title: Do eye movement impairments in patients with small vessel cerebrovascular disease depend on lesion load or on cognitive deficits? A video-oculographic and MRI study.
abstract: Small vessel cerebrovascular disease (SVCD) is one of the most frequent vessel disorders in the aged brain. Among the spectrum of neurological disturbances related to SVCD, oculomotor dysfunction is a not well understood symptom- in particular, it remains unclear whether vascular lesion load in specific brain regions affects oculomotor function independent of cognitive decline in SVCD patients or whether the effect of higher brain function deficits prevails. In this study, we examined a cohort of 25 SVCD patients and 19 healthy controls using video-oculographic eye movement recording in a laboratory environment, computer-based MRI assessment of white matter lesion load (WMLL), assessment of extrapyramidal motor deficits, and psychometric testing. In comparison to controls, the mean WMLL of patients was significantly larger than in controls. With respect to eye movement control, patients performed significantly worse than controls in almost all aspects of oculomotion. Likewise, patients showed a significantly worse performance in all but one of the neuropsychological tests. Oculomotor deficits in SVCD correlated with the patients' cognitive dysfunctioning while there was only weak evidence for a direct effect of WMLL on eye movement control. In conclusion, oculomotor impairment in SVCD seems to be mainly contingent upon cognitive deterioration in SVCD while WMLL might have only a minor specific effect upon oculomotor pathways.
authors.affiliation: Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany.
authors.forename: Elmar H
authors.initials: EH
authors.lastname: Pinkhardt
authors.forename: Hazem
authors.initials: H
authors.lastname: Issa
authors.forename: Martin
authors.initials: M
authors.lastname: Gorges
authors.forename: Reinhart
authors.initials: R
authors.lastname: Jürgens
authors.forename: Dorothée
authors.initials: D
authors.lastname: Lulé
authors.forename: Johanna
authors.initials: J
authors.lastname: Heimrath
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Müller
authors.forename: Albert C
authors.initials: AC
authors.lastname: Ludolph
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Becker
authors.forename: Jan
authors.initials: J
authors.lastname: Kassubek
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001480:Basal Ganglia Diseases / Q000175:diagnosis / Q000209:etiology; D059345:Cerebral Small Vessel Diseases / Q000473:pathology* / Q000523:psychology*; D003072:Cognition Disorders / Q000209:etiology* / Q000523:psychology; D015331:Cohort Studies; D005133:Eye Movements; D005260:Female; D019416:Head Movements; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015835:Ocular Motility Disorders / Q000209:etiology*