Translational Neurology of Slow Saccades

Extensive knowledge has been gained over recent decades about anatomic and pathophysiologic mechanisms governing saccades, rapid eye movements by which gaze is shifted between visual targets. In this focused review, we highlight the physiology and anatomy of normal saccades as they pertain to pathological saccade slowing of central brainstem origin, with emphasis on excitatory and inhibitory burst neurons and omnipause neuron function. We summarize insights into saccadic dysfunction from nonhuman basic science research and further utilize these insights to review advances from translational research in common and uncommon human central neurological disease states that lead to vertical and/or horizontal saccade slowing, such as progressive supranuclear palsy, Niemann-Pick type C, and post-cardiac surgery.