Validation of a clinical antisaccadic eye movement test in the assessment of dementia
J. Currie, B. Ramsden, C. McArthur and P. Maruff
Neurophysiology and Neurovisual Research Unit, Mental Health Research Institute of Victoria, Parkville, Australia.
The ability to generate antisaccades (eye movements deliberately made in
the direction opposite to that of a visual stimulus) may be used to assess
central nervous system function in a variety of neurologic and psychiatric
disorders. However, the usefulness of this paradigm in clinical practice is
limited by the need for an oculographic laboratory. We describe a clinical
version of such an antisaccadic task and present normative data from 332
subjects. We also examined clinical antisaccades and cognitive performance
in 30 patients with Alzheimer's disease, five patients with Huntington's
disease, and 12 patients with pseudodementia. In Alzheimer's disease, error
rates in the clinical antisaccadic test correlated well with those from a
laboratory-based antisaccadic task measured on the same day by infrared
oculography, confirming that the clinical antisaccadic test is a valid
analog of the more sophisticated laboratory paradigms. Clinical
antisaccadic error rates correlated strongly with the severity of dementia
in Alzheimer's disease, and correlations with cognitive performance
suggested that the clinical antisaccadic test may have some specificity for
frontal lobe dysfunction. Patients with pseudodementia had normal clinical
antisaccadic error rates, and the test may therefore be of use in
differentiating dementia from pseudodementia. This clinical antisaccadic
test provides a simple, reliable, and inexpensive quantitative clinical
tool that is of value in the assessment of disturbances of higher cortical
function.
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