Saccadic abnormalities in frontotemporal dementia

Burrell, James R.; Hornberger, Michael; Carpenter, R. H. S.; Kiernan, Matthew C.; Hodges, John R.

doi:10.1212/wnl.0b013e318258f75c

Cited by 46 publications

(28 citation statements)

References 32 publications

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“…However this has been found to be both less sensitive and less specific than psychometric testing (Torlot et al 2013). Saccadometry, on the other hand, provides an objective and quantitative measure that has been validated as a marker of cognitive function in a number of other neurological pathologies (Ali et al 2006;Antoniades et al 2010;Burrell et al 2012Burrell et al , 2013Dawson et al 2011;Ghosh et al 2010;Michell et al 2006;Perneczky et al 2011;Roos et al 2006;Temel et al 2009). Moreover, it is comparatively rapid, taking only 7 min to gain a data set, and requires no specialist training or personnel to administer.…”

Section: Discussionmentioning

confidence: 99%

Using saccades to diagnose covert hepatic encephalopathy

et al. 2015

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Covert Hepatic Encephalopathy (CHE), previously known as Minimal Hepatic Encephalopathy, is a subtle cognitive defect found in 30-70 % of cirrhosis patients. It has been linked to poor quality of life, impaired fitness to drive, and increased mortality: treatment is possible. Despite its clinical significance, diagnosis relies on psychometric tests that have proved unsuitable for use in a clinical setting. We investigated whether measurement of saccadic latency distributions might be a viable alternative. We collected data on 35 cirrhosis patients at Addenbrooke's Hospital, Cambridge, with no evidence of clinically overt encephalopathy, and 36 age-matched healthy controls. Performance on standard psychometric tests was evaluated to determine those patients with CHE as defined by the World Congress of Gastroenterology. We then compared visually-evoked saccades between those with CHE and those without, as well as reviewing blood test results and correlating saccadic latencies with biochemical parameters and prognostic scores. Cirrhosis patients have significantly longer median saccadic latencies than healthy controls. Those with CHE had significantly prolonged saccadic latencies when compared with those without CHE. Analysis of a cirrhosis patient's saccades can diagnose CHE with a sensitivity of 75 % and a specificity of 75 %. We concluded that analysis of a cirrhosis patient's saccadic latency distributions is a fast and objective measure that can be used as a diagnostic tool for CHE. This improved early diagnosis could direct avoidance of high-risk activities such as driving, and better inform treatment strategies.

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Section: Discussionmentioning

confidence: 99%

Using saccades to diagnose covert hepatic encephalopathy

et al. 2015

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“…Hence, in a study comparing FTD (n = 22) and control (n = 23) subjects, saccadic latency was prolonged and early saccades were increased, reflecting increased atrophy of the left frontal eye field and reduced speed of decision making processes. 108 In addition, a study demonstrated that FTD (n = 28) subjects presented abnormalities in reflexive visually guided saccades, as did AD (n = 10) participants. 109 In a smaller size study of FTD associated with motor neuron disease (MND), and in whom gross ocular abnormalities were present, slowing of both vertical and horizontal saccades was observed.…”

Section: Eye Movementsmentioning

confidence: 97%

Oculo‐visual changes and clinical considerations affecting older patients with dementia

Armstrong

Kergoat

2015

Ophthalmic Physiologic Optic

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Purpose Dementia is associated with various alterations of the eye and visual function. Over 60% of cases are attributable to Alzheimer's disease, a significant proportion of the remainder to vascular dementia or dementia with Lewy bodies, while frontotemporal dementia, and Parkinson's disease dementia are less common. This review describes the oculo‐visual problems of these five dementias and the pathological changes which may explain these symptoms. It further discusses clinical considerations to help the clinician care for older patients affected by dementia. Recent findings Visual problems in dementia include loss of visual acuity, defects in colour vision and visual masking tests, changes in pupillary response to mydriatics, defects in fixation and smooth and saccadic eye movements, changes in contrast sensitivity function and visual evoked potentials, and disturbance of complex visual functions such as in reading ability, visuospatial function, and the naming and identification of objects. Pathological changes have also been reported affecting the crystalline lens, retina, optic nerve, and visual cortex. Clinically, issues such as cataract surgery, correcting the refractive error, quality of life, falls, visual impairment and eye care for dementia have been addressed. Summary Many visual changes occur across dementias, are controversial, often based on limited patient numbers, and no single feature can be regarded as diagnostic of any specific dementia. Nevertheless, visual hallucinations may be more characteristic of dementia with Lewy bodies and Parkinson's disease dementia than Alzheimer's disease or frontotemporal dementia. Differences in saccadic eye movement dysfunction may also help to distinguish Alzheimer's disease from frontotemporal dementia and Parkinson's disease dementia from dementia with Lewy bodies. Eye care professionals need to keep informed of the growing literature in vision/dementia, be attentive to signs and symptoms suggestive of cognitive impairment, and be able to adapt their practice and clinical interventions to best serve patients with dementia.

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“…In addition, patients with FTD had an increased incidence of early saccades, which may be due to reduced inhibition of primitive responses. 31 Although FTLD, CBD, and PSP might present with similar pathology, they do represent distinct syndromes. 32 The results of the ocular motor studies so far suggest that saccadic analysis may be useful in differentiating these groups (saccadic gain and velocity, and antisaccade performance).…”

Section: Research Findingsmentioning

confidence: 99%

Ocular motor abnormalities in neurodegenerative disorders

Antoniades

Kennard

2014

Eye

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Eye movements are a source of valuable information to both clinicians and scientists as abnormalities of them frequently act as clues to the localization of a disease process. Classically, they are divided into two main types: those that hold the gaze, keeping images steady on the retina (vestibulo-ocular and optokinetic reflexes) and those that shift gaze and redirect the line of sight to a new object of interest (saccades, vergence, and smooth pursuit). Here we will review some of the major ocular motor abnormalities present in neurodegenerative disorders.

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Saccadic abnormalities in frontotemporal dementia

Abstract: Saccades are abnormal in FTD, reflecting reduced decision-making speed, and these abnormalities related to atrophy of the left frontal eye field. In addition, patients with FTD had an increased incidence of early saccades, which may be due to reduced inhibition of primitive responses.

Cited by 46 publications

References 32 publications

Using saccades to diagnose covert hepatic encephalopathy

Using saccades to diagnose covert hepatic encephalopathy

Oculo‐visual changes and clinical considerations affecting older patients with dementia

Ocular motor abnormalities in neurodegenerative disorders

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