Clinical value of video oculomotor evaluation in the differential diagnosis of multiple system atrophy and Parkinson's disease.

BACKGROUND: Multiple system atrophy (MSA) is a neurodegenerative disease that progresses rapidly and has a poor prognosis. This study aimed to assess the value of video oculomotor evaluation (VOE) in the differential diagnosis of MSA and Parkinson's disease (PD). METHODS: In total, 28 patients with MSA, 31 patients with PD, and 30 age- and sex-matched healthy controls (HC) were screened and included in this study. The evaluation consisted of a gaze-holding test, smooth pursuit eye movement (SPEM), random saccade, and optokinetic nystagmus (OKN). RESULTS: The MSA and PD groups had more abnormalities and decreased SPEM gain than the HC group (64.29%, 35.48%, 10%, p < .001). The SPEM gain in the MSA group was significantly lower than that in the PD group at specific frequencies. Patients with MSA and PD showed prolonged latencies in all saccade directions compared with those with HC. However, the two diseases had no significant differences in the saccade parameters. The OKN gain gradually decreased from the HC to the PD and the MSA groups (p < .05). Compared with the PD group, the gain in the MSA group was further decreased in the OKN test at 30°/s (Left, p = .010; Right p = .016). Receiver operating characteristic curves showed that the combination of oculomotor parameters with age and course of disease could aid in the differential diagnosis of patients with MSA and PD, with a sensitivity of 89.29% and a specificity of 70.97%. CONCLUSIONS: The combination of oculomotor parameters and clinical data may aid in the differential diagnosis of MSA and PD. Furthermore, VOE is vital in the identification of neurodegenerative diseases.

Gaze and attention: Mechanisms underlying the therapeutic effect of optokinetic stimulation in spatial neglect.

Left smooth pursuit eye movement training in response to large-field visual motion (optokinetic stimulation) has become a promising rehabilitation method in left spatial inattention or neglect. The mechanisms underlying the therapeutic effect, however, remain unknown. During optokinetic stimulation, there is an error in visual localisation ahead of the line of sight. This could indicate a change in the brain's estimate of one's own direction of gaze. We hypothesized that optokinetic stimulation changes the brain's estimate of gaze. Because this estimate is critical for coding the locus of attention in the visual space relative to the body and across sensory modalities, its change might underlie the change in spatial attention. Here, we report that in healthy participants optokinetic stimulation causes not only a directional bias in the proprioceptive signal from the extraocular muscles, but also a corresponding shift of the locus of attention. Both changes outlasted the period of stimulation. This result forms a step in investigating a causal link between the adaptation in the sensorimotor gaze signals and the recovery in spatial neglect.

Inhibition functions can be improved in children with autism spectrum disorders: An eye-tracking study.

Cognitive remediation therapy interventions could improve cognitive functioning in subjects with autism. To investigate the benefit of a short cognitive training rehabilitation in children with autism spectrum disorder (ASD) on pursuit and fixation performances. We recruited two groups (G1 and G2) of 30 children with ASD, sex-, IQ- and age-matched (mean 11.6 ± 0.5 years), and pursuit and fixation eye movements were recorded twice at T1 and T2. Between T1 and T2, a 10-min cognitive training was performed by the G1 group only, whereas the G2 group had a 10-min of rest. For all children with ASD enrolled in the study, there was a positive correlation between restricted and repetitive behaviour scores of both Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) and the number of saccades recorded during the fixation task at T1. At T1, oculomotor performances were similar for both groups of ASD children (G1 and G2). At T2, we observed a significant reduction in the number of saccades made during both pursuit and fixation tasks. Our findings underlined the importance to promote cognitive training rehabilitation for children with ASD, leading to a better performance in inhibitory and attention functioning responsible for pursuit and fixation eye movement's performance.

The influence of stimulus and behavioral histories on predictive control of smooth pursuit eye movements.

