Z. Kapoula

Binocular coordination of saccades in 7 years old children in single word reading and target fixation

The purpose of the present study was to examine in 7 years old normal children who just learnt to read, saccade and fixation characteristics during reading single words. Eight children were studied and their results were compared to those of eight normal adults doing the same task. For each group word reading data were also compared with data in a task requiring saccades and fixations to target-LEDs. Horizontal saccades from both eyes were recorded with a photoelectric device (Oculometer, Bouis). Latencies of saccades both to words and to LEDs presented at predictable location were similar, and they were also similar between children and adults. In contrast, disconjugacy of saccades was significantly increased for children and similar in the two tasks (LEDs or words). Disconjugate post-saccadic drift and its velocity were also significantly higher in children and similar in the two tasks. Substantial conjugate leftward drift was present for children only, and for the word task only. Finally, fixation duration on words was significantly longer in children than in adults. We conclude that binocular coordination and fixation stability is poor in children and that it could be partially responsible for the long fixation duration. Binocular coordination does not depend on the task (LEDs or words) neither for adults, nor for children; this contrasts prior reports.

Effects of a two-diopter vertical prism on posture.

Postural control in upright stance requires the central integration of visual, vestibular, somatosensory (as cutaneous receptors) and proprioceptive (as joint receptors) inputs. Clinical studies seem to indicate an association between vertical heterophoria (VH) and balance control. The purpose of the study was to simulate a VH and examine its influence on body stabilisation in quiet stance. We studied 15 healthy subjects (25.6+/-3.0 years). The postural stability was measured with a platform under the following conditions: normal viewing, with a two-diopter prism base down placed on the dominant eye (PDE) or the non-dominant eye (PNDE). Both eyes were open in all conditions. All conditions were run at two distances: 200 and 40 cm. The results showed: (i) PNDE increased the antero-posterior body sway for both distances; this result could be related to sensory processing of disparity and/or to inappropriate eye movement response to the disparity induced by the prism; (ii) PDE improved the postural stability only at far distance (reduction of the center-of-pressure excursion area and of the lateral body sway). Such positive result could be due to appropriate sensory processing of disparity and/or eye movement response; the latter would reduce vertical disparity and modify the dynamic and tonic eye muscle activity relative to normal viewing at far distance. We conclude that: (i) experimentally induced vertical phoria does indeed influence postural control; (ii) vertical prisms, even of small power, can have complex effects, positive or negative, depending on the eye wearing it and at the distance fixated.

Prolongation of latency of horizontal saccades in elderly is distance and task specific.

The present study examined horizontal saccades in healthy subjects: 9 adults (20-32 years) and 10 aged subjects (63-83 years), under gap (fixation target extinguishes prior to target onset) and overlap (fixation stays on after target onset). The gap paradigm is known to promote fast initiation of saccades while the overlap paradigm promotes voluntary saccades with longer latency. In real life we perform saccades at various distances. In this study each paradigm was run at three viewing distances-20, 40 and 150 cm, corresponding to a convergence angle of 17.1 degrees, 8.6 degrees and 2.3 degrees, respectively. Eye movements were recorded with the Chronos video eye tracker or with the photoelectric IRIS. The main findings are: (i) increase in latency of saccades with age, with distance and with the overlap condition; (ii) evidence for interaction between these factors, indicating the following anomaly: in the gap condition and at near, aged subjects show short latencies similar to those of young adults; (iii) express type of latencies (between 80 and 120 ms) occur most frequently at near in the gap condition and at similar rates in young (25%) and aged subjects (20%). The specificity of close distance combined with the gap for triggering short latency saccades could be related to both attention and oculomotor fixation disengagement. The strength of coupling between fixation-eye movement control and visual attention control varies for different locations in space, and its decline with aging can be also different.

Aging does not affect the accuracy of vertical saccades nor the quality of their binocular coordination: A study of a special elderly group

