PMID- 32519289
OWN - NLM
STAT- MEDLINE
DCOM- 20220406
LR  - 20220406
IS  - 1473-4230 (Electronic)
IS  - 1473-4222 (Linking)
VI  - 20
IP  - 5
DP  - 2021 Oct
TI  - Asymmetry in Gaze-Holding Impairment in Acute Unilateral Ischemic Cerebellar 
      Lesions Critically Depends on the Involvement of the Caudal Vermis and the 
      Dentate Nucleus.
PG  - 768-779
LID - 10.1007/s12311-020-01141-7 [doi]
AB  - Stabilizing the eyes in space when looking at a target is provided by a 
      brainstem/cerebellar gaze-holding network, including the flocculus/paraflocculus 
      complex (non-human primate studies) and the caudal vermis, biventer, and inferior 
      semilunar lobule (human studies). Previous research suggests that acute 
      lateralized cerebellar lesions preferentially lead to gaze-evoked nystagmus (GEN) 
      on ipsilesional gaze. Here, we further characterize the effect of unilateral 
      cerebellar lesions on gaze-holding and hypothesize that the side-specific 
      magnitude of gaze-holding impairment depends on the lesion location. Nine 
      patients (age range = 31-62 years) with acute/subacute (</= 10 days old) 
      MRI-confirmed unilateral cerebellar stroke were included. Horizontal gaze holding 
      was quantified while looking at a slowly moving (0.5 degrees /s) flashing target (gaze 
      angle = +/-40 degrees ). Asymmetry in eye-drift velocity was calculated and compared with 
      the different MRI patterns of cerebellar lesions. Individual peak eye-drift 
      velocities (range = 1.7-8.8 degrees /s) occurred at the most eccentric eye positions 
      (gaze angle = 28-38 degrees ). We found significantly asymmetric eye-drift velocity (EDV) 
      in eight out of nine patients. The four patients with MRI-confirmed involvement 
      of the caudal vermis and the dentate nucleus all presented with 
      ipsilesionally-predominant EDV, while in the five patients with lesions 
      restricted to the cerebellar hemisphere, EDV was stronger on contralesional gaze 
      in three out of four found with an asymmetric EDV. Involvement of the caudal 
      vermis and the dentate nucleus is critical for determining the directional GEN 
      asymmetry in unilateral cerebellar lesions. Thus, our findings support the 
      occurrence of GEN without floccular/parafloccular lesions and suggest that the 
      EDV asymmetry in relation to the side of the lesion provides information about 
      the involvement of specific structures.
CI  - (c) 2020. Springer Science+Business Media, LLC, part of Springer Nature.
FAU - Romano, F
AU  - Romano F
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
AD  - Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland.
AD  - Clinical Neuroscience Center, Zurich, Switzerland.
FAU - Bockisch, C J
AU  - Bockisch CJ
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
AD  - Clinical Neuroscience Center, Zurich, Switzerland.
AD  - Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland.
AD  - Department of Otorhinolaryngology, University Hospital Zurich, Zurich, 
      Switzerland.
AD  - Medizinisch Radiologisches Institut, Zurich, Switzerland.
FAU - Schuknecht, B
AU  - Schuknecht B
AD  - Medizinisch Radiologisches Institut, Zurich, Switzerland.
FAU - Bertolini, G
AU  - Bertolini G
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
AD  - Swiss Concussion Center, Schulthess Clinic, Zurich, Switzerland.
AD  - Clinical Neuroscience Center, Zurich, Switzerland.
AD  - University of Zurich, Faculty of Medicine, Zurich, Switzerland.
FAU - Tarnutzer, Alexander A
AU  - Tarnutzer AA
AUID- ORCID: 0000-0002-6984-6958
AD  - Department of Neurology, University Hospital Zurich, Zurich, Switzerland. 
      alexander.tarnutzer@ksb.ch.
AD  - Clinical Neuroscience Center, Zurich, Switzerland. alexander.tarnutzer@ksb.ch.
AD  - University of Zurich, Faculty of Medicine, Zurich, Switzerland. 
      alexander.tarnutzer@ksb.ch.
AD  - Neurology, Cantonal Hospital of Baden, Baden, Switzerland. 
      alexander.tarnutzer@ksb.ch.
LA  - eng
GR  - NA/Betty and David Koetser Foundation for Brain Research/
GR  - NA/Hartmann Muller-Stiftung fur Medizinische Forschung/
GR  - NA/EMDO Stiftung/
PT  - Journal Article
PL  - United States
TA  - Cerebellum
JT  - Cerebellum (London, England)
JID - 101089443
SB  - IM
MH  - Animals
MH  - Cerebellar Nuclei/diagnostic imaging
MH  - *Cerebellar Vermis
MH  - Cerebellum/diagnostic imaging/pathology
MH  - Eye Movements
MH  - Humans
MH  - *Nystagmus, Pathologic
OTO - NOTNLM
OT  - Gaze-evoked nystagmus
OT  - Stroke
OT  - Vestibular
OT  - Video-oculography
EDAT- 2020/06/11 06:00
MHDA- 2022/04/07 06:00
CRDT- 2020/06/11 06:00
PHST- 2020/06/11 06:00 [pubmed]
PHST- 2022/04/07 06:00 [medline]
PHST- 2020/06/11 06:00 [entrez]
AID - 10.1007/s12311-020-01141-7 [pii]
AID - 10.1007/s12311-020-01141-7 [doi]
PST - ppublish
SO  - Cerebellum. 2021 Oct;20(5):768-779. doi: 10.1007/s12311-020-01141-7.