The smooth pursuit system has the ability to perform predictive feedforward control of eye movements. This study attempted to examine how stimulus and behavioral histories of past trials affect the control of predictive pursuit of target motion with randomized velocities. We used sequential ramp stimuli where the rightward velocity was fixed at 16 deg/s while the leftward velocity was either fixed (predictable) at one of seven velocities (4, 8, 12, 16, 20, 24, or 28 deg/s) or randomized (unpredictable). As a result, predictive pursuit responses were observed not only in the predictable condition but also in the unpredictable condition. Linear mixed-effects (LME) models showed that both stimulus and behavioral histories of the previous two or three trials influenced the predictive pursuit responses in the unpredictable condition. Intriguingly, the goodness of fit of the LME model was improved when both historical effects were fitted simultaneously rather than when each type of historical data was fitted alone. Our results suggest that predictive pursuit systems allow us to track randomized target motion using weighted averaging of the information of target velocity (stimulus) and motor output (behavior) in past time sequences.

The role of frontal pursuit area in interaction between smooth pursuit eye movements and attention: A TMS study.

Close coupling between attention and smooth pursuit eye movements has been widely established and frontal eye field (FEF) is a "hub" region for attention and eye movements. Frontal pursuit area (FPA), a subregion of the FEF, is part of neural circuit for the pursuit, here, we directly checked the role of the FPA in the interaction between the pursuit and attention. To do it, we applied a dual-task paradigm where an attention demanding task was integrated into the pursuit target and interrupted the FPA using transcranial magnetic stimulation (TMS). In the study, participants were required to pursue a moving circle with a letter inside, which changed to another one every 100 ms and report whether "H" (low attentional load) or one of "H," "S," or "L" (high attentional load) appeared during the trial. As expected, increasing the attentional load decreased accuracy of the letter detection. Importantly, the FPA TMS had no effect on both the pursuit and letter detection tasks in the low load condition, whereas it reduced 200 to 320 ms gain, but tended to increase the letter detection accuracy in the high load condition. Moreover, individual's FPA TMS effect on pursuit gain was significantly correlated with that on letter detection accuracy. Presumably, the pursuit gain control by the FPA was compensated by attention in low load condition, and the FPA may flexibly allocate attentional resources between the pursuit and letter detection task in high load condition. Altogether, it seems that the FPA has a control over attentional allocation between tasks.

Expectations about motion direction affect perception and anticipatory smooth pursuit differently.

Smooth pursuit eye movements and visual motion perception rely on the integration of current sensory signals with past experience. Experience shapes our expectation of current visual events and can drive eye movement responses made in anticipation of a target, such as anticipatory pursuit. Previous research revealed consistent effects of expectation on anticipatory pursuit-eye movements follow the expected target direction or speed-and contrasting effects on motion perception, but most studies considered either eye movement or perceptual responses. The current study directly compared effects of direction expectation on perception and anticipatory pursuit within the same direction discrimination task to investigate whether both types of responses are affected similarly or differently. Observers (n = 10) viewed high-coherence random-dot kinematograms (RDKs) moving rightward and leftward with a probability of 50%, 70%, or 90% in a given block of trials to build up an expectation of motion direction. They were asked to judge motion direction of interleaved low-coherence RDKs (0%-15%). Perceptual judgements were compared with changes in anticipatory pursuit eye movements as a function of probability. Results show that anticipatory pursuit velocity scaled with probability and followed direction expectation (attraction bias), whereas perceptual judgments were biased opposite to direction expectation (repulsion bias). Control experiments suggest that the repulsion bias in perception was not caused by retinal slip induced by anticipatory pursuit, or by motion adaptation. We conclude that direction expectation can be processed differently for perception and anticipatory pursuit.NEW & NOTEWORTHY We show that expectations about motion direction that are based on long-term trial history affect perception and anticipatory pursuit differently. Whereas anticipatory pursuit direction was coherent with the expected motion direction (attraction bias), perception was biased opposite to the expected direction (repulsion bias). These opposite biases potentially reveal different ways in which perception and action utilize prior information and support the idea of different information processing for perception and pursuit.

Oculomotor inhibition during smooth pursuit and its dependence on contrast sensitivity.

