{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T11:03:49Z","timestamp":1783595029732,"version":"3.55.0"},"reference-count":72,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T00:00:00Z","timestamp":1479772800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To evaluate the role of neural integrators (<jats:styled-content style=\"fixed-case\">NI<\/jats:styled-content>) in the oculomotor system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A literature search was carried out using several electronic databases during the months of June 2014 to March 2015. The following keywords were used to generate focused results: \u2018neural integrators\u2019, \u2018gaze\u2010holding\u2019, \u2018oculomotor integration\u2019, \u2018impaired gaze\u2010holding\u2019, \u2018gaze evoked nystagmus\u2019 and \u2018gaze dysfunction\u2019. Further materials were found through searching relevant articles within reference lists. Seventy\u2010one articles were sourced for this review which analysed animal and human subjects and network models; 45 were studies of humans, 16 studies of primates, three studies of felines and one study from rats and network models. The remaining articles were literature reviews.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The horizontal and vertical, including torsional, NI are located logically in the brainstem, nearby their appropriate target extraocular motoneuron nuclei for stable eye position in eccentric position. The nucleus prepositus hypoglossi (<jats:styled-content style=\"fixed-case\">NPH<\/jats:styled-content>) and medial vestibular nuclei (<jats:styled-content style=\"fixed-case\">MVN<\/jats:styled-content>) are closely linked at the caudal pons and dorsal rostral medulla, integrating horizontal conjugate eye movement. The interstitial nucleus of Cajal (<jats:styled-content style=\"fixed-case\">INC<\/jats:styled-content>) integrates vertical and torsional eye movement at the upper midbrain. The integrator time constant is averaged to 25\u00a0seconds in human horizontal and animal vertical <jats:styled-content style=\"fixed-case\">NI<\/jats:styled-content> to perform its function. Case reports revealed that dysfunction of horizontal NI also resulted in vertical ocular deviations, indicating some overlap of horizontal and vertical gaze control. Furthermore, pharmacological inactivation of NI exposed a population of inhibitory neurotransmitters that permits its mechanism of action; allowing for smooth conjugate movement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Neural integrators operate to integrate eye velocity and eye position information to provide signals to extraocular motoneurons to attain and maintain a new position. Therefore, NI allow image stabilization during horizontal and vertical eye movements at eccentric positions for comfortable single vision.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aos.13307","type":"journal-article","created":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T12:56:52Z","timestamp":1479819412000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Role of neural integrators in oculomotor systems: a\u00a0systematic narrative literature review"],"prefix":"10.1111","volume":"96","author":[{"given":"Katherine","family":"Sanchez","sequence":"first","affiliation":[{"name":"Department of Orthoptics Royal Preston Hospital Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona J.","family":"Rowe","sequence":"additional","affiliation":[{"name":"Department of Health Services Research University of Liverpool Liverpool 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