Impaired fixation suppression of horizontal vestibular nystagmus during smooth pursuit: pathophysiology and clinical implications.
fixation suppression
nystagmus
pursuit
vestibular
Journal
European journal of neurology
ISSN: 1468-1331
Titre abrégé: Eur J Neurol
Pays: England
ID NLM: 9506311
Informations de publication
Date de publication:
08 2021
08 2021
Historique:
revised:
04
05
2021
received:
23
02
2021
accepted:
05
05
2021
pubmed:
14
5
2021
medline:
14
8
2021
entrez:
13
5
2021
Statut:
ppublish
Résumé
A peripheral spontaneous nystagmus (SN) is typically enhanced or revealed by removing fixation. Conversely, failure of fixation suppression of SN is usually a sign of a central disorder. Based on Luebke and Robinson (Vision Res 1988, vol. 28 (8), pp. 941-946), who suggested that the normal fixation mechanism is disengaged during pursuit, it is hypothesized that vertical tracking in the light would bring out or enhance a horizontal SN. Eighteen patients with acute vestibular neuritis were studied. Eye movements were recorded using video-oculography at straight-ahead gaze with and without visual fixation, and during smooth pursuit. The slow-phase velocity and the fixation suppression indices of nystagmus (relative to SN in darkness) were compared in each condition. During vertical tracking, the slow-phase velocity of horizontal SN with eyes near straight-ahead gaze was significantly higher (median 2.7°/s) than under static visual fixation (median 1.2°/s). Likewise, the fixation index was significantly higher (worse suppression) during pursuit (median 48%) than during fixation (median 26%). A release of SN was also suggested during horizontal pursuit, if one assumes superposition of SN on a normal and symmetrical pursuit capability.
Sections du résumé
BACKGROUND AND PURPOSE
A peripheral spontaneous nystagmus (SN) is typically enhanced or revealed by removing fixation. Conversely, failure of fixation suppression of SN is usually a sign of a central disorder. Based on Luebke and Robinson (Vision Res 1988, vol. 28 (8), pp. 941-946), who suggested that the normal fixation mechanism is disengaged during pursuit, it is hypothesized that vertical tracking in the light would bring out or enhance a horizontal SN.
METHODS
Eighteen patients with acute vestibular neuritis were studied. Eye movements were recorded using video-oculography at straight-ahead gaze with and without visual fixation, and during smooth pursuit. The slow-phase velocity and the fixation suppression indices of nystagmus (relative to SN in darkness) were compared in each condition.
RESULTS
During vertical tracking, the slow-phase velocity of horizontal SN with eyes near straight-ahead gaze was significantly higher (median 2.7°/s) than under static visual fixation (median 1.2°/s). Likewise, the fixation index was significantly higher (worse suppression) during pursuit (median 48%) than during fixation (median 26%). A release of SN was also suggested during horizontal pursuit, if one assumes superposition of SN on a normal and symmetrical pursuit capability.
Identifiants
pubmed: 33983645
doi: 10.1111/ene.14909
pmc: PMC8362184
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2614-2621Subventions
Organisme : Swiss National Science Foundation
ID : Grant #320030_173081
Pays : Switzerland
Informations de copyright
© 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
Références
Ear Hear. 2020 Nov/Dec;41(6):1747-1751
pubmed: 33136647
Neurology. 2021 Jan 5;96(1):34-38
pubmed: 33004609
Eur Arch Otorhinolaryngol. 2012 Jul;269(7):1759-62
pubmed: 22057154
J Clin Neurol. 2013 Oct;9(4):203-13
pubmed: 24285961
J Vestib Res. 2019;29(2-3):57-87
pubmed: 31256095
J Neurol Neurosurg Psychiatry. 1983 Jan;46(1):61-6
pubmed: 6842202
Vision Res. 1988;28(8):941-6
pubmed: 3250089
J Neurol Neurosurg Psychiatry. 2005 Mar;76(3):451-3
pubmed: 15716550
Eur J Neurol. 2021 Aug;28(8):2614-2621
pubmed: 33983645
J Neurol Neurosurg Psychiatry. 2009 Aug;80(8):900-3
pubmed: 19336432
Cerebellum. 2016 Apr;15(2):182-9
pubmed: 26082303
Exp Brain Res. 2016 Jan;234(1):277-86
pubmed: 26449967
Brain. 1976 Jun;99(2):207-34
pubmed: 990897
J Pediatr Ophthalmol Strabismus. 1997 Jan-Feb;34(1):52-7
pubmed: 9027681
Philos Trans R Soc Lond B Biol Sci. 2017 Apr 19;372(1718):
pubmed: 28242738
Neuron. 2010 May 27;66(4):477-91
pubmed: 20510853
Biol Cybern. 1986;55(1):43-57
pubmed: 3801529
J Laryngol Otol. 2012 Dec;126(12):1209-15
pubmed: 23098070
Neurology. 2021 Jul 6;97(1):e42-e51
pubmed: 33986142
Curr Opin Neurol. 2018 Feb;31(1):74-80
pubmed: 29120919
J Neurol Neurosurg Psychiatry. 2007 Oct;78(10):1113-8
pubmed: 17220287
Ann Neurol. 1978 Apr;3(4):373-4
pubmed: 307363
J Neurol Neurosurg Psychiatry. 2013 Apr;84(4):446-51
pubmed: 23172866