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Chudzik A, Śledzianowski A, Przybyszewski AW. Machine Learning and Digital Biomarkers Can Detect Early Stages of Neurodegenerative Diseases. SENSORS (BASEL, SWITZERLAND) 2024; 24:1572. [PMID: 38475108 DOI: 10.3390/s24051572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
Neurodegenerative diseases (NDs) such as Alzheimer's Disease (AD) and Parkinson's Disease (PD) are devastating conditions that can develop without noticeable symptoms, causing irreversible damage to neurons before any signs become clinically evident. NDs are a major cause of disability and mortality worldwide. Currently, there are no cures or treatments to halt their progression. Therefore, the development of early detection methods is urgently needed to delay neuronal loss as soon as possible. Despite advancements in Medtech, the early diagnosis of NDs remains a challenge at the intersection of medical, IT, and regulatory fields. Thus, this review explores "digital biomarkers" (tools designed for remote neurocognitive data collection and AI analysis) as a potential solution. The review summarizes that recent studies combining AI with digital biomarkers suggest the possibility of identifying pre-symptomatic indicators of NDs. For instance, research utilizing convolutional neural networks for eye tracking has achieved significant diagnostic accuracies. ROC-AUC scores reached up to 0.88, indicating high model performance in differentiating between PD patients and healthy controls. Similarly, advancements in facial expression analysis through tools have demonstrated significant potential in detecting emotional changes in ND patients, with some models reaching an accuracy of 0.89 and a precision of 0.85. This review follows a structured approach to article selection, starting with a comprehensive database search and culminating in a rigorous quality assessment and meaning for NDs of the different methods. The process is visualized in 10 tables with 54 parameters describing different approaches and their consequences for understanding various mechanisms in ND changes. However, these methods also face challenges related to data accuracy and privacy concerns. To address these issues, this review proposes strategies that emphasize the need for rigorous validation and rapid integration into clinical practice. Such integration could transform ND diagnostics, making early detection tools more cost-effective and globally accessible. In conclusion, this review underscores the urgent need to incorporate validated digital health tools into mainstream medical practice. This integration could indicate a new era in the early diagnosis of neurodegenerative diseases, potentially altering the trajectory of these conditions for millions worldwide. Thus, by highlighting specific and statistically significant findings, this review demonstrates the current progress in this field and the potential impact of these advancements on the global management of NDs.
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Affiliation(s)
- Artur Chudzik
- Polish-Japanese Academy of Information Technology, Faculty of Computer Science, 86 Koszykowa Street, 02-008 Warsaw, Poland
| | - Albert Śledzianowski
- Polish-Japanese Academy of Information Technology, Faculty of Computer Science, 86 Koszykowa Street, 02-008 Warsaw, Poland
| | - Andrzej W Przybyszewski
- Polish-Japanese Academy of Information Technology, Faculty of Computer Science, 86 Koszykowa Street, 02-008 Warsaw, Poland
- UMass Chan Medical School, Department of Neurology, 65 Lake Avenue, Worcester, MA 01655, USA
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2
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Melnyk K, Friedman L, Komogortsev OV. What can entropy metrics tell us about the characteristics of ocular fixation trajectories? PLoS One 2024; 19:e0291823. [PMID: 38166054 PMCID: PMC10760742 DOI: 10.1371/journal.pone.0291823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 09/06/2023] [Indexed: 01/04/2024] Open
Abstract
In this study, we provide a detailed analysis of entropy measures calculated for fixation eye movement trajectories from the three different datasets. We employed six key metrics (Fuzzy, Increment, Sample, Gridded Distribution, Phase, and Spectral Entropies). We calculate these six metrics on three sets of fixations: (1) fixations from the GazeCom dataset, (2) fixations from what we refer to as the "Lund" dataset, and (3) fixations from our own research laboratory ("OK Lab" dataset). For each entropy measure, for each dataset, we closely examined the 36 fixations with the highest entropy and the 36 fixations with the lowest entropy. From this, it was clear that the nature of the information from our entropy metrics depended on which dataset was evaluated. These entropy metrics found various types of misclassified fixations in the GazeCom dataset. Two entropy metrics also detected fixation with substantial linear drift. For the Lund dataset, the only finding was that low spectral entropy was associated with what we call "bumpy" fixations. These are fixations with low-frequency oscillations. For the OK Lab dataset, three entropies found fixations with high-frequency noise which probably represent ocular microtremor. In this dataset, one entropy found fixations with linear drift. The between-dataset results are discussed in terms of the number of fixations in each dataset, the different eye movement stimuli employed, and the method of eye movement classification.
