Eye movement abnormalities in essential tremor versus tremor dominant Parkinson's disease

Clin Neurophysiol. 2019 May;130(5):683-691. doi: 10.1016/j.clinph.2019.01.026. Epub 2019 Feb 23.

Abstract

Objective: To show that eye movement abnormalities differ between essential tremor (ET) and tremor dominant Parkinson's disease (PD-T), and that these abnormalities reflect cerebellar dysfunction in ET and basal ganglia pathology in PD-T.

Methods: In this exploratory study, in 23 patients with ET, 21 age-matched patients with PD-T, and 19 age-matched healthy controls (HCs), we investigated visually guided saccades, antisaccades, and smooth pursuit eye movements (SPEM).

Results: While the ET group had a normal gain (saccade amplitude/target amplitude) and latency of saccades, the PD-T group had hypometric visually guided saccades, and a prolonged latency of visually guided saccades and antisaccades. The SPEM gain was similarly low in both ET and PD-T and was significantly lower in both patient groups than in the HC group.

Conclusions: In ET, SPEM gain was reduced in the presence of normal saccades, whereas in PD-T, the reduced SPEM gain was accompanied by delayed saccade initiation and hypometric saccades, in line with cerebellar dysfunction in ET and basal ganglia dysfunction in PD-T.

Significance: These findings support the presumed cerebellar pathology in ET. In addition, the difference in saccade features may contribute to the groundwork for a quantitative diagnostic test to differentiate between these disorders.

Keywords: Basal ganglia; Cerebellum; Essential tremor; Eye movements; Parkinson's disease.

MeSH terms

  • Aged
  • Basal Ganglia / physiopathology*
  • Cerebellum / physiopathology*
  • Diagnosis, Differential
  • Essential Tremor / diagnosis*
  • Essential Tremor / physiopathology
  • Eye Movement Measurements
  • Eye Movements / physiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / physiopathology
  • Tremor / diagnosis*
  • Tremor / physiopathology