{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T10:03:50Z","timestamp":1791021830385,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,5,30]],"date-time":"2021-05-30T00:00:00Z","timestamp":1622332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Clinical diagnosis of Parkinsonism is still challenging, and the diagnostic biomarkers of Multiple System Atrophy (MSA) are scarce. This study aimed to investigate the diagnostic value of the combined eye movement tests in patients with Parkinson's disease (PD) and those with MSA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled 96 PD patients, 33 MSA patients (18 with MSA\u2010P and 15 with MSA\u2010C), and 40 healthy controls who had their horizontal ocular movements measured. The multiple\u2010step pattern of memory\u2010guided saccade (MGS), the hypometria\/hypermetria of the reflexive saccade, the abnormal saccade in smooth pursuit movement (SPM), gaze\u2010evoked nystagmus, and square\u2010wave jerks in gaze\u2010holding test were qualitatively analyzed. The reflexive saccadic parameters and gain of SPM were also quantitatively analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The MGS test showed that patients with either diagnosis had a significantly higher incidence of multiple\u2010step pattern compared with controls (68.6%, 65.2%, and versus. 2.5%, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05, in PD, MSA, versus. controls, respectively). The reflexive saccade test showed that MSA patients showing a prominent higher incidence of the abnormal saccade (63.6%, both hypometria and hypermetria) than that of PD patients and controls (33.3%, 7.5%, respectively, hypometria) (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05). The SPM test showed PD patients had mildly decreased gain among whom 28.1% presenting \u201csaccade intrusions\u201d; and that MSA patients had the significant decreased gain with 51.5% presenting \u201ccatch\u2010up saccades\u201d(<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05). Only MSA patients showed gaze\u2010evoked nystagmus (24.2%), square\u2010wave jerks (6.1%) in gaze\u2010holding test (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A panel of eye movements tests may help to differentiate PD from MSA. The combined presence of hypometria and hypermetria in saccadic eye movement, the impaired gain of smooth pursuit movement with \u201ccatch\u2010up saccades,\u201d gaze\u2010evoked nystagmus, square\u2010wave jerks in gaze\u2010holding test, and multiple\u2010step pattern in MGS may provide clues to the diagnosis of MSA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/brb3.2184","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T02:56:06Z","timestamp":1622429766000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The differential diagnostic value of a battery of oculomotor evaluation in Parkinson's Disease and Multiple System Atrophy"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-4160","authenticated-orcid":false,"given":"Hong","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Neurology Peking University First Hospital 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China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunchuang","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neurology Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Neurology Peking University First Hospital Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmar H","family":"Pinkhardt","sequence":"additional","affiliation":[{"name":"Department of Neurology Ulm University Ulm Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Landwehrmeyer","sequence":"additional","affiliation":[{"name":"Department of Neurology Ulm 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