Pervasive Ocular Tremor in Patients With Parkinson Disease

Gitchel, George T.; Wetzel, Paul A.; Baron, Mark S.

doi:10.1001/archneurol.2012.70

Cited by 64 publications

(70 citation statements)

References 23 publications

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“…Recent controversy has arisen over the report of ocular tremor in Parkinson’s disease (PD) patients by Gitchel et al[69] They report a pervasive ocular tremor with an average fundamental frequency of 5–6 Hz and mean horizontal amplitude of 0.27 degrees. This tremor was reported in all 112 patients in the study, hence it was deemed pervasive, and it was suggested that further investigations could lead to use of this ocular tremor as an early diagnostic marker for PD.…”

Section: Ocular Tremor In Parkinson’s Diseasementioning

confidence: 99%

Acquired pendular nystagmus

Kang¹,

Shaikh²

2017

Journal of the Neurological Sciences

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Acquired pendular nystagmus is comprised of quasi-sinusoidal oscillations of the eyes significantly affecting gaze holding and clarity of vision. The most common causes of acquired pendular nystagmus include demyelinating disorders such as multiple sclerosis and the syndrome of ocular palatal tremor. However, several other deficits, such as pharmacological intoxication, metabolic and genetic disorders, and granulomatous disorders can lead to syndromes mimicking acquired pendular nystagmus. Study of the kinematic features of acquired pendular nystagmus has suggested a putative pathophysiology of an otherwise mysterious neurological disorder. Here we review clinical features of neurological deficits that co-occur with acquired pendular nystagmus. Subsequent discussion of the pathophysiology of individual forms of pendular nystagmus speculates on mechanisms of the underlying disease while providing insights into pharmacotherapy of nystagmus.

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Section: Ocular Tremor In Parkinson’s Diseasementioning

confidence: 99%

Acquired pendular nystagmus

Kang¹,

Shaikh²

2017

Journal of the Neurological Sciences

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“…Gitchel and colleagues studied the eye movements of 112 patients with idiopathic PD during steady fixation (15). They identified a continuous oscillatory fixation instability that they termed “pervasive ocular tremor” in every PD patient.…”

Section: “Pervasive Ocular Tremor” In Pdmentioning

confidence: 99%

“…The oscillations had an average fundamental frequency of 5.7 Hz (i.e., within the range of the limb tremor in PD; 4–7 Hz), a mean horizontal amplitude of 0.27°, and mean vertical amplitude of 0.33°. The tremor persisted for the duration of the recording, although the waveform characteristics were variable (15). Figure 1 taken from the original manuscript shows a typical 1.2 s recording of the ocular tremor.…”

Section: “Pervasive Ocular Tremor” In Pdmentioning

confidence: 99%

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Ocular Tremor in Parkinson’s Disease: Discussion, Debate, and Controversy

Kaski

Bronstein

2017

Front. Neurol.

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The identification of ocular tremor in a small cohort of patients with Parkinson’s disease (PD) had lay somewhat dormant until the recent report of a pervasive ocular tremor as a universal finding in a large PD cohort that was, however, generally absent from a cohort of age-matched healthy subjects. The reported tremor had frequency characteristics similar to those of PD limb tremor, but the amplitude and frequency of the tremor did not correlate with clinical tremor ratings. Much controversy ensued as to the origin of such a tremor, and specifically as to whether a pervasive ocular tremor was a fundamental feature of PD, or rather a compensatory eye oscillation secondary to a transmitted head tremor, and thus a measure of a normal vestibulo-ocular reflex. In this mini review, we summarize some of the evidence for and against the case for a pervasive ocular tremor in PD and suggest future experiments that may help resolve these conflicting opinions.

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“…Fixational eye movements are characteristically unstable in PD, with more frequent small saccadic intrusions and tremor than in healthy controls. 24,25 Larger-amplitude square-wave jerks-saccades of similar magnitude, going into opposite directions, separated by a brief time interval-have particularly been found in patients with progressive supranuclear palsy (PSP) and other Parkinsonian movement disorders, 24,26,27 but also in PD patients.…”

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confidence: 99%

Visual Contrast Sensitivity in Early-Stage Parkinson's Disease

Ming

Palidis

Spering

et al. 2016

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. Visual impairments are frequent in Parkinson's disease (PD) and impact normal functioning in daily activities. Visual contrast sensitivity is a powerful nonmotor sign for discriminating PD patients from controls. However, it is usually assessed with static visual stimuli. Here we examined the interaction between perception and eye movements in static and dynamic contrast sensitivity tasks in a cohort of mildly impaired, early-stage PD patients. METHODS.Patients (n ¼ 13) and healthy age-matched controls (n ¼ 12) viewed stimuli of various spatial frequencies (0-8 cyc/deg) and speeds (08/s, 108/s, 308/s) on a computer monitor. Detection thresholds were determined by asking participants to adjust luminance contrast until they could just barely see the stimulus. Eye position was recorded with a videobased eye tracker. RESULTS.Patients' static contrast sensitivity was impaired in the intermediate spatial-frequency range and this impairment correlated with fixational instability. However, dynamic contrast sensitivity and patients' smooth pursuit were relatively normal. An independent component analysis revealed contrast sensitivity profiles differentiating patients and controls.CONCLUSIONS. Our study simultaneously assesses perceptual contrast sensitivity and eye movements in PD, revealing a possible link between fixational instability and perceptual deficits. Spatiotemporal contrast sensitivity profiles may represent an easily measurable metric as a component of a broader combined biometric for nonmotor features observed in PD.

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Pervasive Ocular Tremor in Patients With Parkinson Disease

Cited by 64 publications

References 23 publications

Acquired pendular nystagmus

Acquired pendular nystagmus

Ocular Tremor in Parkinson’s Disease: Discussion, Debate, and Controversy

Visual Contrast Sensitivity in Early-Stage Parkinson's Disease

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