Session Information
Date: Monday, June 20, 2016
Session Title: Parkinsonism, MSA, PSP (secondary and parkinsonism-plus)
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To determine peculiar changes in oculomotor profile that may help in distinguishing atypical parkinsonism with overlapping clinical features.
Background: Atypical Parkinsonian disorders (APDs) include a-synucleinopathies [such as multiple system atrophy (cerebellar (MSA-C) or Parkinsonian (MSA-P) subtypes], and tauopathies [progressive supranuclear palsy (PSP), or corticobasal degeneration (CBD)]. APDs are characterized by progressive and levodopa-refractory parkinsonism associated with distinctive atypical features. Oculomotor abnormalities such as saccade dysmetria, increased latency, saccadic intrusions, nystagmus and vertical gaze palsy are often described in APDs with inconstant specificity.
Methods: We recorded the eye movements of eight patients with MSA-C (mean age 57.5±6,3 years-old), four with MSA-P (58.5±6,2), five with PSP (72±6,7) and three with CBD (62±14). Horizontal (±10°and 18°) and vertical (up/down 8°) visually-guided saccades and antisaccades were tested and compared with EVAlab’s normative data. Three minutes of steady fixation were recorded. Standard saccadic parameters, antisaccade errors with relative corrections and fixation changes were evaluated.
Results: MSA-C showed fast and dysmetric (often hypermetric) horizontal saccades. MSA-P exhibited horizontal and vertical saccadic hypometria. Very slow and fragmented horizontal and, mostly, vertical saccades were typical in PSP. CBD showed increase of latency, slowness and hypometria of eye movements. PSP and CBD exhibited the higher number of antisaccade errors, with the lowest percentage of spontaneous error corrections in CBD. Steady fixation was interrupted by sporadic saccadic intrusions in all groups, with the lowest frequency in CBD.
Conclusions: Our findings testify the presence of peculiar oculomotor abnormalities in APDs. Slowing of all ocular movements is the hallmark in PSP patients; loss of accuracy with preserved velocity is typical in MSA, particularly MSA-C. Performance on voluntary saccades is more impaired in CBD group than MSA, suggesting a greater cortical impairment.
I Congress of the European Academy of Neurology, helded in Berlin on 20-23 June 2015.
To cite this abstract in AMA style:
F. Rosini, G. Lucii, P. Federighi, E. Pretegiani, F. Giannini, R. Rocchi, A. Federico, A. Rufa. Atypical Parkinsonian disorders: Insights for a differential diagnosis through the analysis of oculomotor profile in MSA, PSP and CBD patients [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/atypical-parkinsonian-disorders-insights-for-a-differential-diagnosis-through-the-analysis-of-oculomotor-profile-in-msa-psp-and-cbd-patients/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/atypical-parkinsonian-disorders-insights-for-a-differential-diagnosis-through-the-analysis-of-oculomotor-profile-in-msa-psp-and-cbd-patients/