Brain, Vol 121, Issue 6 1165-1183, Copyright © 1998 by Oxford University Press
JJ Barton and JA Sharpe
The relationship of sinusoidal smooth pursuit defects to pursuit defects
with step-ramp targets in patients with cerebral lesions is unclear. We
examined pursuit and saccades to both step-ramp and sinusoidal targets in
17 patients with unilateral cerebral lesions. Two types of pursuit defects
were found. One group of three patients had ipsi-directional sinusoidal
pursuit defects from lesions to the posterior internal capsule. Their chief
abnormality with step-ramp targets was increased contra-directional
pursuit. Their ipsi- directional step-ramp pursuit was often normal and
disproportionately better than their ipsi-directional sinusoidal pursuit.
Another patient with a parietal lesion had a second type of pursuit defect.
He had low- normal sinusoidal pursuit bilaterally, but decreased ipsi- and
contra- directional step-ramp pursuit. Also, he had an abnormal contra-
directional drift after saccades to stationary targets. Despite these
pursuit defects, saccadic accuracy did not show poor compensation for
target motion in either patient type. The patient with the parietal lesion
also had increased latencies for contralateral saccades. Recovery of
pursuit was studied in one patient with an infarct of the posterior
internal capsule. Initially he had a contra-directional bias that caused
decreased ipsi-directional pursuit, increased contra- directional pursuit,
and a contra-directional drift after saccades to stationary targets. Four
months later, ipsi-directional pursuit and the post-saccadic drift to
stationary targets had recovered, but contra- directional pursuit remained
abnormally high. We conclude that lesions of descending pursuit tracts in
the internal capsule are characterized by a contra-directional bias which
recovers partly through a direction- specific adaptation. Lesions that
affect the human homologue of posterior parietal cortex cause asymmetric
bi-directional defects in pursuit initiation and increased contralateral
saccadic latencies.
ARTICLES
Ocular tracking of step-ramp targets by patients with unilateral cerebral lesions
Division of Neurology, Toronto Hospital, University of Toronto, Canada. jbarton@bidmc.harvard.edu
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