Oculomotor pursuit in schizophrenia

Eye tracking in normals: spem asymmetries and association with schizotypy

SPEM was recorded electro-oculographically during visual tracking of sinusoidal targets oscillating at .4 and .8 cycles per second in one hundred nineteen undergraduates. The logarithms of median root mean square values were used to assess tracking accuracy for leftward and rightward halfcycles of tracking. Over the entire sample, there was a significant superiority of rightward over leftward tracking, which, given evidence for the ipsilateral mediation of SPEM at the cortical level, suggests a right hemisphere predominance in the control of SPEM in normal subjects. Individual tracking asymmetry was associated with overall tracking accuracy such that subjects with relatively deficient leftward tracking and those with a larger absolute magnitude of asymmetry had poorer overall tracking. High scores on an MMPI schizotypy measure (Sum 2-7-8-0) were significantly related to poorer overall SPEM accuracy, individual tracking asymmetry, the absolute magnitude of tracking asymmetry, and phase lag, though the subjects' sex, handedness, and crossed hand-foot dominance were found to affect the relationships between schizotypy and tracking accuracy. These findings suggest that although control of SPEM may be predominantly right hemispheric, in some persons with a vulnerability to schizophrenia spectrum disorders, expressed as poorer overall SPEM accuracy and high schizotypy scores, left hemisphere-mediated (leftward) SPEM may be particularly impaired.

Comparison of the smooth eye tracking disorder of schizophrenics with that of nonhuman primates with specific brain lesions

The smooth pursuit eye tracking deficit (ETD) often associated with schizophrenia has generated enormous interest over the last 20 years. The deficit is observed in about 80% of schizophrenics and in half of their first degree relatives. It is not affected by neuroleptic medication and is not due to inattention. A review of 52 studies (and actual records when available) on ETD in schizophrenia reveals that the deficit can consistently be described as low gain pursuit augmented with catch-up saccades and often peppered with intrusive saccades. A review of the brain areas that have been shown to be involved in pursuit provides the necessary background for the subsequent section which details the nature of the smooth tracking deficits following experimental lesions. This section reveals that the ETD following lesions of the frontal lobe is unique in that it closely resembles the ETD of schizophrenics. This finding lends further support for frontal lobe theories of schizophrenia.

Lithium effect on smooth pursuit eye movements of healthy volunteers

Smooth pursuit eye movement (SPEM) dysfunctions in major affective disorder patients have been reported to be associated with lithium treatment. We report that SPEM of 13 healthy volunteers, either taking lithium (n = 7) or placebo (n = 6), were not significantly impaired by lithium. This could point to a pathophysiologic difference between affective disorder patients and a normal population.

A model of smooth pursuit performance illustrates the relationship between gain, catch-up saccade rate, and catch-up saccade amplitude in normal controls and patients with schizophrenia

Smooth pursuit eye-tracking performance of 37 unmedicated patients with schizophrenia and 45 normal controls was recorded with infrared oculography, and digitized for off-line analysis of gain and other measures. Target velocity was 5 degrees/sec. Patients with schizophrenia had significantly lower gain than normal controls, confirming several earlier reports. During low gain smooth pursuit tracking, when eye velocity is slower than target velocity, the saccadic system corrects for the accumulating position error with catch-up saccades (CUS). The rate of CUS and the median CUS amplitude were compared between groups. Patients had significantly more CUS than controls, but the median CUS amplitudes were not significantly different. A nonlinear mathematical model of the relationship between gain, CUS amplitude, and CUS rate during steady-state constant velocity tracking was developed to integrate these findings. According to this model, for a given gain, correction for position error can result from either a few large CUS or many small CUS. The fit of the model to empirical data, as assessed graphically and with linear and nonlinear regression techniques, was excellent. The model fit the data for both patients and controls. The psychiatric eye-tracking literature is discussed from the perspective suggested by the modeled relationship.

