Differences in cortical activation during smooth pursuit and saccadic eye movements following cerebellar lesions.

Current evidence supports the proposal that the cerebellum mediates the activity of other brain areas involved in the control of eye movements. Most of the evidence so far has concentrated on the vermis and flocculi as the cerebellar agents of oculomotor control. But there is also evidence for an involvement of the cerebellar hemispheres in eye movement control. Straube et al. (Ann Neurol 42:891-898, 1997) showed that lateral hemispheric lesions affect initiation of smooth pursuit (SPEM) and saccadic eye movements. Ron and Robinson (J Neurophysiol 36:1004-1022, 1973) evoked smooth pursuit and saccadic eye movements by electrical stimulation of crus I and II, as well as in the dentate nuclei of the monkey. Functional MRI studies also provide evidence that the cerebellar hemispheres play a significant role in SPEM and saccadic eye movements. To clarify the role of the cerebral hemispheres in eye movement control we compared the eye movement related blood oxygen level dependent (BOLD) responses of 12 patients with cerebellar lesions due to stroke with those of an aged-matched healthy control group. Six patients showed oculomotor abnormalities such as dysmetric saccades or saccadic SPEM during the experiment. The paradigm consisted of alternating blocks of fixation, visually guided saccades and visually guided SPEM. A nonparametric random-effects group analysis showed a degraded pattern of activation in the patient group during the performance of SPEM and saccadic eye movements in posterior parietal areas putatively containing the parietal eye fields.