Our eyes are never still, but tend to "freeze" in response to stimulus onset. This effect is termed "oculomotor inhibition" (OMI); its magnitude and time course depend on the stimulus parameters, attention, and expectation. We previously showed that the time course and duration of microsaccade and spontaneous eye-blink inhibition provide an involuntary measure of low-level visual properties such as contrast sensitivity during fixation. We investigated whether this stimulus-dependent inhibition also occurs during smooth pursuit, for both the catch-up saccades and the pursuit itself. Observers followed a target with continuous back-and-forth horizontal motion while a Gabor patch was briefly flashed centrally with varied spatial frequency and contrast. Catch-up saccades of the size of microsaccades had a similar pattern of inhibition as microsaccades during fixation, with stronger inhibition onset and faster inhibition release for more salient stimuli. Moreover, a similar stimulus dependency of inhibition was shown for pursuit latencies and peak velocity. Additionally, microsaccade latencies at inhibition release, peak pursuit velocities, and latencies at minimum pursuit velocity were correlated with contrast sensitivity. We demonstrated the generality of OMI to smooth pursuit for both microsaccades and the pursuit itself and its close relation to the low-level processes that define saliency, such as contrast sensitivity.

Micro-pursuit: A class of fixational eye movements correlating with smooth, predictable, small-scale target trajectories.

Humans generate ocular pursuit movements when a moving target is tracked throughout the visual field. In this article, we show that pursuit can be generated and measured at small amplitudes, at the scale of fixational eye movements, and tag these eye movements as micro-pursuits. During micro-pursuits, gaze direction correlates with a target's smooth, predictable target trajectory. We measure similarity between gaze and target trajectories using a so-called maximally projected correlation and provide results in three experimental data sets. A first observation of micro-pursuit is provided in an implicit pursuit task, where observers were tasked to maintain their gaze fixed on a static cross at the center of screen, while reporting changes in perception of an ambiguous, moving (Necker) cube. We then provide two experimental paradigms and their corresponding data sets: a first replicating micro-pursuits in an explicit pursuit task, where observers had to follow a moving fixation cross (Cross), and a second with an unambiguous square (Square). Individual and group analyses provide evidence that micro-pursuits exist in both the Necker and Cross experiments but not in the Square experiment. The interexperiment analysis results suggest that the manipulation of stimulus target motion, task, and/or the nature of the stimulus may play a role in the generation of micro-pursuits.

Confidence in predicted position error explains saccadic decisions during pursuit.

A fundamental problem in motor control is the coordination of complementary movement types to achieve a common goal. As a common example, humans view moving objects through coordinated pursuit and saccadic eye movements. Pursuit is initiated and continuously controlled by retinal image velocity. During pursuit, eye position may lag behind the target. This can be compensated by the discrete execution of a catch-up saccade. The decision to trigger a saccade is influenced by both position and velocity errors, and the timing of saccades can be highly variable. The observed distributions of saccade frequency and trigger time remain poorly understood, and this decision process remains imprecisely quantified. Here, we propose a predictive, probabilistic model explaining the decision to trigger saccades during pursuit to foveate moving targets. In this model, expected position error and its associated uncertainty are predicted through Bayesian inference across noisy, delayed sensory observations (Kalman filtering). This probabilistic prediction is used to estimate the confidence that a saccade is needed (quantified through log-probability ratio), triggering a saccade upon accumulating to a fixed threshold. The model qualitatively explains behavioral observations on the frequency and trigger time distributions of saccades during pursuit over a range of target motion trajectories. Furthermore, this model makes novel predictions that saccade decisions are highly sensitive to uncertainty for small predicted position errors, but this influence diminishes as the magnitude of predicted position error increases. We suggest that this predictive, confidence-based decision-making strategy represents a fundamental principle for the probabilistic neural control of coordinated movements.NEW & NOTEWORTHY This is the first stochastic dynamical systems model of pursuit-saccade coordination accounting for noise and delays in the sensorimotor system. The model uses Bayesian inference to predictively estimate visual motion, triggering saccades when confidence in predicted position error accumulates to a threshold. This model explains saccade frequency and trigger time distributions across target trajectories and makes novel predictions about the influence of sensory uncertainty in saccade decisions during pursuit.

Test-retest reliability of the Vestibular Ocular Motor Screening (VOMS) tool and modified Balance Error Scoring System (mBESS) in US military personnel.

