Impairment of smooth pursuit as a marker of early multiple sclerosis

Nathaniel Lizak, Meaghan Clough, Lynette Millist, Tomas Kalincik, Owen B. White, Joanne Fielding

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Multiple sclerosis (MS) is a diffuse disease that disrupts wide-ranging cerebral networks. The control of saccades and smooth pursuit are similarly dependent upon widespread networks, with the assessment of pursuit offering an opportunity to examine feedback regulation. We sought to characterize pursuit deficits in MS and to examine their relationship with disease duration.
Methods: Twenty healthy controls, 20 patients with a clinically isolated syndrome (CIS), and 40 patients with clinically definite MS (CDMS) participated. Thirty-six trials of Rashbass’ step–ramp paradigm of smooth pursuit, evenly split by velocity (8.65°, 17.1°, and 25.9°/s) and ramp direction (left/right), were performed. Four parameters were measured: latency of pursuit onset, closed-loop pursuit gain, number of saccades, and summed saccade amplitudes during pursuit. For CDMS patients, these were correlated with disease duration and Expanded Disability Status Scale (EDSS) score.
Results: Closed-loop pursuit gain was significantly lower in CIS than controls at all speeds. CDMS gain was lower than controls at medium pursuit velocity. CDMS patients also displayed longer pursuit latency than controls at all velocities. All patients accumulated increased summed saccade amplitudes at slow and medium pursuit speeds, and infrequent high-amplitude saccades at the fast speed. No pursuit variable significantly correlated with EDSS or disease duration in CDMS patients.
Conclusion: Smooth pursuit is significantly compromised in MS from onset. Low pursuit gain and increased saccadic amplitudes may be robust markers of disseminated pathology in CIS and in more advanced MS. Pursuit may be useful in measuring early disease.
Original languageEnglish
Article number206
Number of pages7
JournalFrontiers in Neurology
Volume7
DOIs
Publication statusPublished - 21 Nov 2016

Keywords

  • multiple sclerosis
  • smooth pursuit
  • clinically isolated syndrome
  • ocular motor system
  • neuro-ophthalmology

Cite this

@article{13bd90c2aa564b40a0d081f37d9f2e27,
title = "Impairment of smooth pursuit as a marker of early multiple sclerosis",
abstract = "Background: Multiple sclerosis (MS) is a diffuse disease that disrupts wide-ranging cerebral networks. The control of saccades and smooth pursuit are similarly dependent upon widespread networks, with the assessment of pursuit offering an opportunity to examine feedback regulation. We sought to characterize pursuit deficits in MS and to examine their relationship with disease duration.Methods: Twenty healthy controls, 20 patients with a clinically isolated syndrome (CIS), and 40 patients with clinically definite MS (CDMS) participated. Thirty-six trials of Rashbass’ step–ramp paradigm of smooth pursuit, evenly split by velocity (8.65°, 17.1°, and 25.9°/s) and ramp direction (left/right), were performed. Four parameters were measured: latency of pursuit onset, closed-loop pursuit gain, number of saccades, and summed saccade amplitudes during pursuit. For CDMS patients, these were correlated with disease duration and Expanded Disability Status Scale (EDSS) score.Results: Closed-loop pursuit gain was significantly lower in CIS than controls at all speeds. CDMS gain was lower than controls at medium pursuit velocity. CDMS patients also displayed longer pursuit latency than controls at all velocities. All patients accumulated increased summed saccade amplitudes at slow and medium pursuit speeds, and infrequent high-amplitude saccades at the fast speed. No pursuit variable significantly correlated with EDSS or disease duration in CDMS patients.Conclusion: Smooth pursuit is significantly compromised in MS from onset. Low pursuit gain and increased saccadic amplitudes may be robust markers of disseminated pathology in CIS and in more advanced MS. Pursuit may be useful in measuring early disease.",
keywords = "multiple sclerosis, smooth pursuit, clinically isolated syndrome, ocular motor system, neuro-ophthalmology",
author = "Nathaniel Lizak and Meaghan Clough and Lynette Millist and Tomas Kalincik and White, {Owen B.} and Joanne Fielding",
year = "2016",
month = "11",
day = "21",
doi = "10.3389/fneur.2016.00206",
language = "English",
volume = "7",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Media",

}

Impairment of smooth pursuit as a marker of early multiple sclerosis. / Lizak, Nathaniel; Clough, Meaghan; Millist, Lynette; Kalincik, Tomas; White, Owen B.; Fielding, Joanne.

