Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear palsy
Identifieur interne : 002717 ( Main/Corpus ); précédent : 002716; suivant : 002718Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear palsy
Auteurs : Matteo Bologna ; Rocco Agostino ; Bruno Gregori ; Daniele Belvisi ; Donatella Ottaviani ; Carlo Colosimo ; Giovanni Fabbrini ; Alfredo BerardelliSource :
- Brain [ 0006-8950 ] ; 2009-02.
Abstract
Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients’ clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.
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DOI: 10.1093/brain/awn317
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Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Agostino, Rocco" sort="Agostino, Rocco" uniqKey="Agostino R" first="Rocco" last="Agostino">Rocco Agostino</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Gregori, Bruno" sort="Gregori, Bruno" uniqKey="Gregori B" first="Bruno" last="Gregori">Bruno Gregori</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Belvisi, Daniele" sort="Belvisi, Daniele" uniqKey="Belvisi D" first="Daniele" last="Belvisi">Daniele Belvisi</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Ottaviani, Donatella" sort="Ottaviani, Donatella" uniqKey="Ottaviani D" first="Donatella" last="Ottaviani">Donatella Ottaviani</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Colosimo, Carlo" sort="Colosimo, Carlo" uniqKey="Colosimo C" first="Carlo" last="Colosimo">Carlo Colosimo</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Fabbrini, Giovanni" sort="Fabbrini, Giovanni" uniqKey="Fabbrini G" first="Giovanni" last="Fabbrini">Giovanni Fabbrini</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation></author><author><name sortKey="Berardelli, Alfredo" sort="Berardelli, Alfredo" uniqKey="Berardelli A" first="Alfredo" last="Berardelli">Alfredo Berardelli</name><affiliation><mods:affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: alfredo.berardelli@uniroma1.it</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Brain</title><idno type="ISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-02">2009-02</date><biblScope unit="volume">132</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="502">502</biblScope><biblScope unit="page" to="510">510</biblScope></imprint><idno type="ISSN">0006-8950</idno></series><idno type="istex">9C4720D02C70375336EF513F72016530372C1C48</idno><idno type="DOI">10.1093/brain/awn317</idno><idno type="ArticleID">awn317</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0006-8950</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients’ clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.</div></front></TEI><istex><corpusName>oup</corpusName><author><json:item><name>Matteo Bologna</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Rocco Agostino</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Bruno Gregori</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Daniele Belvisi</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Donatella Ottaviani</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Carlo Colosimo</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Giovanni Fabbrini</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string></affiliations></json:item><json:item><name>Alfredo Berardelli</name><affiliations><json:string>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</json:string><json:string>E-mail: alfredo.berardelli@uniroma1.it</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Original Articles</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>progressive supranuclear palsy</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>blinking</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>movement control</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients’ clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.</abstract><qualityIndicators><score>8.26</score><pdfVersion>1.4</pdfVersion><pdfPageSize>612.68 x 790.866 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>4</keywordCount><abstractCharCount>1629</abstractCharCount><pdfWordCount>6463</pdfWordCount><pdfCharCount>40847</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>230</abstractWordCount></qualityIndicators><title>Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear 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type="first">Bruno</forename><surname>Gregori</surname></persName><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation></author><author><persName><forename type="first">Daniele</forename><surname>Belvisi</surname></persName><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation></author><author><persName><forename type="first">Donatella</forename><surname>Ottaviani</surname></persName><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation></author><author><persName><forename type="first">Carlo</forename><surname>Colosimo</surname></persName><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation></author><author><persName><forename type="first">Giovanni</forename><surname>Fabbrini</surname></persName><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation></author><author corresp="yes"><persName><forename type="first">Alfredo</forename><surname>Berardelli</surname></persName><email>alfredo.berardelli@uniroma1.it</email><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation></author></analytic><monogr><title level="j">Brain</title><idno type="pISSN">0006-8950</idno><idno type="eISSN">1460-2156</idno><imprint><publisher>Oxford University Press</publisher><date type="published" when="2009-02"></date><biblScope unit="volume">132</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="502">502</biblScope><biblScope unit="page" to="510">510</biblScope></imprint></monogr><idno type="istex">9C4720D02C70375336EF513F72016530372C1C48</idno><idno type="DOI">10.1093/brain/awn317</idno><idno type="ArticleID">awn317</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2008-11-29</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients’ clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.</p></abstract><textClass><keywords scheme="keyword"><list><item><term>Original Articles</term></item></list></keywords></textClass><textClass><keywords scheme="keyword"><list><head>Keywords</head><item><term>progressive supranuclear palsy</term></item><item><term>blinking</term></item><item><term>movement control</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2008-11-29">Created</change><change when="2009-02">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/9C4720D02C70375336EF513F72016530372C1C48/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus oup" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="utf-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" URI="journalpublishing.