title: Patterns of Eye Movement Impairment Correlate with Regional Brain Atrophy in Neurodegenerative Parkinsonism.
abstract: BACKGROUND
  One common feature of neurodegenerative parkinsonism including Parkinson's disease (PD), multisystem atrophy (MSA), and progressive supranuclear palsy (PSP) is altered eye movement control. Characteristic regional structural atrophy patterns in MRI can be observed in PD, MSA, and PSP.
  
  
  OBJECTIVE
  To investigate the association between eye movement disturbances and regional brain atrophy in patients with PD, MSA, and PSP.
  
  
  METHODS
  High-resolution 3-dimensional T1-weighted MRI images and video-oculographic recordings (EyeLink®) were obtained from 39 PD, 32 PSP, and 18 MSA patients and 24 matched healthy control subjects. Automatic regional volumetric assessment was performed using atlas-based volumetry (ABV).
  
  
  RESULTS
  The prevalence of saccadic intrusions as a measure of inhibitory control was significantly increased in PD patients compared to controls (p < 0.001) and negatively correlated with whole brain volume, cerebral brain volume, and occipital lobe volume (p = 0.0057, p = 0.0049, and p = 0.0059, respectively; all p values are false discovery rate corrected). In MSA, smooth pursuit was disturbed by characteristic "catch-up" saccades (p < 0.001) and it was significantly correlated with cerebellar volume (p = 0.004) and pontine volume (p < 0.001). The hallmark of PSP was pathologically slowed vertical peak eye velocities (p < 0.001); the lower the peak eye velocity, the more marked midbrain atrophy (p = 0.007).
  
  
  CONCLUSIONS
  Foci of regional atrophy correlated with disease-specific eye movement alterations in all investigated parkinsonian syndromes. Oculomotor impairment in PD, predominantly the result of executive dysfunction, was linked to cerebral atrophy. Impairment in the corresponding oculomotor pathways was associated with atrophy of pontocerebellar oculomotor structures in MSA and midbrain atrophy in PSP.
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany.
authors.forename: Olga
authors.initials: O
authors.lastname: Vintonyak
authors.forename: Martin
authors.initials: M
authors.lastname: Gorges
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Müller
authors.forename: Elmar H
authors.initials: EH
authors.lastname: Pinkhardt
authors.forename: Albert C
authors.initials: AC
authors.lastname: Ludolph
authors.forename: Hans-Jürgen
authors.initials: HJ
authors.lastname: Huppertz
authors.forename: Jan
authors.initials: J
authors.lastname: Kassubek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001284:Atrophy / Q000000981:diagnostic imaging / Q000473:pathology; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D004585:Electrooculography; D005133:Eye Movements; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019578:Multiple System Atrophy / Q000150:complications*; D015835:Ocular Motility Disorders / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology*; D010300:Parkinson Disease / Q000150:complications*; D013494:Supranuclear Palsy, Progressive / Q000150:complications*
keywords: Atlas-based volumetry; Magnetic resonance imaging; Multisystem atrophy; Oculomotor function; Parkinson’s disease; Progressive supranuclear palsy; Video-oculography