saccade (obtained approximately 230 ms post-stimulus onset) differed between word and non-word stimuli; (2) the patient spent a greater amount of time fixating the contralesional side of word than non-word strings. Moreover, we also found that F.C. failed to identify the left letters of a string despite having fixated them, thus showing a clear dissociation between eye movement responses and conscious access to orthographic stimuli. Our data suggest the existence of multiple interactions between lexical, attentional and eye movement systems that occur from very initial stages of visual word recognition.

Attention↗

Disorders of gaze during head rotation.

We investigated gaze functions during sinusoidal head rotation in patients with peripheral and central vestibular lesions. Various kinds of gaze disturbance appeared in relation to deficient compensation (labyrinthine lesions), inaccurate gain regulation (cerebellar lesions), impaired gaze-induced suppression (cerebellar lesions), and inadequate visual correction (brain stem lesions). Analysis of gaze during head rotation may help to understand the regulation system of the vestibulo-ocular reflex as well as to detect gaze disturbances in patients with vestibular disorders, which cannot be attained by conventional vestibular examinations.

Adult↗

Evaluation and diagnosis of incomitant ocular deviations.

Incomitant ocular deviations can indicate the presence of a significant health care problem and can produce distressful patient symptoms. Appropriate diagnosis and management of such problems are needed. This clinical review discusses the etiology, classification, and extraocular muscle changes associated with incomitant ocular deviations. The various testing procedures needed to determine the specific extraocular muscle involved are discussed in detail. The basic management of such deviations is reviewed.

Adult↗

Subcortical contributions to head movements in macaques. I. Contrasting effects of electrical stimulation of a medial pontomedullary region and the superior colliculus.

1. These studies were initiated to understand the neural sites and mechanisms controlling head movements during gaze shifts. Gaze shifts are made by saccadic eye movements with and without head movements. Sites were stimulated electrically within the brain stem of awake, trained monkeys relatively free to make head movements to study the head-movement components of gaze shifts. 2. Electrical stimulation in and around the gigantocellular reticular nucleus evoked head movements in the ipsilateral direction. Gaze shifts were never evoked from these sites, presumably because the vestibulo-ocular reflex compensated. The rough topography of this region included large head movements laterally, small movements medially, downward movements from dorsal sites, and upward movements more ventrally. 3. The initial position of the head influenced the magnitude of the elicited movement with larger movements produced when the head was directed to the contralateral side. Attentive fixation was associated with larger and faster head movements when compared with those evoked during spontaneous behavior. 4. The superior colliculus makes a significant contribution to gaze shifts and has been shown to contribute to head movements. Because the colliculus is a major source of afferents to the gigantocellular reticular nucleus, comparable stimulation studies of the superior colliculus were conducted. When the colliculus was excited, shifts of gaze in the contralateral direction were predominant. These were most often accomplished by saccadic eye movements, however, we frequently elicited head movements that had an average latency 10 ms longer than those elicited from the reticular head movement region. Sites evoking head movements tended to be deeper and more caudal than loci eliciting eye movements. Neither the onset latencies, amplitudes, nor peak velocities of head movements and eye movements were correlated. Gaze shifts evoked from the caudal colliculus with the head free were larger than those elicited from the same site with the head fixed. 5. These studies demonstrate that both the superior colliculus and gigantocellular reticular nucleus mediate head movements. The colliculus plays a role in orienting to external events, and so collicular head movements predominantly were associated with gaze shifts, with the eye and head movements uncoupled. The medullary reticular system may play a role in the integration of a wider range of movements. Head movements from the medullary reticular sites probably participate in several forms of head movements, such as those that are related to postural reflexes, started volitionally, and/or oriented to external events.

Animals↗

The relationship between disordered pursuit and vestibulo-ocular reflex suppression.

The performance of the smooth pursuit reflex and the ability to suppress the vestibulo-ocular reflex were assessed in 10 normal subjects and in patients with a variety of diseases of the central nervous system. Pursuit was measured as the maximum velocity of slow phase eye movement in response to a laser target moving sinusoidally at various frequencies up to 1 Hz and with amplitudes stepped up to 35° peak. Suppression of the vestibulo-ocular reflex was assessed with subjects seated in a Barany chair rotating sinusoidally in yaw at matching frequencies. The breakpoint of vestibulo-ocular reflex supression was defined as the peak velocity of oscillation at which nystagmus appeared on electro-oculographic recording as determined by the method of ascending and descending thresholds. For normal subjects, at all frequencies, the breakpoint of suppression corresponded closely with the peak velocity of pursuit at the corresponding frequency of target oscillation. In some patients pursuit and suppression were comparably impaired. In others either pursuit or suppression could be selectively impaired with the other function left intact. The results demonstrate that the mechanisms of pursuit and visual suppression of the vestibulo-ocular reflex have similar dynamics and share a common pathway at least to the level of the cerebellum. Thereafter, there is presumably an anatomical and functional dissociation of the signals mediating the two functions. The key area involved appears to be the flocculus for lesions of this structure alone cause impairment of both functions. The findings also indicate that the appropriate way to test smooth pursuit in relationship to suppression is to increase the amplitude of target oscillation until the peak slow eye movement velocity is determined for each frequency. The finding that increasing excursion increases maximum pursuit velocity supports the view that pursuit has an acceleration limit which is more critical in determining performance than velocity limitations. The results establish the assessment of vestibulo-ocular reflex suppression as a powerful test of the integrity of CNS function independent of its previous association with disordered pursuit.

