What do eye movements tell us about patients with neurological disorders? — An introduction to saccade recording in the clinical setting

• Published in: Proceedings of the Japan Academy, Series B Vol. 93; no. 10; pp. 772 - 801
• Main Authors: HIKOSAKA, Okihide, FUKUDA, Hideki, TERAO, Yasuo
• Format: Journal Article
• Language: English
• Published: Japan The Japan Academy 2017
• Subjects: Abnormalities; Alzheimer's disease; Ataxia; Attention deficit hyperactivity disorder; basal ganglia; Brain; Brain stem; Cerebellar ataxia; Cerebellum; cerebral cortex; Deep brain stimulation; Disorders; Eye; Eye movements; Human motion; Neurodegenerative diseases; Neurological diseases; Neurological disorders; Oculomotor system; Parkinson's disease; parkinsonism; Patients; Review; saccade; Saccadic eye movements; saccade; cerebral cortex; basal ganglia; ataxia; parkinsonism; cerebellum
• ISSN: 0386-2208; 1349-2896; 1349-2896
• DOI: 10.2183/pjab.93.049

Non-invasive and readily implemented in the clinical setting, eye movement studies have been conducted extensively not only in healthy human subjects but also in patients with neurological disorders. The purpose of saccade studies is to “read out” the pathophysiology underlying neurological disorders from the saccade records, referring to known primate physiology. In the current review, we provide an overview of studies in which we attempted to elucidate the patterns of saccade abnormalities in over 250 patients with neurological disorders, including cerebellar ataxia and brainstem pathology due to neurodegenerative disorders, and what they tell about the pathophysiology of patients with neurological disorders. We also discuss how interventions, such as deep brain stimulation, affect saccade performance and provide further insights into the workings of the oculomotor system in humans. Finally, we argue that it is important to understand the functional significance and behavioral correlate of saccade abnormalities in daily life, which could require eye tracking methodologies to be performed in settings similar to daily life.