{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T21:47:49Z","timestamp":1793051269172,"version":"4.5.0"},"reference-count":28,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T00:00:00Z","timestamp":1762128000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurology International"],"abstract":"<jats:p>Background: Antibodies to glutamic acid decarboxylase (anti-GAD) can give rise to stiff person syndrome (SPS), an infrequent autoimmune condition of the central nervous system marked by fluctuating muscular rigidity and stimulus-evoked spasms. Disturbances in eye-movement control are rarely identified yet may provide insight into underlying neural involvement. Methods: Two individuals with anti-GAD-related SPS showing distinctive ocular-motor abnormalities were examined with quantitative videonystagmography, supplemented by representative video documentation. Results: Recordings demonstrated varied patterns of ocular-motor disturbance, including reduced smooth-pursuit accuracy, delayed saccadic initiation, dysmetria, intrusive saccades, and several nystagmus types. Partial improvement occurred after immunomodulatory therapy. Conclusions: These findings extend current understanding of the anti-GAD SPS phenotype and indicate that quantitative analysis of eye movements may offer a sensitive, non-invasive marker of disease activity. Larger, prospective studies are needed to clarify prevalence and responsiveness to treatment.<\/jats:p>","DOI":"10.3390\/neurolint17110179","type":"journal-article","created":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T13:47:58Z","timestamp":1762177678000},"page":"179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Oculomotor Abnormalities in Anti-Glutamic Acid Decarboxylase-Positive Stiff Person Syndrome"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5630-9822","authenticated-orcid":false,"given":"Pavol","family":"Skacik","sequence":"first","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"},{"name":"Jessenius Faculty of Medicine Martin, Commenius University Bratislava, Mala Hora 4, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaroslav","family":"Petrisin","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristian","family":"Sveda","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7864-6560","authenticated-orcid":false,"given":"Monika","family":"Turcanova-Koprusakova","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"},{"name":"Jessenius Faculty of Medicine Martin, Commenius University Bratislava, Mala Hora 4, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0464-0497","authenticated-orcid":false,"given":"Milan","family":"Grofik","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"},{"name":"Jessenius Faculty of Medicine Martin, Commenius University Bratislava, Mala Hora 4, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0348-3082","authenticated-orcid":false,"given":"Stefan","family":"Sivak","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"},{"name":"Jessenius Faculty of Medicine Martin, Commenius University Bratislava, Mala Hora 4, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1025-6830","authenticated-orcid":false,"given":"Egon","family":"Kurca","sequence":"additional","affiliation":[{"name":"Neurology Department, University Hospital Martin, Kollarova 2, 036 01 Martin, Slovakia"},{"name":"Jessenius Faculty of Medicine Martin, Commenius University Bratislava, Mala Hora 4, 036 01 Martin, Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"ref_1","unstructured":"Muranova, A., and Shanina, E. (2025, January 25). Stiff Person Syndrome. [Updated 10 July 2023], StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK573078\/."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1038\/s41582-024-01012-3","article-title":"Stiff-person syndrome and related disorders\u2014Diagnosis, mechanisms and therapies","volume":"20","author":"Dalakas","year":"2024","journal-title":"Nat. Rev. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1002\/acn3.51791","article-title":"Stiff person spectrum disorder diagnosis, misdiagnosis, and suggested diagnostic criteria","volume":"10","author":"Chia","year":"2023","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/pn-2023-003974","article-title":"Stiff-person syndrome","volume":"25","author":"Bose","year":"2025","journal-title":"Pract. Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"577915","DOI":"10.1016\/j.jneuroim.2022.577915","article-title":"Stiff person syndrome spectrum disorders; more than meets the eye","volume":"369","author":"Newsome","year":"2022","journal-title":"J. Neuroimmunol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1136\/jnnp.2004.036558","article-title":"Stiff person syndrome with eye movement abnormality, myasthenia gravis, and thymoma","volume":"76","author":"Thomas","year":"2005","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e665","DOI":"10.1097\/WNO.0000000000001084","article-title":"Ocular motor and vestibular characteristics of antiglutamic acid decarboxylase-associated neurologic disorders","volume":"41","author":"Wang","year":"2021","journal-title":"J. Neuroophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.jaut.2019.04.007","article-title":"The neurological syndromes associated with glutamic acid decarboxylase antibodies","volume":"101","year":"2019","journal-title":"J. Autoimmun."