Pontine Lesions Impair Visually Guided Eye and Hand Movements

Summary Although animal research and some rare human case reports suggest that lesions of the dorsal pons yield saccadic and smooth pursuit eye movement deficits, little is known about the functional topology of the human pontine nuclei (PN) and whether limb movements are similarly affected as eye movements. Saccadic as well as SP eye and pointing movements were measured in six patients with lesions in the PN region. Five patients of the six exhibited dysmetric saccades, whilst smooth pursuit gain was reduced in four. Pontine lesions also alter the relationship between amplitude, velocity, and velocity skewness of saccadic eye movements. Limb movement trajectories were more curved in four patients. The results suggest that the lesions impair a general calibration mechanism that uses the parallel fiber-Purkinjecell synapse in the cerebellar cortex to adjust the timing of muscle innervation in visually guided oculomotor as well as limb movement tasks.