The association between eye-tracking dysfunctions and thought disorder in psychosis.

The relationship between the presence of smooth-pursuit eye-movement dysfunctions and degree of thought disorder was assessed in four groups: schizophrenics, manics, atypical psychotic patients, and normal persons. A positive relationship, constant for all groups, was found to be significant but low. Impaired eye tracking accounted for 4.22% of the total variance of thought disorder. Diagnosis accounted for over 10% of the thought-disorder variance. Although there is a tendency for those persons with poor eye tracking to have higher amounts of thought disorder than those with unimpaired eye tracking, all psychotic patients, regardless of diagnostic class, tended to have thought disorder scores in the pathological range, as measured by the Thought Disorder Index. Although the data may be viewed as supporting similar hypothetical processes that underlie pursuit dysfunctions and thought disorder, the greater likelihood exists that the coupling of thought disorder and eye-tracking dysfunctions may be explained differently in the schizophrenia and in the major affective disorders.

Pursuit eye movement dysfunctions in schizophrenia. Family evidence for specificity.

In a number of previous investigations, eye tracking dysfunctions had been reliably found in from 50% to 85% of schizophrenic patients, about 40% of manic-depressive patients, and about 8% of the normal population. We report similar smooth pursuit eye movement dysfunctions in 34% of the parents (or 55% of parental pairs) of schizophrenic patients compared with 10% of the parents (or 7% of parental pairs) of manic-depressive patients. Parental eye movement dysfunctions are significantly related to the diagnosis of the patient and not to the patient's eye tracking performance. These data suggest that, in the absence of other CNS disease, these eye tracking dysfunctions represent familial markers of vulnerability to schizophrenia.

Changes in eye tracking during clinical stabilization in schizophrenia.

Eye tracking abnormalities have been proposed as a trait marker for schizophrenia on the basis of their familial prevalence and the consistency of tracking over time in clinically stable patients. However, few studies have examined stability through acute episodes of illness, and most studies have not analyzed changes in different forms of eye movements. Therefore, the authors examined eye tracking, clinical state, and neuroleptic dose during 4 consecutive weeks in nine recently hospitalized schizophrenic patients. For the patients and controls, qualitative ratings of pursuit accuracy remained relatively stable over time. In contrast, saccade frequency increased significantly, with a 57% increase in small saccades and a 77% reduction in larger saccades. In comparison with cross-sectional studies which have found no correlation between neuroleptic dose and tracking performance, a reduction in large saccades was strongly correlated with increase in neuroleptic dose. The findings suggest that pursuit accuracy may be a trait characteristic of schizophrenia, while the frequency and size of saccades are state dependent characteristics.

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