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Brain, Vol. 117, No. 6, 1423-1432, 1994
© 1994 Guarantors of Brain


research-article

Vestibular, cervical and visual remembered saccades in Parkinson's disease

T. Nakamura*, A. M. Bronstein, C. Lueck, C. D. Marsden and P. Rudge

MRC Human Movement and Balance Unit, Institute of Neurology, National Hospital for Neurology and Neurosurgery London, UK

Correspondence to: Correspondence to: Dr Adolfo Bronstein, MRC HMBU Section of Neuro-Otology, National Hospital for Neurology and Neurosurgery, Queen Square, London WCIN 3BG, UK

In order to assess both vestibulo-cervical perception of head rotation and saccadic function in Parkinson's disease, 14 patients with idiopathic Parkinson's disease were subjected to discrete sigmoid-shaped rotational displacements whilst fixating a target aligned with primary gaze in an otherwise dark room. The rotational stimuli were applied to (i) the whole body (vestibular stimulus); (ii) the trunk whilst the head remained stationary in space (cervical stimulus); (Hi) to the head alone whilst the trunk remained stationary (combined vestibular and cervical stimulus). The fixation target was then extinguished and the subjects had to estimate the angle travelled by the head or trunk with an ocular-pointing task, using information from the preceding rotational stimulus (vestibular and cervical ‘remembered’ saccades). It was found that, although these saccades in Parkinson's disease patients were multiple-step and hypometric, the final position of the eyes matched the rotational stimulus as accurately as in normal subjects. A complementary experiment in six patients showed that visual remembered saccades were hypometric, but significantly less so than vestibular remembered saccades. It is concluded that (i) vestibular and cervical perception of head/neck rotation is normal in Parkinson's disease; (ii) abnormalities of ‘remembered’ saccades, previously reported in Parkinson's disease, are not confined to the visual modality but involve other sensory modalities as well; (Hi) across different modalities of memory-guided saccades, visual input improves saccadic performance. This result demonstrates that the known increased visual dependence found in Parkinson's disease extends to memory-driven tasks.

Parkinson's disease; saccades; vestibular; visual; memory

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Received March 17, 1994. Revised May 17, 1994. Accepted July 19, 1994.


*Present address: ENT Department, Yamagata University Medical School, Yamagata, Japan


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