The Military Acute Concussion Evaluation 2 (MACE 2), which includes the Vestibular-Ocular Motor Screening (VOMS) tool and the single-leg stance component of the modified Balance Error Scoring System (mBESS), was introduced in 2018 as an assessment of acute mTBI in US military personnel. However, the reliability of the VOMS and mBESS in this population has not been established. OBJECTIVES: The primary purpose of this study was to examine the reliability of the VOMS across a 6-month period in healthy, uninjured US Army Special Operations Command (USASOC) personnel. DESIGN: Active duty/heathy military personnel (n=108) completed the VOMS and mBESS at baseline and follow-up 6 months later (±1 month). METHOD: Cronbach's alpha was used to examine the internal consistency of the VOMS and mBESS at both time points. Two-way mixed intra-class correlation coefficients (ICC) with consistency agreement were used to evaluate test-retest reliability. RESULTS: VOMS demonstrated excellent internal consistency (α=0.99), whereas, the mBESS demonstrated poor internal consistency (α=0.29). Test-retest reliability of VOMS items was moderate-to-good with ICCs ranging from 0.60 to 0.81. Test-retest reliability was moderate for mBESS total score (ICC=0.59) and double-leg stance (ICC=0.73), while single-leg (ICC=0.49) and tandem (ICC=0.02) stances were poor. CONCLUSIONS: The findings suggest that VOMS has high internal consistency and moderate-to-good test-retest reliability. mBESS has poor internal consistency and poor-to-moderate test-retest reliability. The results suggest that VOMS is a reliable addition to the MACE-2, whereas, mBESS single-leg stance is less reliable. As such, mBESS double-leg stance may be a more reliable measure of balance in this population.

Properties of smooth pursuit and visual motion reaction time to second-order motion stimuli.

A large number of psychophysical and neurophysiological studies have demonstrated that smooth pursuit eye movements are tightly related to visual motion perception. This could be due to the fact that visual motion sensitive cortical areas such as meddle temporal (MT), medial superior temporal (MST) areas are involved in motion perception as well as pursuit initiation. Although the directional-discrimination and perceived target velocity tasks are used to evaluate visual motion perception, it is still uncertain whether the speed of visual motion perception, which is determined by visuomotor reaction time (RT) to a small target, is related to pursuit initiation. Therefore, we attempted to determine the relationship between pursuit latency/acceleration and the visual motion RT which was measured to the visual motion stimuli that moved leftward or rightward. The participants were instructed to fixate on a stationary target and press one of the buttons corresponding to the direction of target motion as soon as possible once the target starts to move. We applied five different visual motion stimuli including first- and second-order motion for smooth pursuit and visual motion RT tasks. It is well known that second-order motion induces lower retinal image motion, which elicits weaker responses in MT and MST compared to first-order motion stimuli. Our results showed that pursuit initiation including latency and initial eye acceleration were suppressed by second-order motion. In addition, second-order motion caused a delay in visual motion RT. The better performances in both pursuit initiation and visual motion RT were observed for first-order motion, whereas second-order (theta motion) induced remarkable deficits in both variables. Furthermore, significant Pearson's correlation and within-subjects correlation coefficients were obtained between visual motion RT and pursuit latency/acceleration. Our findings support the suggestion that there is a common neuronal pathway involved in both pursuit initiation and the speed of visual motion perception.

Traumatic Brain Injury in Children: Sport-related Concussions in Children.

Concussion is a worldwide health concern among children and adolescents. Over the decades concussion has been gradually better recognized as an entity that accounts for a significant disability post head trauma in patients. Patients present with cognitive, somatic and oculo-vestibular symptoms that can be incapacitating. Most concussion symptoms are transient and resolve within 1-2 weeks but can persist for years. Concussion pathophysiology is complex and may not be fully understood but it involves numerous mechanisms including cellular metabolic derangements, cerebral blood inflow, and axonal disruption. With no associated objective biomarkers or visible pathologic brain changes, diagnosis of concussion can be challenging. Many organizations and collaborative groups have suggested numerous definitions and diagnostic criteria for concussion in an attempt to improve the evidence-based clinical assessments and therapies for concussion. Proper assessment and evaluation is crucial starting from counseling of the patient, gradual return to cognitive and physical activity in an individualized treatment plan to ensure a timely return to daily activities and full sport participation. This report provides a grasp over the current state of sport-related concussion knowledge, diagnosis, and clinical evaluation in children and adolescent, with a focus on the ocular symptoms and signs.

