Oculomotor Dysfunction in Amyotrophic Lateral Sclerosis

Sharma, Rakesh; Hicks, Stephen L.; Berna, C; Kennard, Christopher; Talbot, Kevin; Turner, Martin R

doi:10.1001/archneurol.2011.130

Cited by 122 publications

(94 citation statements)

References 45 publications

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“…A further limitation of our study is the possible impact of some oculomotor abnormalities in patients with ALS on our results that were not controlled for. Several studies [12,37] reported impairment of eye movement control in patients with ALS. However, any deficits that might impact the performance of the study tasks were excluded by analyzing the data of the training session.…”

Section: Discussionmentioning

confidence: 99%

“…Although some aspects of oculomotor control might be impaired in patients with ALS [12], eye tracking is still a very promising way to study executive functioning in ALS, which has already been used in healthy subjects: One study has implemented an oculomotor version of the trail-making test and found a strong correlation between the paper-pencil and the eye-trackingbased performance of healthy subjects in one subtest [13] whereas another has demonstrated the usability of an eyetracking-based verbal fluency task [14].…”

Section: Introductionmentioning

confidence: 99%

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Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

et al. 2015

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Amyotrophic lateral sclerosis (ALS) primarily affects motor and speech abilities. In addition, cognitive functions are impaired in a subset of patients. There is a need to establish an eye movement-based method of neuropsychological assessment suitable for severely physically impaired patients with ALS. Forty-eight ALS patients and thirty-two healthy controls matched for age, sex and education performed a hand and speech motor-free version of the Raven's coloured progressive matrices (CPM) and the D2-test which had been especially adapted for eye-tracking control. Data were compared to a classical motor-dependent paper-pencil version. The association of parameters of the eye-tracking and the paper-pencil version of the tests and the differences between and within groups were studied. Subjects presented similar results in the eye-tracking and the corresponding paper-pencil versions of the CPM and D2-test: a correlation between performance accuracy for the CPM was observed for ALS patients (p < 0.001) and controls (p < 0.001) and in the D2-test for controls (p = 0.048), whereas this correlation did not reach statistical significance for ALS patients (p = 0.096). ALS patients performed worse in the CPM than controls in the eye-tracking (p = 0.053) and the paper-pencil version (p = 0.042). Most importantly, eye-tracking versions of the CPM (p < 0.001) and the D2-test (p = 0.024) reliably distinguished between more and less cognitively impaired patients. Eye-tracking-based neuropsychological testing is a promising approach for assessing cognitive deficits in patients who are unable to speak or write such as patients with severe ALS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

et al. 2015

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“…By contrast, TrkA expression is not seen in other adult brainstem or spinal motoneurons [58,66], suggesting an important functional role of NGF in the regulation of survival and physiological properties of extraocular motoneurons. Interestingly, it is well known that extraocular motoneurons are much less vulnerable than other brainstem and spinal motoneurons to degenerating motoneuron diseases such as ALS [115][116][117][118], and spinal motoneurons that survive ALS in human patients have shown an increased TrkA expression, suggesting that NGF may provide trophic support to surviving motoneurons in this disease [119].…”

Section: Survival Of Extraocular Motoneurons After Postnatal Axotomy mentioning

confidence: 99%

Complementariness and Functional Parcellation of Neurotrophin Actions on the Oculomotor System

Benítez‐Temiño¹,

Davis-López²,

Morcuende³

et al. 2016

Preprint

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Abstract:Neurotrophins play a principal role in neuronal survival and differentiation during development, but also in the maintenance of appropriate adult neuronal circuits and phenotypes. In the oculomotor system, we have demonstrated that neurotrophins are key regulators of developing and adult neuronal properties, but with peculiarities depending on each neurotrophin. For instance, the administration of NGF, BDNF or NT-3 protects neonatal extraocular motoneurons from cell death after axotomy, but only NGF and BDNF prevent the downregulation in ChAT. In the adult, in vivo recordings of axotomized extraocular motoneurons have demonstrated that the delivery of NGF, BDNF or NT-3 recovers different components of the firing discharge activity of these cells, with some particularities in the case of NGF. All neurotrophins have also synaptotrophic activity, although to different degrees. Accordingly, neurotrophins can restore the axotomy-induced alterations acting selectively on different properties of the motoneuron. In this review we summarize these evidences and discuss them in the context of other motor systems.

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“…63 Such features often occur late rather than at presentation, including in patients with primary lateral sclerosis where the combination with bulbar dysfunction and common postural instability may lead to the erroneous diagnosis of progressive supranuclear palsy. A variety of eye movement abnormalities, including supranuclear gaze palsy, have also been described in MND, 64 but these are rarely prominent.…”

Section: Parkinsonian Featuresmentioning

confidence: 99%

Mimics and chameleons in motor neurone disease

Turner

Talbot

2013

Pract Neurol

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The progression of motor neurone disease (MND) is currently irreversible, and the grave implications of diagnosis naturally fuels concern among neurologists over missing a potential mimic disorder. There is no diagnostic test for MND but in reality there are few plausible mimics in routine clinical practice. In the presence of a progressive pure motor disorder, signs such as florid fasciculations, bilateral tongue wasting, the ‘split hand’, head drop, emotionality, and cognitive or behavioural impairment carry high positive predictive value. MND is clinically heterogeneous, however, with some important chameleon-like presentations and considerable variation in clinical course. Lack of confidence about the scope of such variation, or an approach to diagnosis emphasising investigations over clinical common sense, has the potential to exacerbate diagnostic delay in MND and impede timely planning of the care which is essential to maximising quality of life.

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Oculomotor Dysfunction in Amyotrophic Lateral Sclerosis

Cited by 122 publications

References 45 publications

Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

Complementariness and Functional Parcellation of Neurotrophin Actions on the Oculomotor System

Mimics and chameleons in motor neurone disease

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