Aged↗

Rehabilitation following brain damage: some neurophysiological mechanisms. Functional recovery in the visual and vestibular pathways.

The visual and labyrinthine sensing systems are often neglected in the rehabilitation process of patients with central nervous system (CNS) lesions. Nevertheless, their integrity is essential for the construction of motor tasks ranging from accurate reaching to the co-ordinated behaviours of posture and locomotion. This tasks may be influenced considerably by the roles of the visual and vestibular systems in the perceptual analysis of localizing objects in space ("egocentric localization") and of spatial orientation of the body ("ego-orientation") and in controlling oculomotor and postural stability. The anatomy, physiology, clinical relevance and patterns of recovery of function of two specific visual-vestibular related behaviours is addressed, namely ocular stability and egocentric localization. Emphasis is placed upon such issues as (a) motor learning in complete and incomplete lesions as adjudged from observations of peripheral vestibular nerve disorders; (b) the role of the cerebellum in calibrating motor performance with particular reference to the modifiability of the vestibulo-ocular reflex to attain ocular stability; (c) the use of redundant or complementary structures as assumed from evidence of recovery from chronic visual field deficits; and (d) specified behavioural tactics as a mechanism for adaptation.

Central Nervous System Diseases↗

[Control of gaze and locomotion by spatial orientation].

We reported a new theory for daily vestibular functions which advocates top-down regulation of posture and gaze by supposing the coordinates in the brain. The hypothesis consists of three principles; first, the vestibular system is primarily a sensory system to detect spatial orientation; second, multisensory integrations reconstruct three-dimensional coordinates in the brain, which ascertain spatial orientation; third, daily behaviours like gazing or walking are controlled in a feed-forward manner by programming on the coordinates in the brain. The hypothesis was useful to understand strategic differences between active and passive movements, to distinct gaze control from ocular reflexes, to apply the rules of gaze control to posture control, and to clarify the mechanism to produce motion sickness.

Fixation, Ocular↗

Auditory-visual coordination in neonates.

Neonatal oculomotor behavior was observed under various conditions of visual and auditory stimulation. In 1 experiment babies were observed tracking a moving visual target with their eyes. Such tracking was uninfluenced by the addition of sound to the visual target, nor was it disrupted by the presence of a stationary auditory stimulus. The presentation of a moving auditory stimulus alone was not sufficient to elicit reliable tracking responses. In a second experiment, neonates failed to show ocular orientation toward a laterally presented sound. These findings are interpreted as illustrating the relative independence of auditory and visual perception during the neonatal period.

Acoustic Stimulation↗

Oculokinetic perimetry compared with standard perimetric threshold testing.

To calibrate oculokinetic perimetry (OKP) as developed by Damato in terms of conventional perimetric threshold values, 33 eyes with either glaucoma or ocular hypertension were tested with a standard Humphrey Field Analyzer using the Central 30-2 test and twice with a 26-point OKP chart. The frequency of seeing of the OKP test spot was plotted against 30-2 thresholds. This showed a weak relation between the two tests. Subsequently eyes that were considered to have had poor fixation were omitted, but false positive and false negative results still occurred in 19 remaining eyes. To check whether Troxler's effect (local adaptation) might have caused false positives, 6 subjects were tested with OKP, controlling the fixation times. Increasing the fixation time from 'very short' to 2 and 5 seconds yielded more 'not seen' responses in OKP. False negative data were found to occur preferentially in border areas of visual defects. The average frequency of seeing curve over all data showed a 50% frequency of seeing for the OKP stimulus at a 14.6 dB equivalent conventional threshold value. The spreading of the curve was 7 dB (95% confidence interval 28 dB).

Adult↗

Eye contact: the core of interpersonal relatedness.

This essay will attempt to show, citing evidence from diverse sources, that eye contact plays a central role in interpersonal relations. The eyes preface most new relationships, overshadowing other sensory inputs while transmitting a wide assortment of emotional cues. Visual behavior may at times prove decisive in assuring survival, in amorous encounters, and in clarifying interpersonal motives. Ocular performance, a final common pathway for many social, cultural and emotional determinants, is a crucial factor in defining relationships and in allowing reciprocal influences to be exchanged as persons relate. In psychiatric patients, ocular behavior may provide clues to diagnosis. A common finding in such persons is gaze aversion, a social avoidance phenomenon which indicates a desire to attenuate the interpersonal experience and thereby decrease anxiety.