In: Frontiers in Neurology, Vol. 7, 206, 21.11.2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Impairment of smooth pursuit as a marker of early multiple sclerosis

AU - Lizak, Nathaniel

AU - Clough, Meaghan

AU - Millist, Lynette

AU - Kalincik, Tomas

AU - White, Owen B.

AU - Fielding, Joanne

PY - 2016/11/21

Y1 - 2016/11/21

N2 - Background: Multiple sclerosis (MS) is a diffuse disease that disrupts wide-ranging cerebral networks. The control of saccades and smooth pursuit are similarly dependent upon widespread networks, with the assessment of pursuit offering an opportunity to examine feedback regulation. We sought to characterize pursuit deficits in MS and to examine their relationship with disease duration.Methods: Twenty healthy controls, 20 patients with a clinically isolated syndrome (CIS), and 40 patients with clinically definite MS (CDMS) participated. Thirty-six trials of Rashbass’ step–ramp paradigm of smooth pursuit, evenly split by velocity (8.65°, 17.1°, and 25.9°/s) and ramp direction (left/right), were performed. Four parameters were measured: latency of pursuit onset, closed-loop pursuit gain, number of saccades, and summed saccade amplitudes during pursuit. For CDMS patients, these were correlated with disease duration and Expanded Disability Status Scale (EDSS) score.Results: Closed-loop pursuit gain was significantly lower in CIS than controls at all speeds. CDMS gain was lower than controls at medium pursuit velocity. CDMS patients also displayed longer pursuit latency than controls at all velocities. All patients accumulated increased summed saccade amplitudes at slow and medium pursuit speeds, and infrequent high-amplitude saccades at the fast speed. No pursuit variable significantly correlated with EDSS or disease duration in CDMS patients.Conclusion: Smooth pursuit is significantly compromised in MS from onset. Low pursuit gain and increased saccadic amplitudes may be robust markers of disseminated pathology in CIS and in more advanced MS. Pursuit may be useful in measuring early disease.

AB - Background: Multiple sclerosis (MS) is a diffuse disease that disrupts wide-ranging cerebral networks. The control of saccades and smooth pursuit are similarly dependent upon widespread networks, with the assessment of pursuit offering an opportunity to examine feedback regulation. We sought to characterize pursuit deficits in MS and to examine their relationship with disease duration.Methods: Twenty healthy controls, 20 patients with a clinically isolated syndrome (CIS), and 40 patients with clinically definite MS (CDMS) participated. Thirty-six trials of Rashbass’ step–ramp paradigm of smooth pursuit, evenly split by velocity (8.65°, 17.1°, and 25.9°/s) and ramp direction (left/right), were performed. Four parameters were measured: latency of pursuit onset, closed-loop pursuit gain, number of saccades, and summed saccade amplitudes during pursuit. For CDMS patients, these were correlated with disease duration and Expanded Disability Status Scale (EDSS) score.Results: Closed-loop pursuit gain was significantly lower in CIS than controls at all speeds. CDMS gain was lower than controls at medium pursuit velocity. CDMS patients also displayed longer pursuit latency than controls at all velocities. All patients accumulated increased summed saccade amplitudes at slow and medium pursuit speeds, and infrequent high-amplitude saccades at the fast speed. No pursuit variable significantly correlated with EDSS or disease duration in CDMS patients.Conclusion: Smooth pursuit is significantly compromised in MS from onset. Low pursuit gain and increased saccadic amplitudes may be robust markers of disseminated pathology in CIS and in more advanced MS. Pursuit may be useful in measuring early disease.

KW - multiple sclerosis

KW - smooth pursuit

KW - clinically isolated syndrome

KW - ocular motor system

KW - neuro-ophthalmology

U2 - 10.3389/fneur.2016.00206

DO - 10.3389/fneur.2016.00206

M3 - Article

VL - 7

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 206

ER -