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Ocular fixation instabilities in motor neurone disease

A marker of frontal lobe dysfunction?

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Abstract

Objective

Eye movements are classically felt to be spared in motor neurone disease (MND). Although a range of ocular motor disorders have been reported, no consistent pattern has been established. Disturbances of ocular fixation have been noted in MND; however, fixation has not yet been formally examined. With the recent characterization of ocular fixation using saccadic intrusion amplitude and fixation periods, we performed a cross-sectional study to examine for abnormalities of ocular fixation in non-dementing patients with MND.

Methods

A total of 44 patients and 45 controls were recruited. Fixation was examined using infra-red oculography and all subjects then underwent a neuropsychological evaluation.

Results

Saccadic intrusion amplitude was found to be greater in patients compared to controls and in particular, spinal-onset patients. Saccadic intrusion amplitude in patients correlated with neuropsychological measures sensitive to lesions of the frontal lobes.

Conclusions

This is the first study to identify abnormalities of fixation in MND and these results indicate that ocular fixation instabilities may be a marker of the sub-clinical frontal lobe dysfunction in MND. A longitudinal study to examine if saccadic intrusion amplitude deteriorates with time would be of interest as this could provide a quantifiable objective marker of disease progression.

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Authors and Affiliations

  1. Dept. of Neurology, Royal Victoria Hospital, Belfast, N. Ireland, BT12 6BA

    C. Donaghy MRCP, MD, V. Patterson MB, FRCP & J. M. Gibson FRCP, MD

  2. Northern Ireland Regional Medical Physics Agency, Royal Victoria Hospital, Belfast, N. Ireland

    R. Pinnock PhD, MSc, BSc & R. C. McGivern BSc, PhD, MIPEM, CPhys, CSci

  3. Dept. of Psychology, School of Philosophy, Psychology and language sciences, University of Edinburgh, Edinburgh, Scotland

    S. Abrahams PhD, DCinPsy

  4. School of Medicine and Dentistry, Queens University of Belfast, Royal Victoria Hospital, Belfast, N. Ireland

    C. Cardwell PhD

  5. Dept. of Neurology, Beaumont Hospital, Dublin, Ireland

    O. Hardiman BSc, MD, FRCPI, FAAN

Authors
  1. C. Donaghy MRCP, MD
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  2. R. Pinnock PhD, MSc, BSc
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  3. S. Abrahams PhD, DCinPsy
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  4. C. Cardwell PhD
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  5. O. Hardiman BSc, MD, FRCPI, FAAN
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  6. V. Patterson MB, FRCP
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  7. R. C. McGivern BSc, PhD, MIPEM, CPhys, CSci
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  8. J. M. Gibson FRCP, MD
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Correspondence to C. Donaghy MRCP, MD.

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Donaghy, C., Pinnock, R., Abrahams, S. et al. Ocular fixation instabilities in motor neurone disease. J Neurol 256, 420–426 (2009). https://doi.org/10.1007/s00415-009-0109-x

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  • DOI: https://doi.org/10.1007/s00415-009-0109-x

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