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Affiliation(s)
- Kateryna Melnyk
- Department of Computer Science, Texas State University, San Marcos, TX, United States of America
| | - Lee Friedman
- Department of Computer Science, Texas State University, San Marcos, TX, United States of America
| | - Oleg V. Komogortsev
- Department of Computer Science, Texas State University, San Marcos, TX, United States of America
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3
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Wolf A, Tripanpitak K, Umeda S, Otake-Matsuura M. Eye-tracking paradigms for the assessment of mild cognitive impairment: a systematic review. Front Psychol 2023; 14:1197567. [PMID: 37546488 PMCID: PMC10399700 DOI: 10.3389/fpsyg.2023.1197567] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023] Open
Abstract
Mild cognitive impairment (MCI), representing the 'transitional zone' between normal cognition and dementia, has become a novel topic in clinical research. Although early detection is crucial, it remains logistically challenging at the same time. While traditional pen-and-paper tests require in-depth training to ensure standardized administration and accurate interpretation of findings, significant technological advancements are leading to the development of procedures for the early detection of Alzheimer's disease (AD) and facilitating the diagnostic process. Some of the diagnostic protocols, however, show significant limitations that hamper their widespread adoption. Concerns about the social and economic implications of the increasing incidence of AD underline the need for reliable, non-invasive, cost-effective, and timely cognitive scoring methodologies. For instance, modern clinical studies report significant oculomotor impairments among patients with MCI, who perform poorly in visual paired-comparison tasks by ascribing less attentional resources to novel stimuli. To accelerate the Global Action Plan on the Public Health Response to Dementia 2017-2025, this work provides an overview of research on saccadic and exploratory eye-movement deficits among older adults with MCI. The review protocol was drafted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were systematically searched to identify peer-reviewed articles published between 2017 and 2022 that examined visual processing in older adults with MCI and reported gaze parameters as potential biomarkers. Moreover, following the contemporary trend for remote healthcare technologies, we reviewed studies that implemented non-commercial eye-tracking instrumentation in order to detect information processing impairments among the MCI population. Based on the gathered literature, eye-tracking-based paradigms may ameliorate the screening limitations of traditional cognitive assessments and contribute to early AD detection. However, in order to translate the findings pertaining to abnormal gaze behavior into clinical applications, it is imperative to conduct longitudinal investigations in both laboratory-based and ecologically valid settings.
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Affiliation(s)
- Alexandra Wolf
- Cognitive Behavioral Assistive Technology (CBAT), Goal-Oriented Technology Group, RIKEN Center for Advanced Intelligence Project (AIP), Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kornkanok Tripanpitak
- Cognitive Behavioral Assistive Technology (CBAT), Goal-Oriented Technology Group, RIKEN Center for Advanced Intelligence Project (AIP), Tokyo, Japan
| | - Satoshi Umeda
- Department of Psychology, Keio University, Tokyo, Japan
| | - Mihoko Otake-Matsuura
- Cognitive Behavioral Assistive Technology (CBAT), Goal-Oriented Technology Group, RIKEN Center for Advanced Intelligence Project (AIP), Tokyo, Japan
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4
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Holmqvist K, Örbom SL, Hooge ITC, Niehorster DC, Alexander RG, Andersson R, Benjamins JS, Blignaut P, Brouwer AM, Chuang LL, Dalrymple KA, Drieghe D, Dunn MJ, Ettinger U, Fiedler S, Foulsham T, van der Geest JN, Hansen DW, Hutton SB, Kasneci E, Kingstone A, Knox PC, Kok EM, Lee H, Lee JY, Leppänen JM, Macknik S, Majaranta P, Martinez-Conde S, Nuthmann A, Nyström M, Orquin JL, Otero-Millan J, Park SY, Popelka S, Proudlock F, Renkewitz F, Roorda A, Schulte-Mecklenbeck M, Sharif B, Shic F, Shovman M, Thomas MG, Venrooij W, Zemblys R, Hessels RS. Eye tracking: empirical foundations for a minimal reporting guideline. Behav Res Methods 2023; 55:364-416. [PMID: 35384605 PMCID: PMC9535040 DOI: 10.3758/s13428-021-01762-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 45.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/08/2022]
Abstract
In this paper, we present a review of how the various aspects of any study using an eye tracker (such as the instrument, methodology, environment, participant, etc.) affect the quality of the recorded eye-tracking data and the obtained eye-movement and gaze measures. We take this review to represent the empirical foundation for reporting guidelines of any study involving an eye tracker. We compare this empirical foundation to five existing reporting guidelines and to a database of 207 published eye-tracking studies. We find that reporting guidelines vary substantially and do not match with actual reporting practices. We end by deriving a minimal, flexible reporting guideline based on empirical research (Section "An empirically based minimal reporting guideline").
