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Clinical highlights: Eye movements in Multi System Atrophy - neuroClues

Written by Pauline Lhost | Jul 19, 2022 1:00:00 PM

Clinical highlights – July 2022

We are thrilled to inform you about the science of eye tracking. Every month, we will keep you updated on the latest news shared by the scientific community. The newsletter of this month is related to the analysis of eye movements for differential diagnosis of Multiple System Atrophy.

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Eye tracking, a quest for objective biomarkers in differentiating MSA from PD

There is a wealth of scientific knowledge about eye movements analysis for the differential diagnosis of MSA. We list here a few examples:

Expected variations of oculomotor biomarkers for pathological populations with movement disorders can help differentiate MSA from another movement disorder disease.

Légende: PD: Idiopathic Parkinson’s Disease ; MSA: Multiple System Atrophy ; CBS: Corticobasal Syndrome; PSP: Progressive Supranuclear Palsy ; LBD: Lewy body Dementia; PDD: Parkinson’s Disease Dementia; ATD: Alzheimer’s type Dementia; PNFA: Progressive Nonfluent Aphasia; FTD/tau: Frontotemporal Dementia – tauopathies ; FTD/TDP: Frontotemporal Dementia: – Proteinopathies; sw : square waves ; dbn : downbeat nystagmus ; e.s. : express saccade 

Adapté de Leigh, R. &. Zee (2015-06). The Neurology of Eye Movements. Oxford, UK: Oxford University Press. 

From December 2019 to January 2021, 30 patients with PD and 23 patients with MSA (17 with cerebellar-type MSA and 6 with parkinsonian-type MSA) had a video-oculographic recording of HITs at two university hospitals in South Korea. Researchers found that reversed (p = 0.034) and perverted (p = 0.015) catch-up saccades were more frequently observed in MSA than in PD during HITs. 

Link to the publication

Saccades in MSAP are characterized both by prolonged acceleration and deceleration periodes with reduced peak velocity. In contrast, the velocity profile of PD patients was characterized mainly by prolonged deceleration period

Terao et al. in Clin NeuroPhysiol 2019

According to recent findings, saccade profiles provide useful information for differentiating between PD and MSAP at early stages. While the changes in velocity profiles may be explained by the cerebellar and brainstem pathology in MSAP, the changes in velocity profile in both PD and MSAP correlated significantly with increasing severity of Parkinsonism in both disorders, suggesting a link with striatonigral pathology. 

Link to the publication

Inspection of the saccadic component of pursuit tracking revealed that in MSA saccades typically correct for position errors accumulated during SPEM epochs (“catch-up saccades”), whereas in PD, saccades were often directed toward future target positions (“anticipatory saccades”). 

Link to the publication

 

 

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