Previously we have shown that the SOA that normally contains convergence and divergence cells shows responses related to strabismus angle.
39 Note that the SOA area is distinguished from the SC by the anatomical location
40 (SC is more caudal and dorsal), response to electrical stimulation (no staircase saccades in SOA), and also general firing characteristics (SOA cells showed higher baseline firing rates compared with the SC misalignment-related cells reported here). Analysis of the SOA cells showed that both threshold (same result as rSC cells) and sensitivity (different result from rSC cells) was reduced in animals with exotropia leading to the hypothesis that the SOA connection to medial rectus motoneurons was resulting in reduced vergence tone and therefore contributing to exotropia. Recently Pallus et al.
41 also recorded from SOA of strabismic monkeys and showed similar results in their exotropic monkeys. The SOA connects monosynaptically to the medial rectus motoneurons
42,43 and therefore changes in SOA sensitivity and threshold are likely to directly impact the state of strabismus via changes in medial rectus contractility. On the other hand, the SC projects to the cMRF, which in turn projects to the SOA, the oculomotor nucleus, and the abducens nucleus.
20 Our finding of SC misalignment-related cells places the SC within a vergence and accommodation circuit that is potentially disrupted in strabismus. Interestingly, Pallus et al.
41 found that the esotropic animals they tested also showed reduced SOA sensitivity but not altered thresholds compared with normal animals. In order to account for the reduced SOA sensitivity in esotropic animals (i.e., reduced vergence tone to medial rectus muscle), vergence input to the lateral rectus must be reduced even further. It is possible that the SC input to the abducens via the cMRF can account for the reduced vergence input to the lateral rectus in an esotrope. In this scenario, the misalignment-related cells in SOA play a stronger role in maintenance of exotropia, while the misalignment-related cells in SC play a stronger role in maintaining esotropia. Recording studies must be performed in esotropic animals to test this hypothesis. The SC also projects to the nucleus reticularis tegmenti pontis (NRTP), which subsequently projects to the cerebellum. Both the NRTP and the deep cerebellar nuclei have been shown to contain vergence related neurons.
44–46 We also showed, via muscimol inactivation studies of deep cerebellar nuclei in strabismic monkeys, that the caudal fastigial nucleus and the posterior interposed nucleus can influence the state of strabismus.
6 Since the deep cerebellar nuclei project to the SOA, this provides another pathway by which the SC could influence the state of strabismus.
47