Traumatic Brain Injury in Children: Do the Eyes Have It? The Orthoptic Evaluation of Traumatic Brain Injury.

Because the neuropathological changes caused by mild traumatic brain injury (mTBI) more often manifest as functional impairments than structural abnormalities, the clinical diagnosis of mTBI may rely too heavily on a combination of history and self-reported symptoms. The mechanism of injury in mild traumatic brain injury (mTBI) predicts that supranuclear pathways controlling eye movement systems would be vulnerable to damage, and diagnostic tests of these systems would be high-yield. In fact, tests of oculomotor function have proven to be highly sensitive in detecting neurological soft signs, but may require expensive, specialized equipment. Fortunately, Certified Orthoptists (COs) are skilled at the evaluation of accommodative dysfunction, abnormalities of saccades, smooth pursuit, and vestibular eye movements, and vergence errors using standard ophthalmic equipment. Because COs are accustomed to adapting the sensorimotor exam to infants and pre-verbal children, they are able to modify or design objective methods, the results of which may be difficult for the patient with a functional overlay to decipher and deceive. When the patient with a history of mTBI presents to the ophthalmologist with visual symptoms and a normal routine eye exam, it is important to order a sensorimotor examination by a CO to confirm the diagnosis.

Functional connectivity during smooth pursuit eye movements.

Smooth pursuit eye movements (SPEM) hold the image of a slowly moving stimulus on the fovea. The neural system underlying SPEM primarily includes visual, parietal, and frontal areas. In the present study, we investigated how these areas are functionally coupled and how these couplings are influenced by target motion frequency. To this end, healthy participants (n = 57) were instructed to follow a sinusoidal target stimulus moving horizontally at two different frequencies (0.2 Hz, 0.4 Hz). Eye movements and blood oxygen level-dependent (BOLD) activity were recorded simultaneously. Functional connectivity of the key areas of the SPEM network was investigated with a psychophysiological interaction (PPI) approach. How activity in five eye movement-related seed regions (lateral geniculate nucleus, V1, V5, posterior parietal cortex, frontal eye fields) relates to activity in other parts of the brain during SPEM was analyzed. The behavioral results showed clear deterioration of SPEM performance at higher target frequency. BOLD activity during SPEM versus fixation occurred in a geniculo-occipito-parieto-frontal network, replicating previous findings. PPI analysis yielded widespread, partially overlapping networks. In particular, frontal eye fields and posterior parietal cortex showed task-dependent connectivity to large parts of the entire cortex, whereas other seed regions demonstrated more regionally focused connectivity. Higher target frequency was associated with stronger activations in visual areas but had no effect on functional connectivity. In summary, the results confirm and extend previous knowledge regarding the neural mechanisms underlying SPEM and provide a valuable basis for further investigations such as in patients with SPEM impairments and known alterations in brain connectivity.NEW & NOTEWORTHY This study provides a comprehensive investigation of blood oxygen level-dependent (BOLD) functional connectivity during smooth pursuit eye movements. Results from a large sample of healthy participants suggest that key oculomotor regions interact closely with each other but also with regions not primarily associated with eye movements. Understanding functional connectivity during smooth pursuit is important, given its potential role as an endophenotype of psychoses.

From Gaussian blobs to naturalistic videos: Comparison of oculomotor behavior across different stimulus complexities.

Research on eye movements has primarily been performed in two distinct ways: (1) under highly controlled conditions using simple stimuli such as dots on a uniform background, or (2) under free-viewing conditions with complex images, real-world movies, or even with observers moving around in the world. Although both approaches offer important insights, the generalizability among eye movement behaviors observed under these different conditions is unclear. Here, we compared eye movement responses to video clips showing moving objects within their natural context with responses to simple Gaussian blobs on a blank screen. Importantly, for both conditions, the targets moved along the same trajectories at the same speed. We measured standard oculometric measures for both stimulus complexities, as well as the effect of the relative angle between saccades and pursuit, and compared them across conditions. In general, eye movement responses were qualitatively similar, especially with respect to pursuit gain. For both types of stimuli, the accuracy of saccades and subsequent pursuit was highest when both eye movements were collinear. We also found interesting differences; for example, latencies of initial saccades to moving Gaussian blob targets were significantly faster compared to saccades to moving objects in video scenes, whereas pursuit accuracy was significantly higher in video scenes. These findings suggest a lower processing demand for simple target conditions during saccade preparation and an advantage for tracking behavior in natural scenes due to higher predictability provided by the context information.