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Affiliation(s)
- Kenneth Holmqvist
- Department of Psychology, Nicolaus Copernicus University, Torun, Poland.
- Department of Computer Science and Informatics, University of the Free State, Bloemfontein, South Africa.
- Department of Psychology, Regensburg University, Regensburg, Germany.
| | - Saga Lee Örbom
- Department of Psychology, Regensburg University, Regensburg, Germany
| | - Ignace T C Hooge
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Diederick C Niehorster
- Lund University Humanities Lab and Department of Psychology, Lund University, Lund, Sweden
| | - Robert G Alexander
- Department of Ophthalmology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Jeroen S Benjamins
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Social, Health and Organizational Psychology, Utrecht University, Utrecht, The Netherlands
| | - Pieter Blignaut
- Department of Computer Science and Informatics, University of the Free State, Bloemfontein, South Africa
| | | | - Lewis L Chuang
- Department of Ergonomics, Leibniz Institute for Working Environments and Human Factors, Dortmund, Germany
- Institute of Informatics, LMU Munich, Munich, Germany
| | | | - Denis Drieghe
- School of Psychology, University of Southampton, Southampton, UK
| | - Matt J Dunn
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | | | - Susann Fiedler
- Vienna University of Economics and Business, Vienna, Austria
| | - Tom Foulsham
- Department of Psychology, University of Essex, Essex, UK
| | | | - Dan Witzner Hansen
- Machine Learning Group, Department of Computer Science, IT University of Copenhagen, Copenhagen, Denmark
| | | | - Enkelejda Kasneci
- Human-Computer Interaction, University of Tübingen, Tübingen, Germany
| | | | - Paul C Knox
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| | - Ellen M Kok
- Department of Education and Pedagogy, Division Education, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands
- Department of Online Learning and Instruction, Faculty of Educational Sciences, Open University of the Netherlands, Heerlen, The Netherlands
| | - Helena Lee
- University of Southampton, Southampton, UK
| | - Joy Yeonjoo Lee
- School of Health Professions Education, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jukka M Leppänen
- Department of Psychology and Speed-Language Pathology, University of Turku, Turku, Finland
| | - Stephen Macknik
- Department of Ophthalmology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Päivi Majaranta
- TAUCHI Research Center, Computing Sciences, Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Susana Martinez-Conde
- Department of Ophthalmology, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Antje Nuthmann
- Institute of Psychology, University of Kiel, Kiel, Germany
| | - Marcus Nyström
- Lund University Humanities Lab, Lund University, Lund, Sweden
| | - Jacob L Orquin
- Department of Management, Aarhus University, Aarhus, Denmark
- Center for Research in Marketing and Consumer Psychology, Reykjavik University, Reykjavik, Iceland
| | - Jorge Otero-Millan
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | - Soon Young Park
- Comparative Cognition, Messerli Research Institute, University of Veterinary Medicine Vienna, Medical University of Vienna, Vienna, Austria
| | - Stanislav Popelka
- Department of Geoinformatics, Palacký University Olomouc, Olomouc, Czech Republic
| | - Frank Proudlock
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Frank Renkewitz
- Department of Psychology, University of Erfurt, Erfurt, Germany
| | - Austin Roorda
- Herbert Wertheim School of Optometry and Vision Science, University of California, Berkeley, CA, USA
| | | | - Bonita Sharif
- School of Computing, University of Nebraska-Lincoln, Lincoln, Nebraska, USA
| | - Frederick Shic
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA
- Department of General Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Mark Shovman
- Eyeviation Systems, Herzliya, Israel
- Department of Industrial Design, Bezalel Academy of Arts and Design, Jerusalem, Israel
| | - Mervyn G Thomas
- The University of Leicester Ulverscroft Eye Unit, Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Ward Venrooij
- Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
| | | | - Roy S Hessels
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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5
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On the Effect of Bilateral Eye Movements on Memory Retrieval in Ageing and Dementia. Brain Sci 2022; 12:brainsci12101299. [PMID: 36291233 PMCID: PMC9599909 DOI: 10.3390/brainsci12101299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/20/2022] [Accepted: 09/22/2022] [Indexed: 12/03/2022] Open
Abstract
It has been reported that performing bilateral eye movements for a short period can lead to an enhancement of memory retrieval and recall (termed the “saccade induced retrieval effect (SIRE)”). The source of this effect has been debated within the literature and the phenomenon has come under scrutiny as the robustness of the effect has recently been questioned. To date investigations of SIRE have largely been restricted to younger adult populations. Here, across two experiments, we assess the robustness and generalisability of the SIRE specifically in relation to disease and ageing. Experiment 1 employed a between subject’s design and presented younger and older participants with 36 words prior to completing one of three eye movement conditions (bilateral, antisaccade or a fixation eye movement). Participants then performed a word recognition task. Experiment 2 assessed the SIRE in individuals diagnosed with Alzheimer’s, Mild cognitive impairment and Parkinson’s by employing an online within subject’s design. Results showed no significant difference between groups in the number of words recognised based on eye movement condition. Neither experiment 1 or 2 replicated the SIRE effect therefore the findings from this study add to the growing number of studies that have failed to replicate the SIRE effect.
