Evidence map›Paper›PMID 38353747›Full record

ArticleJournal of neurology2024

Midbrain lesion-induced disconjugate gaze: a unifying circuit mechanism of ocular alignment?

Maximilian U Friedrich, Laurin Schappe, Sashank Prasad, Helen Friedrich, Michael D Fox, Andreas Zwergal, David S Zee, Klaus Faßbender, Klaus-Ulrich Dillmann

Open access · hybridAbstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.7field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Maximilian U Friedrich *Center for Brain Circuit Therapeutics, Brigham and Women's Hospital, 60 Fenwood Rd, Boston, MA, 02115, USA.ORCID http://orcid.org/0000-0002-3695-1268
Laurin Schappe *Department of Neurology, Saarland University Medical Center, Homburg, Germany. Laurin.Schappe@uks.eu.
Sashank PrasadDepartment of Neurology, University of Pennsylvania Perelman School of Medicine, Pennsylvania, USA.
Helen FriedrichCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, 60 Fenwood Rd, Boston, MA, 02115, USA.
Michael D FoxCenter for Brain Circuit Therapeutics, Brigham and Women's Hospital, 60 Fenwood Rd, Boston, MA, 02115, USA.
Andreas ZwergalGerman Center for Vertigo and Dizziness, University Hospital, LMU Munich, Munich, Germany.
David S ZeeDepartments of Neurology, Ophthalmology, Otolaryngology, Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, USA.
Klaus FaßbenderDepartment of Neurology, University of Pennsylvania Perelman School of Medicine, Pennsylvania, USA.
Klaus-Ulrich DillmannDepartment of Neurology, University of Pennsylvania Perelman School of Medicine, Pennsylvania, USA.
Brigham and Women's Hospital · USUniversity of Pennsylvania · USJohns Hopkins University · USLMU Klinikum · DESaarland University · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDisconjugate eye movements are essential for depth perception in frontal-eyed species, but their underlying neural substrates are largely unknown. Lesions in the midbrain can cause disconjugate eye movements. While vertically disconjugate eye movements have been linked to defective visuo-vestibular integration, the pathophysiology and neuroanatomy of horizontally disconjugate eye movements remains elusive.

methodsA patient with a solitary focal midbrain lesion was examined using detailed clinical ocular motor assessments, binocular videooculography and diffusion-weighted MRI, which was co-registered to a high-resolution cytoarchitectonic MR-atlas.

resultsThe patient exhibited both vertically and horizontally disconjugate eye alignment and nystagmus. Binocular videooculography showed a strong correlation of vertical and horizontal oscillations during fixation but not in darkness. Oscillation intensities and waveforms were modulated by fixation, illumination, and gaze position, suggesting shared visual- and vestibular-related mechanisms. The lesion was mapped to a functionally ill-defined area of the dorsal midbrain, adjacent to the posterior commissure and sparing nuclei with known roles in vertical gaze control.

conclusionA circumscribed region in the dorsal midbrain appears to be a key node for disconjugate eye movements in both vertical and horizontal planes. Lesioning this area produces a unique ocular motor syndrome mirroring hallmarks of developmental strabismus and nystagmus. Further circuit-level studies could offer pivotal insights into shared pathomechanisms of acquired and developmental disorders affecting eye alignment.

Indexed as

MesencephalonEye MovementsHumansNystagmus, PathologicOcular Motility DisordersEye movement disordersNeuroimagingPosterior commissureVestibular systemVideooculographyVisual system

Identifiers

PMID38353747
PMCPMC11055718
OpenAlexW4391811746

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.