The coordinate system of endogenous spatial attention during smooth pursuit.

A central question in vision is whether spatial attention is represented in an eye-centered (retinotopic) or world-centered (spatiotopic) reference-frame. Most previous studies on this question focused on how coordinates are modulated across saccades. In the present study, we investigated the reference-frame of attention across smooth pursuit eye-movements using a goal-directed saccade task. In two experiments, participants were asked to pursue a moving target while attending to one or two grating stimuli. On each trial, one stimulus was constant in its retinal position and the other was constant in its spatial position. Upon detection of a slight change in stimulus orientation, participants were asked to stop pursuing and perform a fast saccade toward the modified stimulus. In the focused attention condition, they attended one, predefined, stimulus, and in the divided attention condition they attended both. In Experiment 1 the angle of the orientation change marking the target event was constant across participants and conditions. In Experiment 2, the angle was individually adapted to equate performance across participants and conditions. Findings of the two experiments were consistent and showed that the enhancement of mean visual sensitivity in the focused relative to the divided attention condition was similar in magnitude for both retinotopic and spatiotopic targets. This indicates that during smooth pursuit, endogenous attention was proportionally divided between targets in retinotopic and spatiotopic frames of reference.

Suppressive control of optokinetic and vestibular nystagmus by the primate frontal eye field.

When the eyes are fixated on a spot, fixation neurons in the frontal eye field (FEF) show an increase in activity. Our previous study suggested that fixation neurons in the FEF contribute to the suppression of saccades and smooth pursuit eye movements to maintain active fixation. The present study examined the role of the FEF in the suppressive control of reflexive eye movements, optokinetic and vestibular nystagmus, in trained monkeys. Electrical stimulation in the FEF suppressed the quick and slow phases of optokinetic and vestibular nystagmus at an intensity lower than the threshold for eliciting electrically evoked saccades. Relatively weak suppression influenced the slow phase of vestibular nystagmus. During optokinetic or vestibular nystagmus, presentation of a stationary small spot to the eyes followed by fixation is known to suppress both the quick and slow phases of eye movements. We recorded the activity of fixation neurons in the FEF and found that fixation neurons usually showed a decrease in activity during optokinetic and vestibular nystagmus and an increase in activity during the suppression of nystagmus by visual fixation. The present results show that the activity of fixation neurons in the FEF is related to the suppressive control of optokinetic and vestibular nystagmus for maintaining active fixation. We discuss the role of a generalized visual fixation system that can maintain visual attention on an interesting object.NEW & NOTEWORTHY In this study, electrical stimulation in the frontal eye field (FEF) suppressed the quick and slow phases of optokinetic and vestibular nystagmus at an intensity subthreshold for eliciting saccades. Furthermore, the activity of fixation neurons in the FEF was related to the suppression of optokinetic and vestibular nystagmus by visual fixation. This suggests that a common neuronal assembly in the FEF may contribute to the suppressive control of different functional classes of eye movements.

Two-Dimensional Analysis of Horizontal and Vertical Pursuit in Infantile Nystagmus Reveals Quantitative Deficits in Accuracy and Precision.