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6
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El Haj M, Chapelet G, Moustafa AA, Boutoleau-Bretonnière C. Pupil size as an indicator of cognitive activity in mild Alzheimer's disease. EXCLI JOURNAL 2022; 21:307-316. [PMID: 35382454 PMCID: PMC8977451 DOI: 10.17179/excli2021-4568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 12/07/2021] [Indexed: 12/15/2022]
Abstract
It is well established that pupil activity indexes cognitive processing. For instance, research has consistently demonstrated that the pupil reacts to working memory span task performance. However, little is known about pupil reaction to cognitive processing in Alzheimer's Disease (AD). We thus investigated whether span tasks can modulate pupil size in patients with AD. We invited 24 patients with AD and 24 healthy older adults to perform backward and forward spans, as well as to count aloud in a control condition, while their pupil activity was recorded with eye tracking glasses. In patients with AD, analysis demonstrated larger pupil size during backward spans (M = 2.12, SD = .39) than during forward spans (M = 1.98, SD = .36) [t(23) = 3.22, p = .004], larger pupil size during forward spans than during counting (M = 1.67, SD = .33) [t(23) = 4.75, p < .001], as well as larger pupil size during backward spans than during counting [t(23) = 10.60, p < .001]. In control participants, analysis demonstrated larger pupil size during backward spans (M = 3.36, SD = .49) than during forward spans (M = 2.85, SD = .68) [t(23) = 5.82, p < .001], larger pupil size during forward spans than during counting (M = 2.09, SD = .62) [t(23) = 5.42, < .001], as well as larger pupil size during backward spans than during counting [t(23) = 9.70, p < .001]. Results also demonstrated a significant interaction effect between groups and conditions [F(2,92) = 16.63, p < .001]; in other words, patients with AD have shown fewer variations on the pupil size across the conditions compared to the control participants. The larger pupil size during backward spans, compared with forward spans or counting, can be attributed to the high cognitive load of backward spans. The modulation of pupil size, as observed across backward/forward spans and counting, can possibly be attributed to sympathetic/adrenergic and parasympathetic/cholinergic activities. Our study demonstrates the value of pupillometry as a potential biomarker of cognitive processing in AD.
