title: Oculomotor Deficits after Chemotherapy in Childhood.
abstract: Advances in the diagnosis and treatment of pediatric malignancies have substantially increased the number of childhood cancer survivors. However, reports suggest that some of the chemotherapy agents used for treatment can cross the blood brain barrier which may lead to a host of neurological symptoms including oculomotor dysfunction. Whether chemotherapy at young age causes oculomotor dysfunction later in life is unknown. Oculomotor performance was assessed with traditional and novel methods in 23 adults (mean age 25.3 years, treatment age 10.2 years) treated with chemotherapy for a solid malignant tumor not affecting the central nervous system. Their results were compared to those from 25 healthy, age-matched controls (mean age 25.1 years). Correlation analysis was performed between the subjective symptoms reported by the chemotherapy treated subjects (CTS) and oculomotor performance. In CTS, the temporal control of the smooth pursuit velocity (velocity accuracy) was markedly poorer (p<0.001) and the saccades had disproportionally shorter amplitude than normal for the associated saccade peak velocity (main sequence) (p = 0.004), whereas smooth pursuit and saccade onset times were shorter (p = 0.004) in CTS compared with controls. The CTS treated before 12 years of age manifested more severe oculomotor deficits. CTS frequently reported subjective symptoms of visual disturbances (70%), unsteadiness, light-headedness and that things around them were spinning or moving (87%). Several subjective symptoms were significantly related to deficits in oculomotor performance. To conclude, chemotherapy in childhood or adolescence can result in severe oculomotor dysfunctions in adulthood. The revealed oculomotor dysfunctions were significantly related to the subjects' self-perception of visual disturbances, dizziness, light-headedness and sensing unsteadiness. Assessments of oculomotor function may, thus, offer an objective method to track and rate the level of neurological complications following chemotherapy.
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden.|Faculty of Medicine, University of Iceland, Reykjavik, Iceland.
authors.forename: Einar-Jón
authors.initials: EJ
authors.lastname: Einarsson
authors.affiliation: School of Biosciences, University of East London, London, United Kingdom.|Division of Brain Sciences, Imperial College London, London, United Kingdom.
authors.forename: Mitesh
authors.initials: M
authors.lastname: Patel
authors.affiliation: Faculty of Medicine, University of Iceland, Reykjavik, Iceland.|Department of Otorhinolaryngology, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Hannes
authors.initials: H
authors.lastname: Petersen
authors.affiliation: Department of Paediatrics, Skane University Hospital, Lund, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Wiebe
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden.|Department of Otorhinolaryngology, Skane University Hospital, Lund, Sweden.
authors.forename: Måns
authors.initials: M
authors.lastname: Magnusson
authors.affiliation: Department of Paediatrics, Skane University Hospital, Lund, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Moëll
authors.affiliation: Department of Clinical Sciences, Lund University, Lund, Sweden.
authors.forename: Per-Anders
authors.initials: PA
authors.lastname: Fransson
mesh_terms: D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004244:Dizziness / Q000139:chemically induced; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D011698:Pursuit, Smooth / Q000187:drug effects*; D012438:Saccades / Q000187:drug effects*; D014785:Vision, Ocular / Q000187:drug effects*; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents
references.citation: J Am Acad Audiol. 1991 Oct;2(4):253-60
references.pmid: 1837740
references.citation: Cancer Treat Rev. 1994 Apr;20(2):191-214
references.pmid: 8156541
references.citation: J Pediatr Hematol Oncol. 2005 Apr;27(4):241-2
references.pmid: 15838404
references.citation: J Pediatr Hematol Oncol. 2004 Oct;26(10):649-655
references.pmid: 27811606
references.citation: J Neurol. 1997 Feb;244(2):65-70
references.pmid: 9120498
references.citation: J Biol. 2008;7(4):11
references.pmid: 18439322
references.citation: Neurol Clin. 1983 Nov;1(4):909-28
references.pmid: 6390156
references.citation: Pediatr Blood Cancer. 2004 Mar;42(3):287-8
references.pmid: 14752870
references.citation: Lancet. 1980 Nov 1;2(8201):981
references.pmid: 6107622
references.citation: Vision Res. 2006 Jan;46(1-2):163-70
references.pmid: 16095654
references.citation: Pediatr Neurol. 1995 Nov;13(4):314-8
references.pmid: 8771166
references.citation: Ann N Y Acad Sci. 2002 Apr;956:216-29
references.pmid: 11960806
references.citation: Ann N Y Acad Sci. 2009 May;1164:268-78
references.pmid: 19645911
references.citation: J Neurophysiol. 2010 Oct;104(4):2103-15
references.pmid: 20719930
references.citation: J Neuroeng Rehabil. 2013 Apr 03;10:33
references.pmid: 23551890
references.citation: Clin Neurophysiol. 2010 Dec;121(12):2134-42
references.pmid: 20570556
references.citation: Annu Rev Neurosci. 1987;10:97-129
references.pmid: 3551767
references.citation: Eur J Cancer. 2010 Apr;46(6):1069-78
references.pmid: 20171084
references.citation: Vision Res. 2011 Jul 1;51(13):1457-83
references.pmid: 21237189
references.citation: Oncology. 2003;65 Suppl 2:11-6
references.pmid: 14586141
references.citation: J Biol. 2008;7(4):12
references.pmid: 18430259
references.citation: Neuropsychologia. 2010 Mar;48(4):887-99
references.pmid: 19913042
references.citation: Cancer. 2006 Mar 15;106(6):1395-401
references.pmid: 16453332
references.citation: Percept Mot Skills. 1973 Jun;36(3):801-2
references.pmid: 4704327
references.citation: J Psychosom Res. 1992 Dec;36(8):731-41
references.pmid: 1432863
references.citation: J Biol. 2006;5(7):22
references.pmid: 17125495
references.citation: Neurology. 2005 Mar 22;64(6):1076-7
references.pmid: 15781834
references.citation: Pediatr Blood Cancer. 2004 Feb;42(2):161-8
references.pmid: 14752881
references.citation: Brain. 2009 Jul;132(Pt 7):1898-906
references.pmid: 19467992
references.citation: Neuron. 2002 Jul 18;35(2):355-63
references.pmid: 12160752