Abstract Details

Title Oculomotor Changes in Multiple System Atrophy: Clinical, MRI and Laboratory Features in Seven Patients

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) P06 - (-)

Poster/Presentation
Number 014

Objective

Background BACKGROUND: MSA is a progressive ?-synnucleinopathy presenting dysautonomia variably associated with cerebellar symptoms (MSA-C) or parkinsonism (MSA-P). Oculomotor changes have been described including saccade dysmetria, saccadic intrusions, nystagmus, abnormal pursuit and VOR.

Design/Methods DESIGN/METHODS: Seven patients, five with MSA-C and two with MSA-P were recorded collecting demographic data and clinical history. Eye movements were recorded using a video-based eye tracking system. Reflexive and voluntary visually-guided saccade of (±10[deg]and 18[deg]) and vertical (up/down 8.5[deg]) of eccentricity were tested. Three minutes of steady fixation were recorded. Quantitative analysis of saccade duration, amplitude, peak velocity, mean velocity, latence, gain, and accuracy were performed for reflexive saccades. Error in direction and spontaneous corrections were also evaluated for voluntary saccades. Saccadic performances were compared with EVAlab's normative data. The main sequence relationships were assessed. Frequency, range of amplitude, range of intersaccadic interval and velocity of saccadic intrusions were considered.

Results RESULTS: All patients showed a significant reduction of peak velocity (255±35 ms vs 300±56,6 ms; p=0,0059), amplitude (7,2[deg]±1,6[deg] vs 8,3[deg]±0,09[deg]; p=0,0170) and accuracy (2,26±1,78 vs 1,17±0,49; p=0,0012) of vertical saccades. Amplitude at 18[deg] of horizontal eccentricity (15,68[deg]±4,67[deg] vs 18,3[deg]±0,9[deg]; p<0,0001) and accuracy at 10[deg] (1,75±2,54 vs 0,88±0,52; p=0,0009) and 18[deg] (2,86±4,74 vs 1,22±0,09; p=0,0007) of horizontal saccades were also abnormal. The direction error in antisaccade task was about 45% with a 96% of spontaneous fast correction. Fixation was interrupted by square wave jerks (average number of 16/min and mean amplitude of 1.5[deg]).

Conclusions CONCLUSIONS: Relevant changes of saccade dynamics. Vertical saccades are more impaired than horizontal saccades. Voluntary saccades and fixation are also impaired but less than other similar neurodegenerative diseases. The oculomotor profile helps to differentiate MSA from other neurodegenerative diseases with overlapping clinical features and may facilitate diagnosis.

Authors/Disclosures
PRESENTER	No disclosure on file
Francesca Rosini, MD (Neurological, Neurosurgical and Behavioural Sciences)	No disclosure on file
Pamela Federighi (University of Siena)	No disclosure on file
	No disclosure on file
	No disclosure on file
Antonio Federico, MD, Prof (Dipartimento Medicina, Chirurgia E Neuroscienze)	No disclosure on file
Alessandra Rufa, MD, PhD (Neurosciences University of Siena)	No disclosure on file

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