Anxiety↗

Ocular motor disorders.

Our detailed understanding of the physiology and anatomy of the ocular motor system allows an accurate differential diagnosis of pathological eye movement patterns. This review covers important clinical studies and studies in basic research relevant for the neurologist published during the past year.

Animals↗

The cerebellar contribution to eye movements based upon lesions: binocular three-axis control and the translational vestibulo-ocular reflex.

The study of human cerebellar patients and monkeys with experimental cerebellar lesions has taught us much about the role of the cerebellum in normal ocular motor control. Here we emphasize recent findings that point to a role for the cerebellum in (1) the control of the three-dimensional axis about which the eye rotates in response to visual and vestibular stimuli, and (2) the generation of the translational VOR. Findings in cerebellar patients include abnormalities of eye torsion during attempted fixation that suggest a cerebellar role in the control of torsion so that Listing's law is obeyed. Abnormal torsion during vertical pursuit suggests that central processing of information for smooth pursuit may be based upon a phylogenetically old, semicircular canal coordinate scheme. Inappropriate and disconjugate vertical and torsional eye movements ("cross-coupling") occur during brief, high-acceleration rotations of the head. This suggests a role for the cerebellum in the binocular control of the rotation axis of the VOR. Finally, abnormalities of the modulation of the translational VOR with near viewing in cerebellar patients, but with sparing of the very initial 25-30 msec of response, suggests an important role for the cerebellum in the translational VOR.

Animals↗

[Binocular three-dimensional video-oculography].

BACKGROUND: It has long been a goal to develop a means to measure squint angles in three dimensions simultaneously. A three-dimensional binocular method is naturally needed especially with surgical procedures that affect three dimensions of ocular motility. METHODS: Special modifications of a videographic method provide simultaneous online data on the three-dimensional position of the eyes. The interocular difference is equal to the amount of squint, depending on the direction of gaze, head-tilt/direction of gravity, and convergence. RESULTS: The method introduced provides three-dimensional and binocular documentation of ocular movements. This could lead to improved pre- and postsurgical examination, especially of rotational disturbances, and it could also offer an objective means for comparing the results of various surgical procedures.

Electrooculography↗

Tracking of illusory target motion: differences between gaze and head responses.

We compared ocular and eye-head tracking responses to an illusion of diagonal motion produced when vertical movement of a small visual target was synchronized to horizontal movement of a background display. In response to sinusoidal movement, smooth ocular pursuit followed vertical target motion, with only a small horizontal component. In response to regular stepping movement, all anticipatory saccades were in the direction of the illusion; these erroneous oblique movements were followed by corrective horizontal saccades. When the head was free to move, it usually showed a diagonal trajectory that, for both sinusoidal and stepping target motion, was always in the direction of the illusion; no corrective movements were present. Thus, for our illusory stimuli, eye and head tracking showed qualitative differences that imply that ocular tracking was ultimately controlled by actual target motion but head tracking was controlled by illusory target motion.

Adult↗

Monocular rotary nystagmus.

A patient with transient monocular rotary-vertical nystagmus demonstrated decreased gain of vertical pursuit and normal vestibulo-ocular reflex on electrooculogram. A supranuclear brain stem lesion, resulting in lack of monocular inhibition of oculomotor neurons, is postulated on the basis of these findings.

Dominance, Cerebral↗

Status of vestibular function after prolonged bedrest.

6 young, healthy, male volunteers were submitted to one week of head down (-4 degrees) bedrest. This position simulates the cerebral hemodynamic conditions in weightlessness. Measurements of vestibular equilibrium and of oculomotor system function were made before and after the prolonged bedrest. Analysis of the results indicates that vestibular responses, as measured by the maximal speed of the slow phase of the provoked nystagmus (caloric and sinusoidal rotatory stimulations), are decreased after prolonged bedrest. This statistically significant diminution requires confirmation with a greater number of cases. The reflex conflicting or interacting with the cervico-ocular and optokinetic reflexes on the one hand and the foveal vision on the other, is one of several possible explanations for the observed changes.

Adult↗

Influence of voluntary ocular deviation on vestibular nystagmus.

We examined the influence of voluntary gaze deviation on per-rotary vestibular nystagmus during trapezoidal velocity profiles. Gaze deviation in the direction of the fast-phase component of nystagmus significantly increased slow-phase amplitude, fast-phase amplitude and slow-phase velocity; gaze deviation in the direction of the slow phase marginally decreased these three properties. Schlagfeld deviation and beat frequency were unaffected by per-rotary ocular deviation in either direction. The observed changes in per-rotary eye movements are consistent with post-rotary observations first described by Alexander which later became known as "Alexander's Law".

Adult↗