Dysfunction of omnipause neurons ("gate dysfunction") is unlikely to be the primary cause of slow vertical saccades in progressive supranuclear palsy. Deficient generation of the motor command by midbrain burst neurons is the more likely cause.
Over the past five years, rapid progress has been made in genetically identifying different forms of spinocerebellar atrophy (SCA), for which several characteristic disorders of eye movements have been reported. 1,2 Nonetheless, the genetic disorder in some families has not yet been discovered, and this report concerns one such kinship. We studied a family of Slovenian descent in which 5 of 14 siblings presented with progressive ataxia. Two other siblings, who we did not study, may also show involvement, but neither parent and none of 27 children of the 14 siblings has been affected. We examined the five definitely affected patients several times over a 5year period; electroencephalography, electromyography, and MRI brain imaging were performed. In Patient 5 (the proband), we carried out genetic screening (Athena Laboratories) for Friedreich's ataxia, spinocerebellar ataxia (SCA) 1-3 and 6-8, and Unverricht-Lundborg progressive myoclonic epilepsy (EMP1). We compared results of eye movement studies with a group of 10 normal subjects (2 female; median age 40 years, range 23-60). We measured horizontal and vertical eye movements using the magnetic search coil technique. We tested fixation, horizontal and vertical saccades, smooth pursuit, and vestibulo-ocular reflex (VOR), and vergence, as previously described. 3,4 All patients and subjects gave informed, written consent, as approved by our Institutional Review Board.Clinical findings of the five affected sibs that we studied are summarized in TABLE 1. Disease onset was insidious; early symptoms could be remembered by all sibs during their early twenties, consisting of gait unsteadiness and difficulty read-
Rapid shifts of the point of visual fixation between objects that lie in different directions and at different depths require disjunctive eye movements. We tested whether the saccadic component of such movements is equal for both eyes (Hering's law) or is unequal. We compared the saccadic pulses of abducting and adducting movements when horizontal gaze was shifted from a distant to a near target aligned on the visual axis of one eye (Müller paradigm) in ten normal subjects. We similarly compared horizontal saccades made between two distant targets lying in the same field of movement as during the Müller paradigm tests, and between targets lying symmetrically on either side of the midline, at near side of the midline, at near or far. We measured the ratio of the amplitude of the movements of each eye in corresponding directions due to the saccadic component, as well as corresponding ratios of peak velocity and peak acceleration. In response to a Müller test paradigm requiring about 17 degrees of vergence, the change in position of the unaligned eye was typically twice the size of the corresponding movement of the aligned eye. The ratio of peak velocities for the unaligned/aligned eyes was about 1.5, which was greater than for saccades made between distant targets. The ratio of peak acceleration for unaligned/aligned eyes was about 1.0 during shifts from near to far and about 1.3 for shifts from far to near, these values being similar to corresponding ratios for saccades between distant targets. These measurements of peak acceleration indicate that the saccadic pulses sent to each eye during the Müller paradigm are more equal than would be deduced by comparing the changes in eye position. We retested five subjects to compare directly the peak acceleration of saccades made during the Müller paradigm with similar-sized "conjugate" saccades made between targets at optical infinity. Saccades made during the Müller paradigm were significant slower (P < 0.005) than similar-sized conjugate saccades; this indicated that the different-sized movements during Müller paradigm are not simply due differences in saccadic pulse size but are also influenced by the concurrent vergence movement. A model for saccade-vergence interactions, which incorporates equal saccadic pulses for each eye, and differing contributions from convergence and divergence, accounts for many of these findings.
The gain of the human vestibuloocular reflex (VOR) is influenced by the proximity of the object of regard. In six human subjects, we measured the eye rotations induced by passive, sinusoidal, horizontal head rotations at 2.0 Hz during binocular fixation of a stationary far target at 7 m; a stationary target close to the subject's near point of fixation (<15 cm); and the bridge of the subject's own nose, viewed through a mirror positioned so that, for each subject, the angle of vergence was similar to that during viewing of the near target. The median gain of compensatory eye movements for the group of subjects during far viewing was 0.99 (range 0.80-1.04), during near viewing was 1.21 (range 0.88-1.47), and during mirror viewing was 0.85 (range 0.71-1.01). The gain during near and mirror viewing was significantly different for each subject (P < 0.001) even though the vergence angles were similar. The lower gain values during mirror viewing can be attributed to the geometric relationship between the head rotation, the position of the eyes in the head, and the movement of the subject's virtual image in the mirror. To determine whether visually mediated eye movements were responsible for the observed gain values, we conducted a control experiment in which subjects were rotated using a sum-of-sines stimulus that minimized the effects of predictive visual tracking; differences of gain values between near- and mirror-viewing conditions were similar to those during rotation at 2 Hz. We conclude that, in these experiments, target proximity and vergence angle were not the key determinants of gain of the visuo-vestibular response during head rotation while viewing a near target but that contextual cues from motion vision were more important in generating the appropriate response.
NASA is developing a new capsule-based, crewed vehicle that will land in the ocean, and the space agency desires to reduce the risk of injury from impact during these landings. Because landing impact occurs for each flight and the crew might need to perform egress tasks, current injury assessment reference values (IARV) were deemed insufficient. Because NASCAR occupant restraint systems are more effective than the systems used to determine the current IARVs and are similar to NASA's proposed restraint system, an analysis of NASCAR impacts was performed to develop new IARVs that may be more relevant to NASA's context of vehicle landing operations. Head IARVs associated with race car impacts were investigated by completing a detailed analysis of all of the 2002-2008 NASCAR impact data. Specific inclusion and exclusion criteria were used to select 4071 impacts from the 4015 recorder files provided (each file could contain multiple impact events). Of the 4071 accepted impacts, 274 were selected for numerical simulation using a custom NASCAR restraint system and Humanetics Hybrid-III 50 th percentile numerical dummy model in LS-DYNA. Injury had occurred in 32 of the 274 selected impacts, and 27 of those injuries involved the head. A majority of the head injuries were mild concussions with or without brief loss of consciousness. The 242 non-injury impacts were randomly selected and representative of the range of crash dynamics present in the total set of 4071 impacts. Head dynamics data (head translational acceleration, translational change in velocity, rotational acceleration, rotational velocity, HIC-15, HIC-36, and the Head 3ms clip) were filtered according to SAE J211 specifications and then transformed to a log scale. The probability of head injury was estimated using a separate logistic regression analysis for each log-transformed predictor candidate. Using the log transformation constrains the estimated probability of injury to become negligible as IARVs approach zero. For the parameters head translational acceleration, head translational velocity change, head rotational acceleration, HIC-15, and HIC-36, conservative values (in the lower 95% confidence interval) that gave rise to a 5% risk of any injury occurring were estimated as 40.0 G, 7.9 m/s, 2200 rad/s 2 , 98.4, and 77.4 respectively. Because NASA is interested in the consequence of any particular injury on the ability of the crew to perform egress tasks, the head injuries that occurred in the NASCAR dataset were classified according to a NASA-developed scale (Classes I -III) for operationally relevant injuries, which classifies injuries on the basis of their operational significance. Additional analysis of the data was performed to determine the probability of each injury class occurring, and this was estimated using an ordered probit model. For head translational acceleration, head translational velocity change, head rotational acceleration, head rotational velocity, HIC-36, and head 3ms clip, conservative values of IARVs that produced a 5% risk of Class...
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