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Gaze holding after anterior-inferior temporal lobectomy

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Abstract

Eye position-sensitive neurons are found in parietooccipital and anterior-inferior temporal cortex. Putative role of these neurons is to facilitate transformation of reference frame from the retina-fixed to world-fixed coordinates and assure precise action. We assessed the nature of ocular motor disorder in a subject who had selective resection of the right anterior-inferior temporal cortex for the treatment of intractable epilepsy from cortical dysplasia. The gaze was stable when the subject was viewing straight-ahead, but centrally directed drifts in the eye position were seen during eccentric horizontal gaze holding. Eye-in-orbit position determined drift velocity and its direction. Conjugate and sinusoidal vertical oscillations were also present. Horizontal drifts and vertical oscillations became prominent and disconjugate in the absence of visual cue. The gaze-holding deficit was consistent with impairment in neural integration, but in the absence of cerebellar and visual deficits. We speculate that brainstem neural integrator might receive cortical feedback regarding world-fixed coordinates. Visual system might calibrate this process. Hence the lesion of the anterior-inferior temporal lobe leads to impairment in the function of neural integrator. Vision might be used to calibrate such feedback, hence the lack of visual cue further impairs the function of the neural integrator leading to worsening of gaze-holding deficits.

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Acknowledgments

This work was supported by financial support from Knights Templar Eye Foundation (FG) and Fight-for-sight (FG) research Grants. We are grateful to R. John Leigh, MD for providing technical equipments. Dr. Shaikh was supported by Dystonia Medical Research Foundation grant. Dr. Leigh was supported by NIH Grant EY06717.

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Authors and Affiliations

  1. Department of Neurology, Emory University, 1841 Clifton Road, NE, Suite 350, Atlanta, GA, 30329-4021, USA

    Aasef G. Shaikh

  2. Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA

    Fatema F. Ghasia

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  1. Aasef G. Shaikh
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  2. Fatema F. Ghasia
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Correspondence to Aasef G. Shaikh.

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Shaikh, A.G., Ghasia, F.F. Gaze holding after anterior-inferior temporal lobectomy. Neurol Sci 35, 1749–1756 (2014). https://doi.org/10.1007/s10072-014-1825-2

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  • DOI: https://doi.org/10.1007/s10072-014-1825-2

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