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    Evaluation of Saccadic and Smooth Pursuit Eye Movements at an Early Stage of Essential Tremor
    (Journal Neurological Sciences, 2016) Celebisoy, Mehmet; Celebisoy, Nese; Ekinci, Aysen Suzen; Akyuz, Esra; Acarer, Ahmet
    Objectives: Though still unclear cerebellar involvement is accepted as the underlying pathophysiological mechanism of at least advanced stages of essential tremor ( ET). Eye movement abnormalities supporting this hypothesis have been reported. We tried to investigate saccadic and pursuit eye movements in ET patients at an early stage of the disease (mean disease duration 20.35 +/- 10.51 months). Materials and Methods: Binocular horizontal saccadic and pursuit eye movements were recorded by using a video-based eye tracker in 25 patients with ET and 16 age matched controls. For the saccades peak saccadic velocity, latency and accuracy and for pursuit eye movements gain at three different target velocities (0.1, 0.2 and 0.4 Hz) was taken into consideration. Results: Peak saccadic latency, velocity and accuracy values recorded from the patients during saccadic eye movements were compared with the values gathered from the healthy controls revealing no significant difference (p>0.05). The same was true for pursuit eye movements. Pursuit gain at three different target velocities recorded from ET patients were not statistically different from the healthy controls (p>0.05). Conclusion: Normal eye movements at the early stage of the disease may indicate cerebellar dysfunction to be a late feature of ET. The other explanation can be the heterogeneous nature of the disease, those with abnormal eye findings representing a specific pathological subset.
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    MRI evaluation of progressive supranuclear palsy: differentiation from Parkinson's disease and multiple system atrophy
    (Taylor & Francis Ltd, 2019) Eraslan, Cenk; Acarer, Ahmet; Guneyli, Serkan; Akyuz, Esra; Aydin, Elcin; Colakoglu, Zafer; Kitis, Omer; Calli, Mehmet Cem
    Objectives: To evaluate the magnetic resonance imaging (MRI)-derived parameters in differentiation of patients with progressive supranuclear palsy (PSP) from patients with Parkinson's disease (PD), multiple system atrophy (MSA), and control subjects was aimed. Methods: Thirty-three patients [mean age, 65.21 +/- 4.75 years; PSP (n = 9), MSA (n = 8), PD (n = 6), and control subjects (n = 10)] who have undergone cranial MRI were included in this retrospective study. MRI-derived parameters including areas of midbrain and pons, midbrain area-to-pons area (M/P) ratio, widths of middle cerebellar peduncle (MCP) and superior cerebellar peduncle (SCP), MCP/SCP ratio, magnetic resonance parkinsonism index (MRPI), cerebral interpeduncular angle, and length of midbrain tegmentum were compared in patients with PSP, PD, MSA, and control subjects through the analysis of variance and Kruskal-Wallis tests with Bonferroni correction and Mann-Whitney U test. Results: The length of midbrain tegmentum, midbrain area, SCP, and M/P ratio were found to be lower, while cerebral interpeduncular angle and MRPI were higher in patients with PSP. Pons area, MCP width, and MCP/SCP ratio were found to be lower in patients with MSA. For PSP, cerebral interpeduncular angle has a sensitivity of 100% and specifity of 90%, and MRPI had a sensitivity of 88.9% and specifity of 100% for PSP. Discussion: Several MRI-derived parameters can be used in differentiation of patients with PSP from patients with PD, MSA and control subjects. The cerebral interpeduncular angle and MRPI, which demonstrated higher values in patients with PSP, were more significant for PSP than the other parameters.