Annual Baseline King-Devick Oculomotor Function Testing Is Needed Due to Scores Varying by Age

Objective: To document baseline King-Devick (K-D) oculomotor function scores for male and female participants aged between 4 and 20 years old. Methods: Utilising a cross section of schools, rugby clubs and gymnastic clubs, 1936 participants (1300 male, 636 female) completed the spiral-bound K-D test for the identification of disturbed oculomotor function. Results: This study identified that overall, the baseline scores of the K-D test became faster by 1.4 (0.3 to 4.5) s per year, when compared with the previous age group in the same number of reading card groups. When comparing normative values of the original K-D validation study with the same age groups of the current cohort, participants aged 6 to 11 years recorded a faster baseline time (range 3.5 to 8.6 s), while those in the 12 to 14 years. age group recorded slower baseline times (range −3.9 to −7.9 s). Discussion: In general, there were age group differences, but not sex differences, for K-D test times in the current cohort. Analysis of single card times, across all age groups, showed changes likely due to improved reading time. Conclusion: The results support the need for individualised annual pre-injury baseline testing of the K-D test.

Ocular Motor Abnormalities in Anti-IgLON5 Disease

ObjectiveAnti-IgLON5 disease forms an interface between neuroinflammation and neurodegeneration and includes clinical phenotypes that are often similar to those of neurodegenerative diseases. An early diagnosis of patients with anti-IgLON5 disease and differentiation from neurodegenerative diseases is necessary and may have therapeutic implications.MethodsIn our small sample size study we investigated oculomotor function as a differentiating factor between anti-IgLON5 disease and neurodegenerative disorders. We examined ocular motor and vestibular function in four patients suffering from anti-IgLON5 disease using video-oculography (VOG) and a computer-controlled rotational chair system (sampling rate 60 Hz) and compared the data with those from ten age-matched patients suffering from progressive supranuclear palsy (PSP) and healthy controls (CON).ResultsPatients suffering from anti-IgLON5 disease differed from PSP most strikingly in terms of saccade velocity and accuracy, the presence of square wave jerks (SWJ) (anti-IgLON5 0/4 vs. PSP 9/10) and the clinical finding of supranuclear gaze palsy (anti-IgLON5 1/4). The presence of nystagmus, analysis of smooth pursuit eye movements, VOR and VOR suppression was reliable to differentiate between the two disease entities. Clear differences in all parameters, although not always significant, were found between all patients and CON.DiscussionWe conclude that the use of VOG as a tool for clinical neurophysiological assessment can be helpful in differentiating between patients with PSP and patients with anti-IgLON5 disease. VOG could have particular value in patients with suspected PSP and lack of typical Parkinson’s characteristics. future trials are indispensable to assess the potential of oculomotor function as a biomarker in anti-IgLON5 disease.

Polygenic risk scores for schizophrenia are associated with oculomotor endophenotypes

Background Schizophrenia is a heterogeneous disorder with substantial heritability. The use of endophenotypes may help clarify its aetiology. Measures from the smooth pursuit and antisaccade eye movement tasks have been identified as endophenotypes for schizophrenia in twin and family studies. However, the genetic basis of the overlap between schizophrenia and these oculomotor markers is largely unknown. Here, we tested whether schizophrenia polygenic risk scores (PRS) were associated with oculomotor performance in the general population. Methods Analyses were based on the data of 2956 participants (aged 30–95) of the Rhineland Study, a community-based cohort study in Bonn, Germany. Genotyping was performed on Omni-2.5 exome arrays. Using summary statistics from a recent meta-analysis based on the two largest schizophrenia genome-wide association studies to date, we quantified genetic risk for schizophrenia by creating PRS at different p value thresholds for genetic markers. We examined associations between PRS and oculomotor performance using multivariable regression models. Results Higher PRS were associated with higher antisaccade error rate and latency, and lower antisaccade amplitude gain. PRS showed inconsistent patterns of association with smooth pursuit velocity gain and were not associated with saccade rate during smooth pursuit or performance on a prosaccade control task. Conclusions There is an overlap between genetic determinants of schizophrenia and oculomotor endophenotypes. Our findings suggest that the mechanisms that underlie schizophrenia also affect oculomotor function in the general population.