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e124","DOI":"10.1212\/WNL.0000000000001512","article-title":"Pearls & Oy-sters: Tonic eye deviation in stiff-person syndrome","volume":"84","author":"Chakravarthi","year":"2015","journal-title":"Neurology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1212\/01.wnl.0000183068.42803.33","article-title":"Eye movement abnormalities in stiff person syndrome","volume":"65","author":"Economides","year":"2005","journal-title":"Neurology"},{"key":"ref_11","first-page":"2","article-title":"Eye movement abnormalities in movement disorders","volume":"1","author":"Rucker","year":"2019","journal-title":"Clin. Park. Relat. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1136\/jnnp.74.7.998","article-title":"Autoantibodies to glutamic acid decarboxylase in downbeat nystagmus","volume":"74","author":"Antonini","year":"2003","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/bs.pbr.2019.04.040","article-title":"Rebound nystagmus, a window into the oculomotor integrator","volume":"249","author":"Colpak","year":"2019","journal-title":"Prog. Brain Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"4409","DOI":"10.1167\/iovs.12-11369","article-title":"Directional asymmetries in human smooth pursuit eye movements","volume":"54","author":"Ke","year":"2013","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1097\/WNP.0000000000000579","article-title":"Eye movement disorders and the cerebellum","volume":"36","author":"Shemesh","year":"2019","journal-title":"J. Clin. Neurophysiol."},{"key":"ref_16","unstructured":"Leigh, R.J., and Zee, D.S. (2006). The Neurology of Eye Movements, Oxford University Press. [4th ed.]."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/j.brainres.2006.03.064","article-title":"A rare saccade velocity profile in Stiff-Person Syndrome with cerebellar degeneration","volume":"1093","author":"Zivotofsky","year":"2006","journal-title":"Brain Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1097\/WCO.0b013e32835c5e1d","article-title":"Saccadic intrusions: Review and update","volume":"26","author":"Lemos","year":"2013","journal-title":"Curr. Opin. Neurol."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Rakocevic, G., Alexopoulos, H., and Dalakas, M.C. (2019). Quantitative clinical and autoimmune assessments in stiff person syndrome: Evidence for a progressive disorder. BMC Neurol., 19.","DOI":"10.1186\/s12883-018-1232-z"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"10","DOI":"10.14802\/jmd.20040","article-title":"Immune-Mediated Cerebellar Ataxias: Clinical Diagnosis and Treatment Based on Immunological and Physiological Mechanisms","volume":"14","author":"Mitoma","year":"2021","journal-title":"J. Mov. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1002\/mdc3.13413","article-title":"Eye Movement Disorders in Movement Disorders","volume":"9","author":"Kassavetis","year":"2022","journal-title":"Mov. Disord. Clin. Pract."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2147\/EB.S389629","article-title":"Ocular Myasthenia Gravis: A Current Overview","volume":"15","author":"Behbehani","year":"2023","journal-title":"Eye Brain"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1001\/jamaneurol.2014.1011","article-title":"Cerebellar ataxia and glutamic acid decarboxylase antibodies","volume":"71","author":"Blanco","year":"2014","journal-title":"JAMA Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2743","DOI":"10.1007\/s00415-023-11611-7","article-title":"Oculomotor fatigability with decrements of saccade and smooth pursuit for diagnosis of myasthenia gravis","volume":"270","author":"Nguyen","year":"2023","journal-title":"J. Neurol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1007\/s11060-008-9650-1","article-title":"Paraneoplastic opsoclonus-myoclonus ataxia associated with non-small-cell lung carcinoma","volume":"90","author":"Musunuru","year":"2008","journal-title":"J. Neurooncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3389\/fneur.2010.00147","article-title":"The disturbance of gaze in progressive supranuclear palsy: Implications for pathogenesis","volume":"1","author":"Chen","year":"2010","journal-title":"Front. Neurol."},{"key":"ref_27","first-page":"e75375","article-title":"Isolated ophthalmoplegia: An uncommon presentation of anti-glutamic acid decarboxylase 65 (anti-GAD65) neurological syndrome","volume":"16","author":"Cruz","year":"2024","journal-title":"Cureus"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"116506","DOI":"10.1016\/j.jns.2019.116506","article-title":"Rituximab improves not only back stiffness but also \u201cstiff eyes\u201d in stiff person syndrome: Implications for immune-mediated treatment","volume":"408","author":"Kodama","year":"2020","journal-title":"J. Neurol. Sci."}],"container-title":["Neurology International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/11\/179\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:03:12Z","timestamp":1762182192000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2035-8377\/17\/11\/179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,3]]},"references-count":28,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["neurolint17110179"],"URL":"https:\/\/doi.org\/10.3390\/neurolint17110179","relation":{},"ISSN":["2035-8377"],"issn-type":[{"value":"2035-8377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,3]]}}}