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">brain</journal-id><journal-id journal-id-type="publisher-id">brainj</journal-id><journal-title>Brain</journal-title><issn pub-type="ppub">0006-8950</issn><issn pub-type="epub">1460-2156</issn><publisher><publisher-name>Oxford University Press</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.1093/brain/awn317</article-id><article-id pub-id-type="publisher-id">awn317</article-id><article-categories><subj-group><subject>Original Articles</subject></subj-group></article-categories><title-group><article-title>Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear palsy</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bologna</surname><given-names>Matteo</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Agostino</surname><given-names>Rocco</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF1"><sup>2</sup></xref></contrib><contrib contrib-type="author"><name><surname>Gregori</surname><given-names>Bruno</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Belvisi</surname><given-names>Daniele</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Ottaviani</surname><given-names>Donatella</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Colosimo</surname><given-names>Carlo</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Fabbrini</surname><given-names>Giovanni</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF1"><sup>2</sup></xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Berardelli</surname><given-names>Alfredo</given-names></name><xref ref-type="aff" rid="AFF1"><sup>1</sup></xref><xref ref-type="aff" rid="AFF1"><sup>2</sup></xref></contrib></contrib-group><aff id="AFF1">1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</aff><author-notes><corresp>Correspondence to: Prof. Alfredo Berardelli, Department of Neurological Sciences, Sapienza, University of Rome, Viale dell’Università n° 30, 00185 Rome, Italy E-mail: <email>alfredo.berardelli@uniroma1.it</email></corresp></author-notes><pub-date pub-type="ppub"><month>2</month><year>2009</year></pub-date><pub-date pub-type="epub"><day>29</day><month>11</month><year>2008</year></pub-date><volume>132</volume><issue>2</issue><fpage>502</fpage><lpage>510</lpage><history><date date-type="received"><day>21</day><month>7</month><year>2008</year></date><date date-type="rev-recd"><day>31</day><month>10</month><year>2008</year></date><date date-type="accepted"><day>31</day><month>10</month><year>2008</year></date></history><permissions><copyright-statement>© The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org</copyright-statement><copyright-year>2008</copyright-year></permissions><abstract><p>Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients’ clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.</p></abstract><kwd-group><kwd>progressive supranuclear palsy</kwd><kwd>blinking</kwd><kwd>movement control</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear palsy</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Voluntary, spontaneous and reflex blinking in patients with clinically probable progressive supranuclear palsy</title></titleInfo><name type="personal"><namePart type="given">Matteo</namePart><namePart type="family">Bologna</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Rocco</namePart><namePart type="family">Agostino</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Bruno</namePart><namePart type="family">Gregori</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Daniele</namePart><namePart type="family">Belvisi</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Donatella</namePart><namePart type="family">Ottaviani</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Carlo</namePart><namePart type="family">Colosimo</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Giovanni</namePart><namePart type="family">Fabbrini</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Alfredo</namePart><namePart type="family">Berardelli</namePart><affiliation>1 Department of Neurological Sciences, Sapienza, University of Rome, Italy 2 Neuromed Institute, Sapienza, University of Rome, Italy</affiliation><affiliation>E-mail: alfredo.berardelli@uniroma1.it</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><subject><topic>Original Articles</topic></subject><originInfo><publisher>Oxford University Press</publisher><dateIssued encoding="w3cdtf">2009-02</dateIssued><dateCreated encoding="w3cdtf">2008-11-29</dateCreated><copyrightDate encoding="w3cdtf">2008</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Patients with progressive supranuclear palsy (PSP) often have blinking abnormalities. In this study we examined the kinematic features of voluntary, spontaneous and reflex blinking in 11 patients with PSP and healthy control subjects. Patients were asked to blink voluntarily as fast as possible; spontaneous blinking was recorded during two 60 s rest periods; reflex blinking was evoked by electrical stimulation of the supraorbital nerve. Eyelid movements were recorded with the SMART analyzer motion system. During voluntary blinking the closing and opening phases lasted longer in patients than in healthy subjects. Furthermore, the peak velocity of the closing phase of voluntary blinking was lower in patients than healthy subjects. During spontaneous blinking the blink rate was markedly lower in patients than in control subjects. Patient's recordings also showed kinematic abnormalities of spontaneous (reduced peak velocity of both closing and opening phases) and reflex (reduced peak velocity and increased duration of the opening phase) blinking. Recordings during reflex blinking disclosed an enhanced excitability of the interneuronal pool mediating the closing and opening blink phases. Finally, the pause, a neurophysiological marker of the switching processes between the closing and opening phases, was prolonged in all the three types of blinking. The abnormal kinematic variables correlated with patients’ clinical and kinematic features. Abnormal voluntary, spontaneous and reflex blinking in patients with PSP reflects the widespread cortical, subcortical and brainstem degeneration related to this disease.</abstract><subject><genre>Keywords</genre><topic>progressive supranuclear palsy</topic><topic>blinking</topic><topic>movement control</topic></subject><relatedItem type="host"><titleInfo><title>Brain</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0006-8950</identifier><identifier type="eISSN">1460-2156</identifier><identifier type="PublisherID">brainj</identifier><identifier type="PublisherID-hwp">brain</identifier><part><date>2009</date><detail type="volume"><caption>vol.</caption><number>132</number></detail><detail type="issue"><caption>no.</caption><number>2</number></detail><extent unit="pages"><start>502</start><end>510</end></extent></part></relatedItem><identifier type="istex">9C4720D02C70375336EF513F72016530372C1C48</identifier><identifier type="DOI">10.1093/brain/awn317</identifier><identifier type="ArticleID">awn317</identifier><accessCondition type="use and reproduction" contentType="copyright">© The Author (2008). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. 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