Quantitative assessment of smooth pursuit gain and catch-up saccades in schizophrenia and affective disorders

The smooth pursuit responses to 5 degrees and 20 degrees/sec constant-velocity stimuli were recorded from 23 patients with schizophrenia, 16 affective disorder patients, and 21 normals using low-noise infrared oculography. Pursuit gain, catch-up saccade (CUS) rate and amplitude, and their interrelationships were examined. Gain in the schizophrenic patients was reduced only at 20 degrees/sec, but for both patient groups, CUS rate at 5 degrees/sec was significantly lower than in normals. Using CUS rate at 20 degrees/sec, the patient groups could be distinguished from each other (the rate for schizophrenic patients being highest, and the rate for affectives the lowest) but neither differed significantly from normals. The diagnostic groups did not differ significantly in mean CUS amplitude, although there was a trend for patients to have larger saccades. Gain-CUS rate correlation was strong in normals but reduced or absent in both patient groups. These results indicate that the ocular motor systems of patients with schizophrenia and affective disorders process eye position error abnormally.

Smooth pursuit eye tracking dysfunction and negative symptoms in schizophrenia

This study examined the hypothesis that negative symptoms are associated with abnormalities of smooth pursuit in schizophrenic patients. The pursuit eye movements of 25 subjects with schizophrenia and 25 matched normal control subjects were recorded using an infrared eye tracking system and quantified using the log of signal-to-noise ratio (1n S/N). The severity of negative symptoms within the schizophrenic group was rated using the Scale for the Assessment of Negative Symptoms. Previous findings of pursuit abnormalities among schizophrenic patients as a group were replicated. There was, however, no significant association between the eye tracking dysfunction and the severity of negative symptoms.

The use of eye movement dysfunctions in exploring the genetic transmission of schizophrenia

Eye movement dysfunctions have been found in a large number of schizophrenic patients and in about half of their first-degree relatives. The distribution of these traits within the families of schizophrenic patients suggests a model of genetic transmission that fits an autosomal dominant model, which we have called the "genetic latent trait model." The model, with seven parameters, was fitted to a U.S. population and the model was cross-validated on an independent Norwegian sample. Although the model does not invalidate other, more conventional solutions to the puzzle of schizophrenic transmission, such as multifactorial transmission, the latent trait model does more easily permit linkage studies and therefore will allow refutation or support from the use of molecular genetics techniques.

Catecholamines and attention. I: Animal and clinical studies

One important function of the catecholamine innervation of the cerebral cortex may be the control of attention. Of particular interest are the catecholamine projections to the cerebral cortex from the reticular formation, namely the dopamine neurons of the ventral tegmentum of the midbrain and the noradrenergic neurons of the locus coeruleus in the upper pons. Animal studies implicate noradrenaline and dopamine in a wide range of attention-related behaviours involving search and exploratory activity, distractibility, response rate, discriminability and the switching of attention. Most human studies come from the clinical literature relating to schizophrenia, Parkinson's disease and attention deficit disorder. An association has been claimed in each of these conditions between abnormal catecholamine activity (in particular dopamine) and attentional dysfunction. In particular, difficulty with the attachment of appropriate responses to environmental stimuli, akin to those observed in animals with lesions to central dopamine pathways, indicates a role for dopamine in response selection processes. Overall, the animal and human studies reviewed indicate a role for central noradrenaline and dopamine in the early and late processing of information, respectively.

Frontal lobe dysfunctions in schizophrenia--I. Eye movement impairments

The phenomena of eye movement impairments in schizophrenia are interpreted in this paper, Part I of a two-paper series, in the context of neural mechanisms of attention and eye movement control. The predominant pattern of attention and eye movement impairment in schizophrenia--a disruption of smooth pursuit by saccadic intrusions--is consistent with a disinhibition of saccades. This disinhibition may be related to a dysfunction of frontal eye field mechanisms involved in feedback regulation of saccades and smooth pursuit during visual tracking. A second, less specific type of smooth pursuit impairment consists of saccadic substitution, and may be interpreted in terms of a dysfunction of temporo-parietal mechanisms of task-engagement.