Effects of diazepam on the latency of saccades for luminance and binocular disparity defined stimuli

Effects of psychotropic drugs on ocular parameters relevant to traffic safety: A systematic review

Driving is a complex neurobehavioural task necessitating the rapid selection, uptake, and processing of visual information. Eye movements that are critical for the execution of visually guided behaviour such as driving are also sensitive to the effects of psychotropic substances. The Embase (via Ovid), EBSCOHost, Psynet, Pubmed, Scopus and Web of Science databases were examined from January 01st, 2000 to December 31st, 2021. Study selection, data extraction and Cochrane Risk of Bias (RoB2) assessments were conducted according to PRISMA guidelines. The review was prospectively registered (CRD42021267554). In total, 36 full-text articles examined the effects of six principal psychotropic drug classes on measures of oculomotor parameters relevant to driving. Centrally depressing substances affect oculomotor responses in a dose-dependent manner. Psychostimulants improve maximal speed, but not accuracy, of visual search behaviours. Inhaled Δ-9-tetrahydrocannabinol (THC) increases inattention (saccadic inaccuracy) but does not consistently affect other oculomotor parameters. Alterations to composite ocular parameters due to psychoactive substance usage likely differently compromises performance precision during driving through impaired ability to select and process dynamic visual information.

The Nature of Illusions: A New Synthesis Based on Verifiability

This overview discusses the nature of perceptual illusions with particular reference to the theory that illusions represent the operation of a sensory code for which there is no meaningful ground truth against which the illusory percepts can be compared, and therefore there are no illusions as such. This view corresponds to the Bayesian theory that “illusions” reflect unusual aspects of the core strategies of adapting to the natural world, again implying that illusions are simply an information processing characteristic. Instead, it is argued that a more meaningful approach to the field that we call illusions is the Ebbinghaus approach of comparing the illusory percept with a ground truth that is directly verifiable as aberrant by the observer in the domain of the illusory phenomenology (as opposed to relying on the authority of other experts). This concept of direct verifiability not only provides an operational definition of “illusion”; it also makes their interactive observation more effective and informative as to the perceptual processes underlying the illusory appearance. An expanded version of Gregory’s categorization of types of illusion is developed, and a range of classic and more recent illusions that illustrate the differences between these philosophical viewpoints is considered in detail. Such cases make it clear that the discrepancies from the measurable image structure cannot be simply regarded as idiosyncrasies of sensory coding, but are categorical exemplars of perceptual illusions. The widespread existence of such illusory percepts is indicative of the evolutionary limits of adaptive sensory coding.

Freezing of saccades in dopa-responsive parkinsonian syndrome

Purpose

Ocular motor abnormalities such as abnormal saccades are common in idiopathic Parkinson's disease (PD) and atypical parkinsonian syndrome, such as progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD). In this study, we describe a case of patient with PD and show a video illustrating severe delay of reflexive saccades.

Observations

A 68-year-old Caucasian woman with diagnosis of PD presented for evaluation of diplopia. Neuro-ophthalmic examination revealed good visual acuity in both eyes and normal optic nerves but prominent ocular motor abnormalities, including hypometric saccades, impaired smooth pursuit, and convergence insufficiency causing diplopia at near. Despite treatment with carbidopa-levodopa three times per day, she exhibited episodic, severe delay of reflexive saccades. During these episodes, the patient appeared frozen and unable to initiate reflexive saccades for 20 s or longer. This freezing of reflexive saccades was variable and occurred suddenly during exam but could be interrupted by smooth pursuit. There was no gait freezing, eyelid apraxia, or prominent exacerbation of other motor symptoms. Freezing of saccades dramatically resolved after increasing dosage of carbidopa-levodopa.

Conclusions and Importance

We describe a patient with dopa-responsive parkinsonian syndrome with intermittent difficulty initiating reflexive saccades mimicking ocular motor apraxia. Resolution of saccadic freezing with higher carbidopa-levodopa is consistent with ocular motor impairment as a result of degeneration and dysfunction of the dopaminergic pathways in supranuclear ocular motor control.

Clinical Characterization of Oculomotricity in Children with and without Specific Learning Disorders

Children with specific learning disorders have been associated with oculomotor problems, with their analysis even suggested to be a potential diagnostic tool. A prospective non-randomized comparative study evaluating 59 children (6–13 years old) divided into three groups was conducted: a control group (CG) including 15 healthy emmetropic children; a group of 18 healthy children with oculomotor abnormalities (OAG); and a group of 26 children diagnosed with specific learning disorders (LDG). In all groups, besides a complete eye exam, oculomotricity was characterized with two clinical tests: Northeastern State University College of Optometry’s Oculomotor (NSUCO) and Developmental Eye Movement (DEM) tests. Concerning the NSUCO test, lower ability, precision, and head/body movement associated scorings were obtained for both smooth pursuits and saccades in OAG and LDG when compared to the CG (p < 0.001). Likewise, significantly longer time needed to read the horizontal sheet of the DEM test and a higher DEM ratio were found in OAG and LDG compared to CG (p ≤ 0.003). No differences between LDG and OAG were found in the performance with the two oculomotor tests (p ≥ 0.141). Oculomotor anomalies can be present in children with and without specific learning disorders, and therefore cannot be used as diagnostic criteria of these type of disorders.

Diazepam-induced changes of optokinetic nystagmus fast phase

Since specific benzodiazepine (Bz) binding sites have been found in the vision and oculomotor control areas of the central nervous system (CNS), the fast phases of optokinetic nystagmus (OKN) should be affected by Bz administration. In this study, we examine the effects of Bzs on OKN fast phases under closed- and open-loop experimental conditions. Six normal subjects participated in the experiments. The eye movements were measured by the magnetic field, search coil technique, 90 min after diazepam or placebo administration. The study was performed in a randomized, double-blind fashion. After diazepam, the mean amplitude (MAmp) and mean peak velocity (MVel) of OKN fast phases decreased significantly under both experimental conditions. The percentage decreases in MAmp and MVel under the open-loop condition were significantly larger than those under the closed-loop condition. The results indicate that the fast phases of OKN could sensitively reflect the pharmacodynamic effects of Bzs on the CNS.