• Malou Janssen, Britta K Ischebeck, Jurryt de Vries, Gert-Jan Kleinrensink, Maarten A Frens, and Jos N van der Geest.
• *Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands †Spine and Joint Centre, Rotterdam, The Netherlands ‡Department of Manual Therapy, Hogeschool Rotterdam, The Netherlands §Erasmus University College, Rotterdam, The Netherlands.
• Spine. 2015 Oct 1; 40 (19): E1052-7.

Study DesignThis is a cross-sectional study.ObjectiveThe purpose of this study is to support and extend previous observations on oculomotor disturbances in patients with neck pain and whiplash-associated disorders (WADs) by systematically investigating the effect of static neck torsion on smooth pursuit in response to both predictably and unpredictably moving targets using video-oculography.Summary Of Background DataPrevious studies showed that in patients with neck complaints, for instance due to WAD, extreme static neck torsion deteriorates smooth pursuit eye movements in response to predictably moving targets compared with healthy controls.MethodsEye movements in response to a smoothly moving target were recorded with video-oculography in a heterogeneous group of 55 patients with neck pain (including 11 patients with WAD) and 20 healthy controls. Smooth pursuit performance was determined while the trunk was fixed in 7 static rotations relative to the head (from 45° to the left to 45° to right), using both predictably and unpredictably moving stimuli.ResultsPatients had reduced smooth pursuit gains and smooth pursuit gain decreased due to neck torsion. Healthy controls showed higher gains for predictably moving targets compared with unpredictably moving targets, whereas patients with neck pain had similar gains in response to both types of target movements. In 11 patients with WAD, increased neck torsion decreased smooth pursuit performance, but only for predictably moving targets.ConclusionSmooth pursuit of patients with neck pain is affected. The previously reported WAD-specific decline in smooth pursuit due to increased neck torsion seems to be modulated by the predictability of the movement of the target. The observed oculomotor disturbances in patients with WAD are therefore unlikely to be induced by impaired neck proprioception alone.Level Of Evidence3.

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