Occurrence of Balínt Syndrome in a Patient with Hypereosinophilic Syndrome

Balínt Syndrome is an acquired disorder manifesting in the inability to recognize several objects at once (simultagnosia), inaccurate visually guided limb movements despite intact motor function (optic ataxia) and the inability to make accurate voluntary saccades to visual targets despite demonstrating unrestricted range of eye movements (ocular motor apraxia). Here we report the first case of a patient presenting with Balínt Syndrome caused by a platelet-derived growth factor receptor A mutation (PDGFRA)-induced Hypereosinophilic Syndrome (HES).

Inducing oculomotor plasticity to disclose the functional link between voluntary saccades and endogenous attention deployed perifoveally

To what extent oculomotor and attention systems are linked remains strongly debated. Previous studies suggested that saccadic adaptation, a well-studied model of oculomotor plasticity, and orienting of attention rely on overlapping networks in the parietal cortex and can functionally interact. Using a Posner-like paradigm in healthy human subjects, we demonstrate for the first time that saccadic adaptation boosts endogenous attention orienting. Indeed, the discrimination of perifoveal targets benefits more from central cues after backward adaptation of leftward voluntary saccades than after a control saccade task. We propose that the overlap of underlying neural networks actually consists of neuronal populations co-activated by oculomotor plasticity and endogenous attention deployed perifoveally. The functional coupling demonstrated here plaids for conceptual models not belonging to the framework of the premotor theory of attention as the latter has been rejected precisely for this voluntary/endogenous modality. These results also open new perspective for rehabilitation of visuo-attentional deficits.

Oculomotor behavior in children with autism spectrum disorders

To identify quantitative indicators of social communication dysfunctions, we explored the oculomotor performances in subjects with autism spectrum disorders. Discordant findings in the literature have been reported for oculomotor behavior in subjects with autism spectrum disorders. This study aimed to explore reflexive and voluntary saccadic performance in a group of 32 children with autism spectrum disorders (mean age: 12.1 ± 0.5 years) compared to 32 age-, sex-, and IQ-matched typically developing children (control group). We used different types of reflexive and voluntary saccades: gap, step, overlap, and anti-saccades. Eye movements were recorded using an eye tracker (Mobile EBT®) and we measured latency, percentage of anticipatory and express saccades, errors of anti-saccades and gain. Children with autism spectrum disorders reported similar latency values with respect to typically developing children for reflexive and voluntary saccades; in contrast, they made more express and anticipatory saccades overall, as shown in paradigm testing (gap, step, overlap, and anti-saccades). Our findings support previous evidence of the atypicality of the cortical network, which is involved in saccade triggering and attentional processes in children with autism spectrum disorders.

Implicit and explicit learning in reactive and voluntary saccade adaptation

Saccades can either be elicited automatically by salient peripheral stimuli or can additionally depend on explicit cognitive goals. Similarly, it is thought that motor adaptation is driven by the combination of a more automatic, implicit process and a more explicit, cognitive process. However, the degree to which such implicit and explicit learning contribute to the adaptation of more reactive and voluntary saccades remains elusive. To study this question, we employed a global saccadic adaptation paradigm with both increasing and decreasing saccade amplitudes. We assessed the resulting adaptation using a dual state model of motor adaptation. This model decomposes learning into a fast and slow process, which are thought to constitute the explicit and implicit learning, respectively. Our results show that adaptation of reactive saccades is equally driven by fast and slow learning, while fast learning is nearly absent when adapting voluntary (i.e. scanning) saccades. This pattern of results was present both when saccade gain was increased or decreased. Our results suggest that the increased cognitive demands associated with voluntary compared to reactive saccade planning interfere specifically with explicit learning.

Inhibition and late errors in the antisaccade task: Influence of task design

In the antisaccade task, subjects are instructed to saccade in the opposite direction of a peripheral visual cue (PVC). Importantly, several psychiatric disorders are associated with increased error rates in this paradigm. Despite this observation, there is no consensus about the mechanism behind antisaccade errors: while often explained as inhibition failures, some studies have suggested that errors are caused by deficits in the ability to initiate voluntary saccades. Using a computational model, we recently showed that under some conditions high latency or late errors can be explained by a race process between voluntary pro- and antisaccades. A limitation of our findings is that in our previous experiment the PVC signaled the trial type, whereas in most studies, subjects are informed about the trial type before the PVC is presented. We refer to these task designs as asynchronous (AC) and synchronous cues (SC) conditions. Here, we investigated to which extent differences in design affect the type and frequency of errors in the antisaccade task. Twenty-four subjects participated in mixed blocks of pro- and antisaccade trials in both conditions. Our results demonstrate that error rates were highly correlated across task designs and a non-negligible fraction of them were classified as late errors in both conditions. In summary, our findings indicate that errors in the AC task are the result of both inhibition failures and inaccurate voluntary action initiation.

Voluntary Saccadic Eye Movements Ride the Attentional Rhythm

Visual perception seems continuous, but recent evidence suggests that the underlying perceptual mechanisms are in fact periodic—particularly visual attention. Because visual attention is closely linked to the preparation of saccadic eye movements, the question arises how periodic attentional processes interact with the preparation and execution of voluntary saccades. In two experiments, human observers made voluntary saccades between two placeholders, monitoring each one for the presentation of a threshold-level target. Detection performance was evaluated as a function of latency with respect to saccade landing. The time course of detection performance revealed oscillations at around 4 Hz both before the saccade at the saccade origin and after the saccade at the saccade destination. Furthermore, oscillations before and after the saccade were in phase, meaning that the saccade did not disrupt or reset the ongoing attentional rhythm. Instead, it seems that voluntary saccades are executed as part of an ongoing attentional rhythm, with the eyes in flight during the troughs of the attentional wave. This finding for the first time demonstrates that periodic attentional mechanisms affect not only perception but also overt motor behavior.