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Influence of target size on vertical gaze palsy in a pathologically proven case of progressive supranuclear palsy

Seemungal, BM; Faldon, M; Revesz, T; Lees, AJ; Zee, DS; Bronstein, AM; (2003) Influence of target size on vertical gaze palsy in a pathologically proven case of progressive supranuclear palsy. MOVEMENT DISORD , 18 (7) 818 - 822. 10.1002/mds.10434.

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Abstract

We document a new oculomotor phenomenon in a patient with pathologically proven progressive supranu-clear gaze palsy (PSP), namely that vertical gaze excursion improves with larger pursuit targets. We used computerised video-oculography during vertical smooth pursuit eye movements (SPEM) of circular targets of diameter 0.16 degrees and 16 degrees, sinusoidally oscillating at 0.08 Hz; (peak-to-peak amplitude 49 degrees). Increasing target size improved vertical gaze excursion from 10 degrees to 25 degrees. There was no concomitant increase in slow phase eye velocity. The findings could be explained by a potentiation of the position control mechanism of pursuit by target size due to increased activation of brainstem pursuit-optokinetic pathways and to higher order attentional mechanisms. This observation may be useful in the clinical assessment of PSP patients with severe neck rigidity in whom the doll's head-eye manoeuvre cannot be performed by comparing the degree of vertical gaze palsy during smooth pursuit testing between at least two differently sized targets and observing whether there is a larger excursion in response to a large target such as a newspaper. (C) 2003 Movement Disorder Society.

Type: Article
Title: Influence of target size on vertical gaze palsy in a pathologically proven case of progressive supranuclear palsy
DOI: 10.1002/mds.10434
Keywords: progressive supranuclear palsy, improved vertical gaze palsy, target size, PURSUIT EYE-MOVEMENTS, RICHARDSON-OLSZEWSKI SYNDROME, SMOOTH-PURSUIT, OPTOKINETIC NYSTAGMUS, ATTENTION, MONKEYS
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Neurodegenerative Diseases
URI: http://discovery.ucl.ac.uk/id/eprint/116009
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