Patients with ephedrone parkinsonism (EP) show a complex, rapidly progressive, irreversible, and levodopa non-responsive parkinsonian and dystonic syndrome due to manganese intoxication. Eye movements may help to differentiate parkinsonian syndromes providing insights into which brain networks are affected in the underlying disease, but they have never been systematically studied in EP. Horizontal and vertical eye movements were recorded in 28 EP and compared to 21 Parkinson's disease (PD) patients, and 27 age- and gender-matched healthy subjects using standardized oculomotor tasks with infrared videooculography. EP patients showed slow and hypometric horizontal saccades, an increased occurrence of square wave jerks, long latencies of vertical antisaccades, a high error rate in the horizontal antisaccade task, and made more errors than controls when pro- and antisaccades were mixed. Based on oculomotor performance, a direct differentiation between EP and PD was possible only by the velocity of horizontal saccades. All remaining metrics were similar between both patient groups. EP patients present extensive oculomotor disturbances probably due to manganese-induced damage to the basal ganglia, reflecting their role in oculomotor system.

Analytical Chemistry and Neurochemistry Department of Chemistry Biomedical Center and SciLife Lab Uppsala University Uppsala Sweden

CRICM UPMC INSERM UMR_S975 CNRS UMR7225 ICM Pitié Salpêtrière Hospital Paris France; Pierre et Marie Curie Paris 6 University Paris France

Department of Neurology and Centre of Clinical Neuroscience Charles University Prague 1st Faculty of Medicine and General University Hospital Prague Czech Republic

Department of Neurology and Centre of Clinical Neuroscience Charles University Prague 1st Faculty of Medicine and General University Hospital Prague Czech Republic; Department of Circuit Theory Faculty of Electrical Engineering Czech Technical University Prague Czech Republic

Department of Neurology and Centre of Clinical Neuroscience Charles University Prague 1st Faculty of Medicine and General University Hospital Prague Czech Republic; Department of Cybernetics Faculty of Electrical Engineering Czech Technical University Prague Czech Republic

Department of Neurology and Centre of Clinical Neuroscience Charles University Prague 1st Faculty of Medicine and General University Hospital Prague Czech Republic; Institute of Pharmacology 1st Faculty of Medicine Charles University Prague and General University Hospital Prague Prague Czech Republic

Department of Neurology S Khechinashvili University Clinic Tbilisi Georgia

Department of Neurology S Khechinashvili University Clinic Tbilisi Georgia; Institute of Medical Research Ilia State University Tbilisi Georgia

Research Institute of Clinical Medicine Tbilisi Georgia

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