Impaired eye movements in Parkinson's disease and their relationship to top–down and bottom–up neural processing
Authors: Takahashi Nobuhiro , Kawamura Mimpei , Kobayashi Yasutaka , Hitosugi Masahito 
Published: February 2024

AbstractIntroductionEye movement disorder in patients with Parkinson's disease (PD) is less likely to appear when observing complex images compared with simple images. However, in case of auditory stimuli, meaningful stimuli can promote PD movement. Thus, we measured visual search movements with an eye tracker to investigate whether visual search changes in PD depending on the meaningfulness of visual stimuli; additionally, we measured event‐related potentials (ERPs) to neurophysiologically examine visual information processing in PD.MethodsData from 11 patients with cognitively unimpaired PD and 10 neurologically healthy individuals (controls) were used in this study. We simultaneously measured eye tracking and ERPs during the observation of three types of images: operation, noun, and meaningless figures. We compared intergroup differences in visual search parameters, such as saccade count, fixation time, and saccade amplitude, as well as in ERPs vertex‐to‐vertex amplitudes and latency among P1, N1, P2, and N2 at the posterior regions. These ERPs reflect different stages of visual information processing and provide insights into the underlying neural mechanisms of visual search in PD.ResultsAll visual search parameters were consistently smaller in the PD group than in the control group, regardless of visual stimulus. The saccade count in the PD group was significantly lower than in the control group for operation and meaningless figures but not for noun figures. Further, P1 and N1 amplitudes—bottom–up processing—were smaller in PD group when viewing operation figures and N2 amplitudes—top–down processing—were larger in PD group when viewing operation and meaningless figures.ConclusionsPD's visual search movements may change depending on the meaningfulness of visual stimuli. Further, the abnormal visual search movements in PD may be due to insufficient bottom–up processing and excessive top–down processing.Plain Language SummaryParkinson's disease (PD) is a neurodegenerative disorder that can cause eye movement disorders. People with PD may have difficulty searching for and processing visual information. In this study, we investigated how meaningfulness affects visual search movements and visual information processing in people with PD. We measured eye movements and brain activity in response to different types of visual stimuli, including meaningful and meaningless images, and compared them to a group of healthy control participants. Our results showed that PD patients had fewer eye movements and different brain activity patterns compared to healthy controls, regardless of the meaningfulness of the visual stimuli. However, we also found that the meaningfulness of visual stimuli had an effect on visual search movements in PD patients. This suggests that meaningfulness can impact the way people with PD process visual information. Understanding these differences could help in the development of new therapies to improve visual processing in people with PD.