Paul Sauleau1, Pierre Pollak2, Paul Krack2, Jean-Hubert Courjon3, Alain Vighetto3, Alim-Louis Benabid2, Denis Pélisson3, Caroline Tilikete4. 1. Department of Neurophysiology, University Hospital of Rennes, University of Rennes 1, France. 2. Department of Clinical and Biological Neurosciences, University Hospital of Grenoble, Grenoble, France; INSERM U 318, University of Grenoble 1, Grenoble, France. 3. UMR-S 864 INSERM Espace et Action, University of Lyon 1, 16 av Doyen Lepine, 69676 Bron, France; Neuro-Ophthalmology Unit, University Hospital of Lyon, Hospices Civils de Lyon, University of Lyon 1, Bron, France. 4. UMR-S 864 INSERM Espace et Action, University of Lyon 1, 16 av Doyen Lepine, 69676 Bron, France; Neuro-Ophthalmology Unit, University Hospital of Lyon, Hospices Civils de Lyon, University of Lyon 1, Bron, France. Electronic address: caroline.tilikete@inserm.fr.
Abstract
OBJECTIVE: To determine the effect of subthalamic stimulation on visually triggered eye and head movements in patients with Parkinson's disease (PD). METHODS: We compared the gain and latency of visually triggered eye and head movements in 12 patients bilaterally implanted into the subthalamic nucleus (STN) for severe PD and six age-matched control subjects. Visually triggered movements of eye (head restrained), and of eye and head (head unrestrained) were recorded in the absence of dopaminergic medication. Bilateral stimulation was turned OFF and then turned ON with voltage and contact used in chronic setting. The latency was determined from the beginning of initial horizontal eye movements relative to the target onset, and the gain was defined as the ratio of the amplitude of the initial movement to the amplitude of the target movement. RESULTS: Without stimulation, the initiation of the head movement was significantly delayed in patients and the gain of head movement was reduced. Our patients also presented significantly prolonged latencies and hypometry of visually triggered saccades in the head-fixed condition and of gaze in head-free condition. Bilateral STN stimulation with therapeutic parameters improved performance of orienting gaze, eye and head movements towards the controls' level CONCLUSIONS: These results demonstrate that visually triggered saccades and orienting eye-head movements are impaired in the advanced stage of PD. In addition, subthalamic stimulation enhances amplitude and shortens latency of these movements. SIGNIFICANCE: These results are likely explained by alteration of the information processed by the superior colliculus (SC), a pivotal visuomotor structure involved in both voluntary and reflexive saccades. Improvement of movements with stimulation of the STN may be related to its positive input either on the STN-Substantia Nigra-SC pathway or on the parietal cortex-SC pathway.
OBJECTIVE: To determine the effect of subthalamic stimulation on visually triggered eye and head movements in patients with Parkinson's disease (PD). METHODS: We compared the gain and latency of visually triggered eye and head movements in 12 patients bilaterally implanted into the subthalamic nucleus (STN) for severe PD and six age-matched control subjects. Visually triggered movements of eye (head restrained), and of eye and head (head unrestrained) were recorded in the absence of dopaminergic medication. Bilateral stimulation was turned OFF and then turned ON with voltage and contact used in chronic setting. The latency was determined from the beginning of initial horizontal eye movements relative to the target onset, and the gain was defined as the ratio of the amplitude of the initial movement to the amplitude of the target movement. RESULTS: Without stimulation, the initiation of the head movement was significantly delayed in patients and the gain of head movement was reduced. Our patients also presented significantly prolonged latencies and hypometry of visually triggered saccades in the head-fixed condition and of gaze in head-free condition. Bilateral STN stimulation with therapeutic parameters improved performance of orienting gaze, eye and head movements towards the controls' level CONCLUSIONS: These results demonstrate that visually triggered saccades and orienting eye-head movements are impaired in the advanced stage of PD. In addition, subthalamic stimulation enhances amplitude and shortens latency of these movements. SIGNIFICANCE: These results are likely explained by alteration of the information processed by the superior colliculus (SC), a pivotal visuomotor structure involved in both voluntary and reflexive saccades. Improvement of movements with stimulation of the STN may be related to its positive input either on the STN-Substantia Nigra-SC pathway or on the parietal cortex-SC pathway.
Authors: Lisa C Goelz; Fabian J David; John A Sweeney; David E Vaillancourt; Howard Poizner; Leonard Verhagen Metman; Daniel M Corcos Journal: Exp Brain Res Date: 2016-11-14 Impact factor: 1.972
Authors: Elmar H Pinkhardt; Reinhart Jürgens; Dorothée Lulé; Johanna Heimrath; Albert C Ludolph; Wolfgang Becker; Jan Kassubek Journal: BMC Neurol Date: 2012-02-29 Impact factor: 2.474