Voluntary control of saccadic and smooth-pursuit eye movements in children with learning disorders.

Eye movement is crucial to humans in allowing them to aim the foveae at objects of interest. We examined the voluntary control of saccadic and smooth-pursuit eye movements in 18 subjects with learning disorders (LDs) (aged 8-16) and 22 normal controls (aged 7-15). The subjects were assigned visually guided, memory-guided, and anti-saccade tasks, and smooth-pursuit eye movements (SPEM). Although, the LD subjects showed normal results in the visually guided saccade task, they showed more errors in the memory-guided saccade task (e.g. they were unable to stop themselves reflexively looking at the cue) and longer latencies, even when they performed correctly. They also showed longer latencies than the controls in the anti-saccade task. These results suggest that they find it difficult to voluntarily suppress reflexive saccades and initiate voluntary saccades when a target is invisible. In SPEM using step-ramp stimuli, the LD subjects showed lower open- and closed-loop gains. These results suggest disturbances of both acceleration of eye movement in the initial state and maintenance of velocity in minimizing retinal slip in the steady state. Recent anatomical studies in LD subjects have suggested abnormalities in the structure of certain brain areas such as the frontal cortex. Frontal eye movement-related areas such as the frontal eye fields and supplementary eye fields may be involved in these disturbances of voluntary control of eye movement in LDs.