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A relative preservation of eye movements is notable in ALS, but saccadic functions have not been studied longitudinally. ALS overlaps with FTD, typically involving executive dysfunction, and eye-tracking offers additional potential for the assessment of extramotor pathology where writing and speaking are both impaired. Eye-tracking measures (including anti-saccade, trail-making and visual search tasks) were assessed at six-monthly intervals for up to two years in a group of ALS (n = 61) and primary lateral sclerosis (n = 7) patients, compared to healthy age-matched controls (n = 39) assessed on a single occasion. Task performance was explored speculatively in relation to resting-state functional MRI (R-FMRI) network connectivity. Results showed that ALS patients were impaired on executive and visual search tasks despite normal basic saccadic function, and impairments in the PLS patients were unexpectedly often more severe. No significant progression was detected longitudinally in either group. No changes in R-FMRI network connectivity were identified in relation to patient performance. In conclusion, eye-tracking offers an objective means to assess extramotor cerebral involvement in ALS. The relative resistance of pure oculomotor function is confirmed, and higher-level executive impairments do not follow the same rate of decline as physical disability. PLS patients may have more cortical dysfunction than has been previously appreciated.

Original publication

DOI

10.3109/21678421.2015.1054292

Type

Journal article

Journal

Amyotroph Lateral Scler Frontotemporal Degener

Publication Date

2015

Volume

17

Pages

101 - 111

Keywords

Motor neuron disease, anti-saccade, cognitive, eye-tracking, magnetic resonance imaging, saccade, trail making, Adult, Aged, Amyotrophic Lateral Sclerosis, Cognition, Cognition Disorders, Eye Movement Measurements, Female, Humans, Longitudinal Studies, Male, Middle Aged, Oculomotor Nerve Diseases, Reproducibility of Results, Saccades, Sensitivity and Specificity