The current paper describes a rare case of a patient who suffered from unilateral apraxia of eye closure as a result of a bilateral stroke. Interestingly, the patient’s ability to voluntarily close both eyelids (i.e. blinking) was not affected, indicating that different neural mechanisms control each type of eye closure. The stroke caused damage to a large part of the right frontal cortex, including the motor cortex, pre-motor cortex and the frontal eye field (FEF). The lesion in the left hemisphere was restricted to the FEF. In order to further study the neural mechanisms of eye closure, we conducted an fMRI study in a group of neurological healthy subjects. We found that all areas of the oculomotor cortex were activated by both left and right winking, including the FEF, supplementary eye field (SEF), and posterior parietal cortex (PPC). Blinking activated FEF and SEF, but not PPC. Both FEF and PPC were significantly more active during winking than blinking. Together, these results provide evidence for a critical role of the FEF in voluntary unilateral eye closure.

中文翻译：

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自主闭眼的神经控制：案例研究和眨眼和眨眼的 fMRI 调查。

目前的论文描述了一个罕见的病例，患者因双侧中风而出现单侧闭眼失用症。有趣的是，患者自动闭合双眼皮（即眨眼）的能力没有受到影响，这表明不同的神经机制控制着每种类型的眼睛闭合。中风对右额叶皮层的大部分造成损害，包括运动皮层、前运动皮层和额叶眼区 (FEF)。左半球的病变仅限于 FEF。为了进一步研究闭眼的神经机制，我们对一组神经系统健康受试者进行了 fMRI 研究。我们发现动眼皮层的所有区域都被左右眨眼激活，包括 FEF、辅助眼场 (SEF) 和后顶叶皮层 (PPC)。闪烁激活 FEF 和 SEF，但不激活 PPC。FEF 和 PPC 在眨眼时都比眨眼时更活跃。总之，这些结果为 FEF 在自愿单侧闭眼中的关键作用提供了证据。