Fine binocular coordination of vertical saccades is a complex process requiring appropriate distribution of innervations to all six extraocular muscles. Loss of such coordination causes vertical binocular disparities that are particularly bothersome. We studied the quality of binocular control of vertical saccades in healthy subjects, 11 young adults (20-28 years) and 11 elderly adults (63-75 years). We used LED targets at 7.5 degrees or 15 degrees from the center (fixation), up or down in four conditions: gap and overlap tasks, each done at two distances--near (40 cm) and far (150 cm). Vertical eye movements were recorded with video-oculography (CHRONOS). The results showed: aged subjects performed vertical saccades as accurately as young subjects. Importantly, the binocular coordination of vertical saccades was well preserved in the elderly; the mean difference of vertical saccades between the two eyes was 0.10 degrees and 0.09 degrees in young and elderly subjects, respectively. Upward saccades were associated with divergence, downward ones with convergence. This secondary phenomenon was also the same and of the similar amplitude for young (1.30 degrees ) and elderly (1.25 degrees) subjects. Thus, despite its complexity, the quality of binocular coordination of vertical saccades remains intact with age. The other observations are mostly dependent of several aspects on the direction (up/down), viewing distances and eccentricities; the horizontal vergence during or after vertical saccades was found to be larger for downward saccades than for upward saccades, for saccades at far distance than at close, and for the more eccentric targets (15 degrees versus 7.5 degrees). All these phenomena are the same for both young and elderly subjects. We conclude that the accuracy and the binocular coordination of vertical saccades, at least for target steps less than 15 degrees , are preserved in elderly subjects <75 years who maintain good physical and intellectual form. The data are consistent with the idea of the existence of non-aging system function in the human CNS.

Transcranial magnetic stimulation of the posterior parietal cortex delays the latency of both isolated and combined vergence–saccade movements in humans

To explore the 3D visual environment most frequently we make combined saccade-vergence eye movements. We studied the effect of transcranial magnetic stimulation (TMS) of the right posterior parietal cortex (rPPC) on such combined eye movements versus isolated saccade and vergence. In the main experiment, TMS was applied on the rPPC 80, 90 or 100 ms after target onset. In a control experiment, TMS was applied over the primary motor cortex at 90 ms after the target presentation. TMS trials were compared with no-TMS trials. TMS of the motor cortex had no effect at all on eye movements. TMS of the rPPC had no effect on the accuracy of eye movements, but it caused a latency increase: the increase was similar for the two components of the combined saccade-vergence movements, and it did not alter the naturally existing tight relationship of latency between the two components. Furthermore, the amount of latency prolongation was similar to that of isolated vergence, and of saccades in either direction (ipsilateral or contralateral relative to the stimulated site). Latency prolongation was time-specific but in a different way for different types of eye movements: for combined and convergence eye movements, the critical time window was -130 ms or more prior to the onset of eye movement, while for saccades and divergence TMS was disruptive later, -110 ms or more prior to the onset of eye movements. The latency increase is attributed to the interference by the TMS with the fixation disengagement process, for which the rPPC is believed to be instrumental. These results suggest that fixation disengagement occurs earlier for convergence and combined eye movements than for saccades and divergence.

Vergence and Standing Balance in Subjects with Idiopathic Bilateral Loss of Vestibular Function

There is a natural symbiosis between vergence and vestibular responses. Deficits in vergence can lead to vertigo, disequilibrium, and postural instability. This study examines both vergence eye movements in patients with idiopathic bilateral vestibular loss, and their standing balance in relation to vergence. Eleven patients participated in the study and 16 controls. Bilateral loss of vestibular function was objectified with many tests; only patients without significant response to caloric tests, to video head impulse tests and without vestibular evoked myogenic potentials were included in the study. Vergence testing (from 8 patients and 15 controls) A LED display with targets at 20, 40, and 100 cm along the median plane was used to elicit vergence eye movements, recorded with the IRIS device. Standing balance (11 patients and 16 controls) Four conditions were run, each lasting 1 min: fixation of a LED at 40 cm (convergence of 9°), at 150 cm (convergence of 2.3°); this last condition was repeated with eyes closed. Comparison of the eyes closed-eyes open conditions at 150 cm allowed evaluation of the Romberg Quotient. In the forth condition, two LEDS, at 20 and at 100 cm, were light on, one after the other for 1 sec, causing the eyes to converge then diverge. Standing balance was recorded with an accelerometer placed at the back near the center of mass (McRoberts, Dynaport). Results Vergence Relative to controls, convergence eye movements in patients showed significantly lower accuracy, lower mean velocity, and saccade intrusions of significantly higher amplitude. Balance The normalized 90% area of body sway was significantly higher for patients than for controls for all conditions. Yet, similarly to controls, postural stability was better while fixating at near (sustained convergence) than at far, or while making active vergence movements. We argue that vestibular loss deteriorates convergence, but even deficient, convergence can be helpful for postural control.

How the Brain Obeys Hering's Law: A TMS Study of the Posterior Parietal Cortex

PURPOSE Human ocular saccades are not perfectly yoked; the origin of this disconjugacy (muscular versus central) remains controversial. The purpose of this study was to test a cortical influence on the binocular coordination of saccades. METHODS The authors used a gap paradigm to elicit vertical or horizontal saccades of 10 degrees , randomly interleaved; transcranial magnetic stimulation (TMS) was applied on the posterior parietal cortex (PPC) 100 ms after the target onset. RESULTS TMS of the left or right PPC increased (i) the misalignment of the eyes during the presaccadic fixation period; (ii) the size difference between the saccades of the eyes, called disconjugacy; the increase of disconjugacy was significant for rightward and downward saccades after TMS of the right PPC and for downward saccades after TMS of the left PPC. CONCLUSIONS The authors conclude that the PPC is actively involved in maintaining eye alignment during fixation and in the control of binocular coordination of saccades.

