INVESTIGATION AND TREATMENT OF OCULAR MOTOR DISORDERS

拟议研究的长期目标是：（1）更多地了解损害日常活动所需视力的人类眼部运动障碍，（2）评估恢复清晰视力的治疗措施。研究策略是将眼动的可靠测量与患者自然行为的视觉投诉联系起来;使用正常和异常眼动的测量来测试生物学上合理的数学模型;并使用对照试验评估眼动力障碍的新治疗方法。有五个具体的目标，这是从以前的研究中发展出来的：第一个项目包括后天摆动性眼球震颤模型的测试。确定大的注视转移和亮度变化的影响将用于测试控制系统和神经网络模型。第二个项目旨在确定头部旋转前的眼球运动是否能提高头部突然转动时前庭眼反射的增益。 这种“启动”效应可能发生在各种先前的眼球运动中，但不会发生在具有缺陷的注视保持机制（神经整合器）的患者中。第三个项目旨在测试赫林定律是否适用于扫视脉冲（即，相等的脉冲大小）。将研究正常受试者和核间性眼肌麻痹患者。第四个项目包括测试的模型，占扫视振荡。利用一种新的实验技术在正常受试者和患者中诱导扫视振荡，将系统地研究小脑和脑干病变的影响。第五个项目是东莨菪碱和加巴喷丁治疗获得性眼球震颤的对照评价。已显示加巴喷丁抑制摆动性眼球震颤，但副作用如共济失调限制了耐受剂量。东莨菪碱可能证明对眼腭震颤患者更有效。总之，这些项目将证明一系列常见的眼动障碍，破坏清晰的视觉的发病机制和治疗的新信息。

The long-term objectives of the proposed research are: (1) to learn more about human ocular motor disorders that impair the vision necessary for everyday activities, and (2) to appraise therapeutic measures to restore clear vision. The research strategies are to relate reliable measurements of eye movements to visual complaints of patients doing natural behaviors; and to use measurements of normal and abnormal eye movements to test mathematical models that are biologically plausible; and evaluate new treatments of disorders of ocular motility using controlled trials. There are five specific aims, which grow out of prior studies: The first project comprises tests of models for acquired pendular nystagmus. Determination of the effects of large gaze shifts and luminance changes will be used to test control systems and neural network models. The second project aims to determine whether eye movements prior to head rotation improve the gain of the vestibulo-ocular reflex, during sudden head turns. This "priming" effect may occur with a variety of prior eye movements but not in patients with a deficient gaze-holding mechanism (neural integrator). The third project aims to test whether Hering's law applies to saccadic pulses (i.e., equal pulse size) during disjunctive gaze shifts. Normal subjects and patients with internuclear ophthalmoplegia will be studied. The fourth project comprises tests of models that account for saccadic oscillations. Using a new experimental technique to induce saccadic oscillations in normal subjects and patients, the effects of cerebellar and brainstem lesions will be systematically investigated. The fifth project is a controlled evaluation of scopolamine and gabapentin as treatment for acquired forms of nystagmus. It has been shown that gabapentin suppresses pendular nystagmus, but side-effects such as ataxia limit the dosage tolerated. Scopolamine may prove more effective in patients with oculopalatel tremor. In sum, these projects will prove new information on the pathogenesis and treatment of a range of common disorders of eye movements that disrupt clear vision.