Parkinsonian patients show impaired predictive smooth pursuit.

To determine if patients with Parkinson's disease (PD) are able to use a visual contextual cue to induce a predictive change in smooth pursuit direction and if this ability depends on the state of the dopaminergic system, we measured predictive smooth pursuit in nine patients with mild to moderate PD during OFF and ON medication. These values were compared with those of nine age-matched and sex-matched healthy controls.Our focus was on the horizontal smooth pursuit when subjects pursued a downward moving target entering a+/-90 deg curve. The target moved on a homogeneous background or on a static "street" that indicated the future trajectory of the target. Our main result is that PD patients were impaired in eliciting predictive smooth pursuit using the context information of the street compared to healthy subjects. The control group elicited predictive pursuit 250 ms before target onset. In contrast, PD patients showed significantly longer latency (100-120 ms) and reduced maximal pursuit velocity. However, without the street guiding pursuit, a delay of about 250 ms was seen in both groups. There was no significant difference in the smooth pursuit performance between OFF and ON medication in the patient group.These results show that early stage PD patients are impaired in the use of static visual information as a cue for predictive pursuit compared to controls and that this deficit does not depend on dopaminergic medication. In the context of predictive eye movement, the involvement of the striatal-frontal pathway and the spatial working memory is discussed.