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Affiliation(s)
- Mohamad El Haj
- Nantes Université, Univ. Angers, Laboratoire de Psychologie des Pays de la Loire (LPPL - EA 4638), F-44000 Nantes, France,Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France,Institut Universitaire de France, Paris, France,*To whom correspondence should be addressed: Mohamad El Haj, Faculté de Psychologie, LPPL – Laboratoire de Psychologie des Pays de la Loire, Université de Nantes, Chemin de la Censive du Tertre, BP 81227, 44312 Nantes Cedex 3, France, E-mail:
| | - Guillaume Chapelet
- CHU Nantes, Clinical Gerontology Department, Bd Jacques Monod, F44093, Nantes, France,Université de Nantes, Inserm, TENS, The Enteric Nervous System in Gut and Brain Diseases, IMAD, Nantes, France
| | - Ahmed A. Moustafa
- School of Psychology, Faculty of Society and Design, Bond University, Gold Coast, Queensland, Australia,Department of Human Anatomy and Physiology, Faculty of Health Sciences, University of Johannesburg, Johannesburg, South Africa
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7
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Vision through Healthy Aging Eyes. Vision (Basel) 2021; 5:vision5040046. [PMID: 34698313 PMCID: PMC8544709 DOI: 10.3390/vision5040046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/20/2021] [Accepted: 09/23/2021] [Indexed: 01/04/2023] Open
Abstract
As life expectancy grows, so too will the number of people adversely affected by age. Although it is acknowledged that many conditions and diseases are associated with age, this mini-review will present a current update of the various visual changes that generally occur in healthy individuals disregarding the possible effects of illness. These alterations influence how the world is perceived and in turn can affect efficiency or the ability to perform ordinary daily tasks such as driving or reading. The most common physical developments include a decreased pupil size and retinal luminance as well as changes both in intercellular and intracellular connections within the retina along the pathway to the visual cortex and within the visual cortex. The quantity and the physical location of retinal cells including photoreceptors, ganglion and bipolar retinal cells are modified. The clarity of intraocular organs, such as the intraocular lens, decreases. These all result in common visual manifestations that include reduced visual acuity, dry eyes, motility changes, a contraction of the visual field, presbyopia, reduced contrast sensitivity, slow dark adaptation, recovery from glare, variation in color vision and a decreased visual processing speed. Highlighting these prevalent issues as well as current and possible future innovations will assist providers to formulate treatments and thereby conserve maximum independence and mobility in the modern mature population.
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8
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Yuen NH, Tam F, Churchill NW, Schweizer TA, Graham SJ. Driving With Distraction: Measuring Brain Activity and Oculomotor Behavior Using fMRI and Eye-Tracking. Front Hum Neurosci 2021; 15:659040. [PMID: 34483861 PMCID: PMC8415783 DOI: 10.3389/fnhum.2021.659040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 06/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Driving motor vehicles is a complex task that depends heavily on how visual stimuli are received and subsequently processed by the brain. The potential impact of distraction on driving performance is well known and poses a safety concern - especially for individuals with cognitive impairments who may be clinically unfit to drive. The present study is the first to combine functional magnetic resonance imaging (fMRI) and eye-tracking during simulated driving with distraction, providing oculomotor metrics to enhance scientific understanding of the brain activity that supports driving performance. Materials and Methods As initial work, twelve healthy young, right-handed participants performed turns ranging in complexity, including simple right and left turns without oncoming traffic, and left turns with oncoming traffic. Distraction was introduced as an auditory task during straight driving, and during left turns with oncoming traffic. Eye-tracking data were recorded during fMRI to characterize fixations, saccades, pupil diameter and blink rate. Results Brain activation maps for right turns, left turns without oncoming traffic, left turns with oncoming traffic, and the distraction conditions were largely consistent with previous literature reporting the neural correlates of simulated driving. When the effects of distraction were evaluated for left turns with oncoming traffic, increased activation was observed in areas involved in executive function (e.g., middle and inferior frontal gyri) as well as decreased activation in the posterior brain (e.g., middle and superior occipital gyri). Whereas driving performance remained mostly unchanged (e.g., turn speed, time to turn, collisions), the oculomotor measures showed that distraction resulted in more consistent gaze at oncoming traffic in a small area of the visual scene; less time spent gazing at off-road targets (e.g., speedometer, rear-view mirror); more time spent performing saccadic eye movements; and decreased blink rate. Conclusion Oculomotor behavior modulated with driving task complexity and distraction in a manner consistent with the brain activation features revealed by fMRI. The results suggest that eye-tracking technology should be included in future fMRI studies of simulated driving behavior in targeted populations, such as the elderly and individuals with cognitive complaints - ultimately toward developing better technology to assess and enhance fitness to drive.
