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Smooth pursuit during dose-related on-off fluctuations in Parkinson's disease

Division of Neurology and the Playfair Neuroscience Unit, The Toronto Hospital and the Departments of Medicine and Ophthalmology, University of Toronto, Toronto, Ontario, Canada.

Smooth pursuit was studied during predictable L-dopa dose-related "OR" periods of morning akinesia and wearing off and during "on" periods in eight patients with idiopathic Parkinson's disease. Smooth pursuit gain was significantly reduced in patients during both on and off phases. Despite marked fluctuations between parkinsonism and periods of near normal skeletal motion, there were no changes in smooth pursuit gain. We conclude that unvarying paresis of smooth pursuit in Parkinson's disease signifies involvement of neural circuits that are distinct from the dopaminergic mechanisms that mediate the on-off phenomenon of somatic motor control.

Address correspondence and reprint requests to Dr. Sharpe, Division of Neurology, The Toronto Hospital, 399 Bathurst Street, Toronto, Ontario M5T 2S8, Canada.

Supported by the Medical Research Council of Canada grants MT5404 and ME5509 (Dr. Sharpe), an Alberta Heritage Foundation for Medical Research Fellowship (Dr. Fletcher) and the E.A. Baker Foundation, Canadian National Institute for the Blind (Dr. Zackon).

Presented in part at the thirty-eighth annual meeting of the American Academy of Neurology, New Orleans, LA, April 1986.

Received September 25, 1986. Accepted for publication in final form November 19, 1986.

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