PROJECT SUMMARY
Eye movements serve as the front-end of the visual system, sampling visual information to bridge low-level
visual input and high-level visuo-cognitive processes. Smooth pursuit for tracking object motion, and saccades
for fixating objects are particularly important for these functions. Oculomotor coordination of these movements
requires a brain network spanning the cortex and subcortex, to provide input to the oculomotor muscles. While
smooth pursuit and saccade circuitry overlaps, they have possibly different developmental trajectories. As
such, disrupting these networks at different points in childhood may cause eye movement deficits, whose
patterns may elucidate mechanisms of compensation and recovery of the circuits generating intact eye
movements. While various brain lesions have resulted in ipsilesional smooth pursuit and contralesional
saccade deficits in adults, oculomotor disruption has not been described after pediatric lesions. Up to 11% of
pediatric epilepsy patients undergo pediatric epilepsy surgery to treat drug-resistant seizures, and surgery may
involve resection of either or both smooth pursuit and saccade network areas. Studying eye movement
patterns in these patients is crucial for delineating the recovery and limitations of oculomotor coordination and
its role in cognitive processes when the brain is at maximal neuroplastic potential. This study combines
behavior and imaging methods to investigate the integrity of smooth pursuit and saccades after pediatric
cortical resection, and the postsurgical malleability of these circuits. Aim 1 of this proposal characterizes
smooth pursuit and saccade profiles after pediatric hemispherectomy compared to controls.
Hemispherectomies result in only one functional hemisphere and are usually performed in childhood. As such,
this work will reveal the response of the oculomotor system at the limits of available functional cortex in
humans, and while developmental plasticity is possibly at its peak. Aim 2 uses functional MRI to study the
neural correlates of smooth pursuit and saccades after focal pediatric cortical resections in two major cortical
oculomotor areas – frontal and parietotemporal– compared to controls. This aim will demonstrate how focal
disruptions impact eye movement profiles, and whether unaffected neural circuitry adapts to support any intact
or compensatory oculomotor function. Finally, Aim 3 examines the neuro-cognitive implications of oculomotor
network disruption under more naturalistic conditions in fMRI. Visual search task performance will be
correlated with neural activity after pediatric resections involving both oculomotor and attentional areas (frontal,
parietal), relative to controls. Overall, this proposal will advance understanding of oculomotor disruption and its
neural and cognitive correlates after pediatric epilepsy surgery. This work will inform an understanding of
surgical risk, and future interventional investigations. My training plan leverages the expertise of my mentors
and resources at Carnegie Mellon and University of Pittsburgh to develop skills in rigorous design and analysis
of eye movement and neuroimaging data which I will apply, in future, to pediatric neurology populations.