Eye tracking metrics to screen and assess cognitive impairment in patients with neurological disorders
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REVIEW ARTICLE
Eye tracking metrics to screen and assess cognitive impairment in patients with neurological disorders Ling Tao 1 & Quan Wang 2 & Ding Liu 3 & Jing Wang 4 & Ziqing Zhu 1 & Li Feng 4 Received: 17 November 2019 / Accepted: 20 February 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Purpose of review Eye tracking is a powerful method to investigate the relationship between behavior and neural mechanisms. In recent years, eye movement analysis has been used in patients with neurological disorders to assess cognitive function. In this review, we explore the latest eye tracking researches in neurological disorders that are commonly associated with cognitive deficits, specifically, amyotrophic lateral sclerosis (ALS), Alzheimer’s disease (AD), Parkinson’s disease (PD), multiple sclerosis (MS), and epilepsy. We focus on the application of ocular measures in these disorders, with the goal of understanding how eye tracking technology can be used in the clinical setting. Findings Eye tracking tasks (especially saccadic tasks) are often used as an adjunct to traditional scales for cognitive assessment. Eye tracking data confirmed that executive dysfunction is common in PD and ALS, whereas AD and MS are characterized by attention deficits. Research in evaluating cognitive function in epilepsy using eye tracking is still in its early stages, but this approach has shown advantages as a sensitive quantitative method with high temporal and spatial resolution. Summary Eye tracking technology can facilitate the assessment of cognitive impairment with higher temporal resolution and finer granularity than traditional cognitive assessment. Oculomotor data collected during cognitive tasks can provide insight into biological processes. Eye tracking provides a nonverbal and less cognitively demanding method of measuring disease progression in cognitively impaired patients. Keywords Eye tracking . Cognition . Neurology . Amyotrophic lateral sclerosis . Alzheimer’s disease . Parkinson’s disease . Multiple sclerosis . Epilepsy
Introduction Eye tracking captures gaze information in the form of fixations and saccades. Fixations occur when subjects focus their vision on a point in space (usually a screen) over time. Fixation count, rate, and duration are measured to reflect * Li Feng [email protected] 1
XiangYa School of Medicine, Central South University, Changsha, Hunan, China
2
Key Laboratory of Biomedical Spectroscopy of Xi’ An, Key Laboratory of Spectral Imaging technology, Xi’an, Institute of Optics and Precision Mechanics (XIOPM), Chinese Academy of Sciences, Xi’ An, China
3
Department of Neurology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
4
Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
attention fixation and stimulation time [1, 2]. In contrast, saccades are quick shifts in eye position. Analyzing saccade angle and scan paths is helpful in distinguishing both stimulusdriven and automatic shifts in attention and execut
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