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J Neurophysiol 89: 338-354, 2003; doi:10.1152/jn.00297.2002
0022-3077/03 $5.00
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J Neurophysiol (January 1, 2003). 10.1152/jn.00297.2002
Submitted on Submitted 22 April 2002; accepted in final form 19 September 2002

Three-Dimensional Eye Position and Slow Phase Velocity in Humans With Downbeat Nystagmus

S. Glasauer, M. Hoshi, U. Kempermann, T. Eggert, and U. Büttner

Department of Neurology with Center for Sensorimotor Research, Klinikum Grosshadern, Ludwig-Maximilians-University, 81377 Munich, Germany

Glasauer, S., M. Hoshi, U. Kempermann, T. Eggert, and U. Büttner. Three-Dimensional Eye Position and Slow Phase Velocity in Humans With Downbeat Nystagmus. J. Neurophysiol. 89: 338-354, 2003. Downbeat nystagmus (DN), a fixation nystagmus with the fast phases directed downward, is usually caused by cerebellar lesions, but the precise etiology is not known. A disorder of the smooth-pursuit system or of central vestibular pathways has been proposed. However, both hypotheses fail to explain why DN is usually accompanied by gaze-holding nystagmus, which implies a leaky neural velocity-to-position integrator. Because three-dimensional (3-D) analysis of nystagmus slow phases provides an excellent means for testing both hypotheses, we examined 19 patients with DN during a fixation task and compared them with healthy subjects. We show that the presentation of DN patients is not uniform; they can be grouped according to their deficits: DN with vertical integrator leakage, DN with vertical and horizontal integrator leakage, and DN without integrator leakage. The 3-D analysis of the slow phases of DN patients revealed that DN is most likely neither caused by damage to central vestibular pathways carrying semicircular canal information nor by a smooth pursuit imbalance. We propose that the observed effects can be explained by partial damage of a brain stem-cerebellar loop that augments the time constant of the neural velocity to position integrators in the brain stem and neurally adjusts the orientation of Listing's plane.




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