Purpose: Infantile nystagmus (IN) presents with continuous, predominantly horizontal eye oscillations. It remains controversial whether those with IN have normal horizontal pursuit, while vertical pursuit has rarely been studied. We examined whether there are pursuit deficits associated with IN by investigating the effect of target direction, velocity, and amplitude. Methods: Twelve adults with idiopathic IN performed a pursuit task, a 0.4° dot moved either horizontally or vertically at 8 or 16°/s, through amplitudes of 8°, 16°, or 32°. Accuracy and precision errors were computed as bivariate probability density functions of target-relative eye velocities. Results: Eye velocity was less precise along the horizontal axis during both horizontal and vertical pursuit, reflecting the primary axis of the eye oscillation. Mean accuracy error along the target trajectory during vertical pursuit was just as impaired as during horizontal pursuit. There was a greater error in accuracy along the target trajectory for 16°/s targets than 8°/s. Finally, targets that oscillated at 2.0 Hz had a greater error in accuracy along the target trajectory than frequencies of 1.0 Hz or 0.5 Hz. When studied using the same experimental protocol, pursuit performance for typical observers was always better. Conclusions: These findings strongly support our hypothesis of severe deficits in pursuit accuracy in observers with IN for horizontally and vertically moving targets, as well as for targets that move at higher speeds or oscillate more quickly. Overall, IN pursuit impairment appears to have previously been underestimated, highlighting a need for further quantitative studies of dynamic visual function in those with IN.

Eye, head, and gaze contributions to smooth pursuit in macular degeneration.

Macular degeneration (MD) often leads to the loss of the fovea and surrounding central visual field. This type of visual loss is very common and can present particular challenges for oculomotor tasks that may rely on the fovea. For certain tasks, individuals develop a new, eccentric fixational locus. Our previous work has shown that smooth pursuit is impaired in MD. However, extent of retinal lesion size and eccentricity of fixation do not directly contribute to changes in smooth pursuit gain. Oculomotor limitations due to eccentric eye position in the orbit may be another culprit. Here we test the hypothesis that deficits in smooth pursuit in MD would be reduced under head-unrestrained conditions. To that end, we examined eye, head, and gaze movements in eight individuals with MD and seven age-matched controls in response to a step-ramp pursuit stimulus. We found that despite variability across participants, both groups had similar smooth pursuit head movements (P = 0.76), while both had significantly higher pursuit gains in the head-restrained condition (P < 0.0001), suggesting that in older populations, head movements may lead to a decrease in pursuit gain. Furthermore, we did not find a correlation between eccentricity of fixation and amount of head displacement during the trial (P = 0.25), suggesting that eccentric eye position does not lead to higher reliance on head movements in smooth pursuit. Our finding that individuals with MD have lower pursuit gains, despite similar head movements as controls, suggests a difference in how MD affects mechanisms underlying eye versus head movements in smooth pursuit.NEW & NOTEWORTHY This article is the first to look at eye and head movements in observers with macular degeneration. It is the first to show that in older individuals, regardless of central field defect, freedom of head movement may reduce pursuit gain. Despite oculomotor limitations due to eccentric fixation, individuals with macular degeneration do not rely on head movements more than age-matched controls, with both groups having a similarly heterogenous eye and head movement strategy for pursuit.

Perceptual decisions about object shape bias visuomotor coordination during rapid interception movements.

Visual processing in parietal areas of the dorsal stream facilitates sensorimotor transformations for rapid movement. This action-related visual processing is hypothesized to play a distinct functional role from perception-related processing in the ventral stream. However, it is unclear how the two streams interact when perceptual identification is a prerequisite to executing an accurate movement. In the current study, we investigated how perceptual decision-making involving the ventral stream influences arm and eye movement strategies. Participants (n = 26) moved a robotic manipulandum using right whole arm movements to rapidly reach a stationary object or intercept a moving object on an augmented-reality display. On some blocks of trials, participants needed to identify the shape of the object (circle or ellipse) as a cue to either hit the object (circle) or move to a predefined location away from the object (ellipse). We found that during perceptual decision-making, there was an increased urgency to act during interception movements relative to reaching, which was associated with more decision errors. Faster hand reaction times were associated with a strategy to adjust the movement postinitiation, and this strategy was more prominent during interception. Saccadic reaction times were faster and initial saccadic peak velocity, initial gaze lags, and gains greater during decisions, suggesting that eye movements adapt to perceptual decision-making requirements. Together, our findings suggest that the integration of ventral stream information with visuomotor planning depends on imposed (or perceived) task demands.NEW & NOTEWORTHY Visual processing for perception and for action is thought to be mediated by two specialized neural pathways. Using a visuomotor decision-making task, we show that participants differentially utilized online perceptual decision-making in reaching and interception and that eye movements necessary for perception influenced motor decision strategies. These results provide evidence that task complexity modulates how pathways processing perception versus action information interact during the visual control of movement.