Latency of saccades, vergence, and combined movements in children with early onset convergent or divergent strabismus

The goal of this study was to examine latency of horizontal eye movements in the natural space (saccades, vergence, and combined saccade-vergence movements) in children with early onset convergent or divergent strabismus. Ten children were tested (8-11 years old): three with divergent strabismus, seven with convergent strabismus. A paradigm was used to elicit pure lateral saccades at far and near distance, pure vergence (convergence and divergence) and saccades combined with vergence movements. Horizontal eye movements from both eyes were recorded simultaneously by a photoelectric device (Oculometer, Dr. Bouis). The latency of saccades (at far and near distance), of vergence (convergence and divergence), and of combined movements greatly varies among subjects and has tendency to be longer than that observed in normal children of matched age, however, these differences reach significance in only a few cases. Children with divergent strabismus and residual gross binocular vision show abnormally longer vergence latencies than children with convergent strabismus without binocular vision. The initiation of combined movements does not show a dominant pattern, such as preceding vergence, as is found in normal children. Finally, strabismus surgery has no major effect on latencies. We conclude that there is no overall deficiency in latencies of eye movements in 3D space in children with early onset strabismus. Most likely, monocular visual input can be efficient as normal binocular vision for vergence movements. In a few subjects with divergent strabismus and fragile, intermittent binocular vision, latencies can be abnormally long, just because of the fragile binocular input and/or attention effort needs to use it. The absence of a pattern of initiation similar to normal children could be due to attention and fixation capabilities.

Postural Control during the Stroop Test in Dyslexic and Non Dyslexic Teenagers

Postural control in quiet stance although simple still requires some cognitive resources; dual cognitive tasks influence further postural control. The present study examines whether or not dyslexic teenagers experience postural instability when performing a Stroop dual task for which their performances are known to be poor. Fifteen dyslexics and twelve non-dyslexics (14 to 17 years old) were recruited from the same school. They were asked to perform three tasks: (1) fixate a target, (2) perform an interference Stroop test (naming the colour or the word rather than reading the word), (3) performing flexibility Stroop task: the subject performed the interference task as in (2) except when the word was in a box, in which case he had to read the word. Postural performances were measured with a force platform. The results showed a main task effect on the variance of speed of body sway only: such variance was higher in the flexibility task than for the other two tasks. No group effect was found for any of the parameters of posture (surface, mediolateral and anteroposterior sway, variance of speed). Further wavelet analysis in the time-frequency domain revealed an increase in the spectral power of the medium frequency range believed to be related to cerebellum control; an accompanying increase in the cancellation time of the high frequency band related to reflexive loops occurred for non-dyslexics only. These effects occurred for the flexibility task and could be due to its high cognitive difficulty. Dyslexics displayed shorter cancellation time for the medium frequency band for all tasks, suggesting less efficient cerebellar control, perhaps of eye fixation and attention influencing body sway. We conclude that there is no evidence for a primary posture deficit in 15 year old teenagers who come from the general population and who were recruited in schools.

Normal Speed and Accuracy of Saccade and Vergence Eye Movements in Dyslexic Reader Children

Objective. Latency of eye movements depends on cortical structures while speed of execution and accuracy depends mostly on subcortical brainstem structures. Prior studies reported in dyslexic reader children abnormalities of latencies of saccades (isolated and combined with vergence); such abnormalities were attributed to deficits of fixation control and of visual attention. In this study we examine speed and accuracy characteristics of horizontal eye movements in natural space (saccades, vergence and combined movements) in dyslexic reader children. Methods. Two paradigms are tested: gap paradigm (fixation offset 200 ms prior to target onset), producing shorter latencies, in both non-dyslexic reader and dyslexic reader children and simultaneous paradigm. Seventeen dyslexic reader children (mean age: 12 ± 0.08 years) and thirteen non-dyslexic reader children (mean age: 12 ± 1 years) were tested. Horizontal eye movements from both eyes were recorded simultaneously by a photoelectric device (Oculometer, Dr. Bouis). Results. For all movements tested (saccades, vergence, isolated or combined) and for both paradigms, the mean velocity and accuracy were similar in dyslexic readers and non-dyslexic readers; no significant difference was found. Conclusion. This negative but important result, suggests no dysfunction of brainstem ocular motor circuits in dyslexic readers. It contrasts results on latencies related to visual attention dysfunction at cortical level.