Influence of Gaze Shift and Emotions on Symptoms of Blepharospasm

NCT01759745 | Withdrawn

• 1 other identifier: BEB_Gaze_Emotion
• Study Type: observational
• Target: N/A
• Locations: 1 country
• Sites: 1

Brief Summary

Blepharospasm (BEB) is a focal dystonia characterized by forceful, involuntary contractions of the orbicularis oculi muscle. (Jankovic et al 1983) Patients with BEB report task and situation specific modulations of their symptoms. So called "sensory tricks" are actions that minimize symptoms and include concentrating, talking, pulling on the eyelids, blowing air, and applying pressure to the periocular or temple region. (Weiner 1984) Many patients describe that other tasks/situations are exacerbate their symptoms specifically under bright fluorescent lights and stress. (Burke 1984) Earlier studies showed that blink patterns differ between BEB patients and control during rest, reading and talking. In healthy subjects gaze evoked blinks are a physiologic phenomenon: initiation of gaze shifts evoke a blink, blinks facilitate gaze shifts. (Evinger 1994) In healthy subjects emotions and thoughts influence gaze shifts and blink rate. (Leal 2008, de Genaro 1988) However, little is known about various task and emotion specific influences on symptoms of BEB (e.g. expecting a gaze shift might worsen symptoms while driving a car). Differences in emotion and gaze related blink patterns between patients and controls will contribute to the understanding of the pathophysiology of BEB. This might offer new therapeutic options, e.g. symptom modulation. The investigators hypothesize that blink patterns, measured by duration and frequency of pupillary occlusion differ between patients and control, when performing gaze shifts and emotion related blink patterns, measured by duration and frequency of pupillary occlusion differ between patients and controls. The aim of this pilot trial is to assess differences in gaze evoked and emotion related blink patterns between patients and controls. These differences might contribute to the understanding of the pathophysiology of BEB.

Conditions

Pupillary Occlusion

Outcome Measures

Primary Outcomes (1)

• Duration and frequency of pupillary occlusion

  Duration and frequency of pupillary occlusion during different tasks and situations will be studied via videooculography

  At baseline

Secondary Outcomes (1)

• Number of blinks and spasms.

  At baseline

Study Arms (2)

Blepharospasm

Blepharospasm, patient's group

Control

Healthy control subjects

Eligibility Criteria

• Age: 18 Years - 80 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

20 patients suffering from BEB, age 18-80 from our Botulinum toxin clinic will be investigated. For controls,20 healthy age matched subjects will be investigated. All participants will sign an informed consent.

You may qualify if:

• Patients:
• Willing to participate
• Idiopathic blepharospasm
• Age 18-80
• Last botulinum toxin injection \<3months
• Control:
• Willing to participate
• Age and sex matched with patients
• Age18-80

You may not qualify if:

• Patients:
• Secondary blepharospasm
• Neurologic Comorbidities
• Other eye disease besides BEB
• History of neuroleptic medication
• Use of medications on the study day, that influence eye blinks\& attention
• Drinking of caffeine or theine containing beverages on the study day
• Patients and Control:
• Intake of psychotropic drugs at day of examination
• History of neuroleptic medication
• present eye disease
• Neurologic diseases that influence blinking
• Use of medications on the study day, that influence eye blinks\& attention
• Drinking of caffeine or theine containing beverages on the study day

Sponsors & Collaborators

• Kirsten Elwischger, MD: lead

Study Sites (1)

Department of Neurology, Medical University of Vienna

Vienna, 1090, Austria

Location

Related Publications (5)

• Jankovic J, Ford J. Blepharospasm and orofacial-cervical dystonia: clinical and pharmacological findings in 100 patients. Ann Neurol. 1983 Apr;13(4):402-11. doi: 10.1002/ana.410130406.

  PMID: 6838174 BACKGROUND

• Weiner WJ, Nora LM. "Trick" movements in facial dystonia. J Clin Psychiatry. 1984 Dec;45(12):519-21.

  PMID: 6501239 BACKGROUND

• Burke RE, Fahn S, Marsden CD, Bressman SB, Moskowitz C, Friedman J. Validity and reliability of a rating scale for the primary torsion dystonias. Neurology. 1985 Jan;35(1):73-7. doi: 10.1212/wnl.35.1.73.

  PMID: 3966004 BACKGROUND

• Richard MJ, Woodward DJ, McCoy AN, Woodward JA. Effect of reading on surface electromyogram recordings in patients with blepharospasm. Ophthalmic Plast Reconstr Surg. 2009 Sep-Oct;25(5):378-81. doi: 10.1097/IOP.0b013e3181b0d630.

  PMID: 19966652 BACKGROUND

• Evinger C, Manning KA, Pellegrini JJ, Basso MA, Powers AS, Sibony PA. Not looking while leaping: the linkage of blinking and saccadic gaze shifts. Exp Brain Res. 1994;100(2):337-44. doi: 10.1007/BF00227203.

  PMID: 7813670 BACKGROUND

MeSH Terms

Conditions

Pupil Disorders

Condition Hierarchy (Ancestors)

Neurologic Manifestations; Nervous System Diseases; Eye Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Thomas Sycha, Prof.Dr.

  Medical University of Vienna

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Dr. Kirsten Elwischger

Study Record Dates

• First Submitted: December 31, 2012
• First Posted: January 3, 2013
• Study Start: December 1, 2014
• Primary Completion: December 1, 2015
• Study Completion: December 1, 2015
• Last Updated: March 1, 2021

Record last verified: 2021-02

Locations

AU (1)