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Saccadic abnormalities in psychotic patients II: the role of neuroleptic treatment

Research output: Contribution to journalJournal article

Published

Journal publication date1995
JournalPsychological Medicine
Journal number3
Volume25
Number of pages11
Pages473-483
Original languageEnglish

Abstract

The effects of dopamine-antagonistic neuroleptic (NL) medication on saccadic eye
movements were compared in matched groups of 40 NL-treated and 18 NL-free schizophrenic
patients and in 18 NL-treated and 14 NL-free bipolar affective patients. Manipulation of the
saccadic paradigm yielded data on four types of saccade: those reflexively elicited by novel stimuli
(REFLEX saccades), those directed towards the remembered location of a target now extinguished
(REM) or towards the location where a predictably alternating target is expected to appear
(PRED), or ANTI saccades, directed away from the stimulus to the mirror image location.
Extensive psychiatric, neurological and neuropsychological assessments were also carried out on all
subjects. The saccades of NL-treated patients, regardless of diagnosis, were less spatially accurate
than those of NL-free patients, with a greater tendency to fall short of the target when generated
towards the locus of a mentally represented target. This effect was greatest with a predictably
alternating target, especially during periods when target visibility was withdrawn, only a temporal
cue remaining. This pattern of impairment which is also found in early stages of Parkinson's disease
is likely to be due to deficiency of striatal dopamine. Its best clinical predictors were disease
duration, and Webster-Parkinsonism scores. Failure to suppress reflexive saccades to the stimulus
in the REM and ANTI paradigms were more closely associated with schizophrenia than with NL
treatment and were best predicted by negative symptoms and Wisconsin perseverative errors, both
of which are widely regarded as indicators of frontal lobe dysfunction.