Journal of Neurology

, Volume 255, Issue 12, pp 1916–1925

Differential diagnostic value of eye movement recording in PSP-parkinsonism, Richardson's syndrome, and idiopathic Parkinson's disease


  • Elmar H. Pinkhardt
    • Dept. of NeurologyUniversity of Ulm
  • Reinhart Jürgens
    • Section Neurophysiology, Dept. of NeurologyUniversity of Ulm
  • Wolfgang Becker
    • Section Neurophysiology, Dept. of NeurologyUniversity of Ulm
  • Federica Valdarno
    • Section Neurophysiology, Dept. of NeurologyUniversity of Ulm
    • Dept. of NeurologyUniversity of Ulm
    • Dept. of NeurologyUniversity of Ulm
    • Section Neurophysiology, Dept. of NeurologyUniversity of Ulm

DOI: 10.1007/s00415-009-0027-y

Cite this article as:
Pinkhardt, E.H., Jürgens, R., Becker, W. et al. J Neurol (2008) 255: 1916. doi:10.1007/s00415-009-0027-y


Vertical gaze palsy is a highly relevant clinical sign in parkinsonian syndromes. As the eponymous sign of progressive supranuclear palsy (PSP), it is one of the core features in the diagnosis of this disease. Recent studies have suggested a further differentiation of PSP in Richardson's syndrome (RS) and PSP-parkinsonism (PSPP). The aim of this study was to search for oculomotor abnormalities in the PSP-P subset of a sample of PSP patients and to compare these findings with those of (i) RS patients, (ii) patients with idiopathic Parkinson's disease (IPD), and (iii) a control group. Twelve cases of RS, 5 cases of PSP-P, and 27 cases of IPD were examined by use of video-oculography (VOG) and compared to 23 healthy normal controls. Both groups of PSP patients (RS, PSP-P) had significantly slower saccades than either IPD patients or controls, whereas no differences in saccadic eye peak velocity were found between the two PSP groups or in the comparison of IPD with controls. RS and PSP-P were also similar to each other with regard to smooth pursuit eye movements (SPEM), with both groups having significantly lower gain than controls (except for downward pursuit); however, SPEM gain exhibited no consistent difference between PSP and IPD. A correlation between eye movement data and clinical data (Hoehn & Yahr scale or disease duration) could not be observed. As PSP-P patients were still in an early stage of the disease when a differentiation from IPD is difficult on clinical grounds, the clear-cut separation between PSP-P and IPD obtained by measuring saccade velocity suggests that VOG could contribute to the early differentiation between these patient groups.

Key words

video-oculographyoculomotor alterations in parkinsonian syndromesRichardson's syndromePSP-parkinsonismprogressive supranuclear palsyidiopathic Parkinson's disease

Copyright information

© Steinkopff-Verlag 2009