The Ocular Microtremor in Schizophrenia Spectrum Disorders during the Process of Mental State Stabilization

Background: oculomotor dysfunction is one of the most stable markers of schizophrenia. At the same time, the attention of researchers is mainly focused on the characteristics of macro eye movements in nervous and mental disorders, while the features of micro eye movements, in particular ocular microtremor (OMT) generated by the oscillators of the brainstem and cerebellum, poorly understood. The aim was to study the potential of OMT as a marker for objective assessment of changes in the functional state of patients with schizophrenia spectrum disorders. Patients, Participants and Methods: the study involved 30 healthy subjects, 47 patients with paranoid schizophrenia, 27 patients with schizotypal disorder and 20 patients with schizoaffective disorder. Instrumental recording of OMT was performed using the super–slow motion video recording method. Average values of OMT frequency and amplitude were calculated, as well as the frequency of OMT frequency values falling within the intervals of 0–40 Hz, 40–50 Hz, 50–60 Hz, 60–70 Hz, 70–100 Hz, 100–110 Hz and the average OMT amplitude in each frequency range. Results: patients differed from the healthy control group by a decrease in the high–frequency component (70–110 Hz) in the OMT spectrum with a simultaneous increase in the proportion of the low–frequency component (40–60 Hz). Intragroup comparison of OMT frequency indicators at the time of inclusion in the study and showed that significant changes were observed only in the group of patients with schizophrenia in the average OMT frequency and in the frequency of OMT frequency falling within the ranges of 60–70 Hz and 70–100 Hz after 8 weeks of antipsychotic therapy. Significant changes in the OMT amplitude during therapy were also observed only in the group of patients with schizophrenia and in the low–frequency component of the OMT. The average values of the OMT amplitude were higher in the groups of patients, regardless of their condition, compared with the values of the OMT amplitude in the healthy control. Conclusion: the potential of using OMT recording to assess the dynamics of the functional state in schizophrenia spectrum disorders can carry important, missing information about the neurophysiological mechanisms of the disease and serve as a tool for differential diagnosis and assessment of the dynamics of the condition.

1. Lyapunov SI, Shoshina II, Lyapunov IS Tremor Eye Movements as an Objective Marker of Driver's Fatigue. Human Physiology. 2022;48(1):71–77. (In Russ.). doi: 10.31857/S013116462201009X

2. Shakhnovich A. Brain and Regulation of Eye Movement. 1st ed. Springer; 2012.

3. Kubarko AI, Lihachev SA, Kubarko NP. Zrenie (nejrofiziologicheskie i nejrooftal‘mologicheskie aspekty). Minsk: BGMU. 2009;2:352. (In Russ.).

4. Graham L, Das J, Vitorio R, McDonald C, Walker R, Godfrey A, Morris R, Stuart S. Ocular microtremor: a structured review. Exp Brain Res. 2023;241(9):2191– 2203. doi: 10.1007/s00221-023-06691-w

5. Graham L, Vitorio R, Walker R, Barry G, Godfrey A, Morris R, Stuart S. Digital Eye-Movement Outcomes (DEMOs) as Biomarkers for Neurological Conditions: A Narrative Review. Big Data Cogn. Comput. 2024;8:198. doi: 10.3390/bdcc8120198

6. Graham L, Vitório R, Walker R, Godfrey A, Morris R, Stuart S. Digital measurement of ocular microtremor in Parkinson's disease: Protocol for a pilot study to assess reliability and clinical validation. Plos One. 2025;20. doi: 10.1371/journal.pone.0313452

7. Kosikova AV, Shoshina II, Lyapunov SI, et al. Characteristics of Visual Contrast Sensitivity and Ocular Microtremor in Schizophrenia. Psychiatry (Moscow) (Psikhiatriya). 2024;22(1):58–67. (In Russ.). doi: 10.30629/2618-6667-2024-22-1-58-67

8. Athanasopoulos F, Saprikis OV, Margeli M, Klein C, Smyrnis N. Towards Clinically Relevant Oculomotor Biomarkers in Early Schizophrenia. Front Behav Neurosci. 2021 Jun 10;15:688683. doi: 10.3389/fnbeh.2021.688683 PMID: 34177483; PMCID: PMC8222521.

9. Morita K, Miura K, Kasai K, Hashimoto R. Eye movement characteristics in schizophrenia: A recent update with clinical implications. Neuropsychopharmacol Rep. 2020 Mar;40(1):2–9. doi: 10.1002/ npr2.12087 Epub 2019 Nov 27. PMID: 31774633; PMCID: PMC7292223.

10. Morozova AYu, Zubkov EA, Zorkina IaA, Reznik AM, Kostyuk GP, Chekhonin VP. Genetic aspects of schizophrenia. S.S. Korsakov Journal of Neurology and Psychiatry. 2017;117(6):126–132. (In Russ.). doi: 10.17116/jnevro201711761126-132

11. Damilou A, Apostolakis S, Thrapsanioti E, Theleritis C, Smyrnis N. Shared and distinct oculomotor function deficits in schizophrenia and obsessive-compulsive disorder. Psychophysiology. 2016;53(6):796–805. doi: 10.1111/psyp.12630

12. Shoshina I, Kosikova A, Karlova A, Lyapunov I. Optical registration of eye microtremor: results and potential use. Procedia Computer Science. 2023;225:3832–3838. doi: 10.1016/j.procs.2023.10.379

13. Shmukler AB. Schizophrenia. Moscow: GEOTAR-Media Publ., 2017:176. (In Russ.).

14. Kotsyubinskij АP. Аutokhtonnye nepsikhoticheskie rasstrojstva. SPb. 2015. (In Russ.).

15. Kotsyubinskiy AP. Schizotypal disorder. In: Psikhiatriya. Natsionalnoe rukovodstvo. 3rd ed M.: GEOTAR-Media. 2018;264–279. (In Russ.).

16. Tsirkin SYu. Analiticheskaya psikhopatologiya. 3rd ed. M.: Binom. 2012:288. (In Russ.).

17. Shashkova NG, Sal'nikova LI, Kir'yanova EM. Schizoaffective disorder: the current state of the issue. Social and Clinical Psychiatry. 2022;32(3):63–72. (In Russ.).

18. Pavlichenko AV, Petrova NN, Stolyarov AR. The Modern Concept of Schizoaffective Disorder: a Narrative Review Consortium Psychiatricum. 2024;5(3):42–55. doi: 10.17816/CP15513

19. Panteleeva GP, Artiukh VV, Kopeiko GI, Bologov PV, Nikiforova IIu, Shchekal KÉ. Clinical-genetic parameters and the nosological evaluation of schizoaffective psychosis in systematics of attack-like endogenous psychoses. S.S. Korsakov Journal of Neurology and Psychiatry. 2011;111(4):12–21. (In Russ.).

20. Golimbet VE, Panteleeva GP, Bologov PV, Korovaitseva GI, Abramova LI. Molecular-genetic approach to the clinical and nosologic differentiation of schizoaffective disorder. S.S. Korsakov Journal of Neurology and Psychiatry. 2010;110(10):48–52. (In Russ.).

21. Neznanov NG, Ivanov MV. Negative and cognitive disorders in endogenous psychoses: diagnostics, clinical features, therapy. M.: MEDpressinform; 2021:320. (In Russ.).