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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
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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