Preservation of eye movements in Parkinson’s disease is stimulus and task specific

Parkinson’s disease (PD) is a neurodegenerative disease that includes motor impairments such as tremor, bradykinesia, and postural instability. Although eye movement deficits are commonly found in saccade and pursuit tasks, preservation of oculomotor function has also been reported. Here we investigate specific task and stimulus conditions under which oculomotor function in PD is preserved. Sixteen PD patients and eighteen healthy, age-matched controls completed a battery of movement tasks that included stationary or moving targets eliciting reactive or deliberate eye movements: pro-saccades, anti-saccades, visually-guided pursuit, and rapid go/no-go manual interception. Compared to controls, patients demonstrated systematic impairments in tasks with stationary targets: pro-saccades were hypometric and anti-saccades were incorrectly initiated toward the cued target in about 35% of trials compared to 14% errors in controls. In patients, task errors were linked to short latency saccades, indicating abnormalities in inhibitory control. However, patients’ eye movements in response to dynamic targets were relatively preserved. PD patients were able to track and predict a disappearing moving target and make quick go/no-go decisions as accurately as controls. Patients’ interceptive hand movements were slower on average but initiated earlier, indicating adaptive processes to compensate for motor slowing. We conclude that PD patients demonstrate stimulus- and task-dependency of oculomotor impairments and propose that preservation of eye and hand movement function in PD is linked to a separate functional pathway through the SC-brainstem loop that bypasses the fronto-basal ganglia network.Significance StatementEye movements are a promising clinical tool to aid in the diagnosis of movement disorders and to monitor disease progression. Although Parkinson’s disease (PD) patients show some oculomotor abnormalities, it is not clear whether previously-described eye movement impairments are task specific. We assessed eye movements in PD under different visual (stationary vs. moving targets) and movement (reactive vs. deliberate) conditions. We demonstrate that PD patients are able to accurately track moving objects but make inaccurate eye movements towards stationary targets. The preservation of eye movements towards dynamic stimuli might enable patients to accurately act upon the predicted motion path of the moving target. These results can inform the development of tools for the rehabilitation or maintenance of functional performance.

Optometric Screening of Elementary Students in Greece

Background: The aim of this study is to provide a wide screening test in elementary school students in Greece in order to trace undiagnosed visual deficiencies, which can affect the visual performance and efficiency. Methods: Examination procedures were approved by the Ministry of Education for the optometric team to enter the school premises and perform the assessments. The researchers performed optometric testing according to standard protocols to evaluate visual acuity (VA), near point of convergence (NPC), accommodative amplitude and facility, vergence facility, stereopsis, and pursuit and saccade oculomotor function. Results: The 835 students that were examined came from a total number of 14 schools so as to enable social stratification of high, medium, and low living standards. Fewer than 17% of the children managed to pass all visual tests at published goal levels. Testing identified a significant number of students who had undiagnosed visual deficiencies (83%). Conclusion: Visual Function in elementary students needs to be evaluated on a regular basis following a comprehensive Optometric screening so that a wide range of visual dysfunctions can be detected. Our ultimate goal is to ensure adequate conditions for every student to develop vision skills needed to meet academic demands.

Screen Time and Developmental Eye Movement Testing in Middle School Students

Background: Screen time continues to increase among children and youth, yet little is known about its potential effects on oculomotor development and function. The aims of the current study were to (a) compare oculomotor function in children today to those tested before smartphone use and (b) explore correlations between screen time use and oculomotor function among children today. Method: A retrospective comparison was conducted comparing normative data published in the Developmental Eye Movement (DEM) Test manual in 1990, prior to the invention of smart devices, to data collected in 2020. Correlations between screen time and DEM variables were also explored within the current sample. Results: Sixty middle school students reported spending on average 45.5 hours/week on screens with approximately 18.5 hours/week on iPhones, 14.5 hours/week on television and 10.5 hours/week on computers. Surprisingly, DEM performance was not significantly improved in the current sample compared to the historical sample. There were also no significant correlations between any screen time variables and oculomotor metrics within the current sample. Conclusion: Despite the significant increase in screen time usage since 1990, DEM performance was replicable among 6th, 7th, and 8th grader students tested 30 years later. A statistically significant difference was found among 7th graders on DEM Vertical, where the 2020 students performed slower however, this difference may not be clinically significant. Importantly, DEM Ratio, a key variable for identifying ocular motility dysfunction (OMD), was also not significantly different between 1990 and 2020. Moreover, screen time in the current sample did not correlate with any DEM variables. This study provides preliminary evidence indicating that as measured by the DEM Test, increased screen time may not affect ocular motility. Further research is warranted using more finite methods for measuring saccade and smooth pursuit eye movements during the use of screened devices.

Towards Clinically Relevant Oculomotor Biomarkers in Early Schizophrenia

In recent years, psychiatric research has focused on the evaluation and implementation of biomarkers in the clinical praxis. Oculomotor function deviances are among the most consistent and replicable cognitive deficits in schizophrenia and have been suggested as viable candidates for biomarkers. In this narrative review, we focus on oculomotor function in first-episode psychosis, recent onset schizophrenia as well as individuals at high risk for developing psychosis. We critically discuss the evidence for the possible utilization of oculomotor function measures as diagnostic, susceptibility, predictive, monitoring, and prognostic biomarkers for these conditions. Based on the current state of research we conclude that there are not sufficient data to unequivocally support the use of oculomotor function measures as biomarkers in schizophrenia.