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Affiliation(s)
- Nicole H Yuen
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Fred Tam
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Nathan W Churchill
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Tom A Schweizer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada.,Division of Neurosurgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Simon J Graham
- Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Physical Sciences Platform, Sunnybrook Research Institute, Toronto, ON, Canada
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9
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Molina R, Redondo B, Molina-Carballo A, García JA, Muñoz-Hoyos A, Vera J, Jiménez R. Capturing attention improves accommodation: An experimental study in children with ADHD using multiple object tracking. Vision Res 2021; 186:52-58. [PMID: 34051609 DOI: 10.1016/j.visres.2021.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 05/13/2021] [Accepted: 05/13/2021] [Indexed: 11/15/2022]
Abstract
The present study was aimed at assessing the impact of manipulating the attentional load using a multiple object tracking (MOT) task on the dynamics of the accommodative response in children with attention deficit hyperactivity disorder (ADHD). The pupil size was recorded to assess the effectiveness of the experimental manipulation, and the role of ADHD medication was also explored. The accommodative and pupil dynamics (magnitude and variability) were monitored with an open-field autorefractometer (WAM-5500) in 41 children with ADHD (24 non-medicated and 17 medicated) and 21 non-ADHD controls, while they performed the MOT task with four different levels of complexity (i.e., tracking zero, one, two, or three targets). We found that increasing the attentional load caused a heightened accommodative response, showing a negative association between MOT complexity and accommodative lag in children with ADHD and non-ADHD controls. Complementarily, the pupil size increased as a function of task complexity, confirming a successful experimental manipulation. The stability of accommodation was insensitive to the attentional manipulation, but it differed between groups. Specifically, non-medicated children with ADHD exhibited a greater variability of accommodation in comparison to controls. Increasing the attentional load is associated with a reduction in the accommodative lag in children with ADHD and controls. Our findings show that the allocation of attention plays an important role in the dynamics of the accommodative response, which may be of relevance in the diagnosis and treatment of accommodative deficits in children with and without ADHD.
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Affiliation(s)
- Rubén Molina
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Beatriz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain.
| | - Antonio Molina-Carballo
- Faculty of Medicine, University of Granada, Neuropediatric and Neurodevelopment Unit of Clinico San Cecilio University Hospital, Spain
| | - José Antonio García
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Antonio Muñoz-Hoyos
- Faculty of Medicine, University of Granada, Neuropediatric and Neurodevelopment Unit of Clinico San Cecilio University Hospital, Spain
| | - Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Spain
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10
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Opwonya J, Doan DNT, Kim SG, Kim JI, Ku B, Kim S, Park S, Kim JU. Saccadic Eye Movement in Mild Cognitive Impairment and Alzheimer's Disease: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2021; 32:193-227. [PMID: 33959887 PMCID: PMC9090874 DOI: 10.1007/s11065-021-09495-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/01/2021] [Indexed: 11/30/2022]
Abstract
Alzheimer’s disease (AD) is the leading cause of dementia, and mild cognitive impairment (MCI) is considered the transitional state to AD dementia (ADD) and other types of dementia, whose symptoms are accompanied by altered eye movement. In this work, we reviewed the existing literature and conducted a meta-analysis to extract relevant eye movement parameters that are significantly altered owing to ADD and MCI. We conducted a systematic review of 35 eligible original publications in saccade paradigms and a meta-analysis of 27 articles with specified task conditions, which used mainly gap and overlap conditions in both prosaccade and antisaccade paradigms. The meta-analysis revealed that prosaccade and antisaccade latencies and frequency of antisaccade errors showed significant alterations for both MCI and ADD. First, both prosaccade and antisaccade paradigms differentiated patients with ADD and MCI from controls, however, antisaccade paradigms was more effective than prosaccade paradigms in distinguishing patients from controls. Second, during prosaccade in the gap and overlap conditions, patients with ADD had significantly longer latencies than patients with MCI, and the trend was similar during antisaccade in the gap condition as patients with ADD had significantly more errors than patients with MCI. The anti-effect magnitude was similar between controls and patients, and the magnitude of the latency of the gap effect varied among healthy controls and MCI and ADD subjects, but the effect size of the latency remained large in both patients. These findings suggest that, using gap effect, anti-effect, and specific choices of saccade paradigms and conditions, distinctions could be made between MCI and ADD patients as well as between patients and controls.
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Affiliation(s)
- Julius Opwonya
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | - Dieu Ni Thi Doan
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea
| | - Seul Gee Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Joong Il Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Boncho Ku
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Soochan Kim
- Department of Electrical and Electronic Engineering, Hankyong National University, Anseong, Republic of Korea
| | - Sunju Park
- Department of Preventive Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea.
| | - Jaeuk U Kim
- Future Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
- Korean Convergence Medicine, University of Science and Technology, Daejeon, Republic of Korea.
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11
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Grillini A, Renken RJ, Vrijling ACL, Heutink J, Cornelissen FW. Eye Movement Evaluation in Multiple Sclerosis and Parkinson's Disease Using a Standardized Oculomotor and Neuro-Ophthalmic Disorder Assessment (SONDA). Front Neurol 2020; 11:971. [PMID: 33013643 PMCID: PMC7506055 DOI: 10.3389/fneur.2020.00971] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/24/2020] [Indexed: 11/13/2022] Open
Abstract
Evaluating the state of the oculomotor system of a patient is one of the fundamental tests done in neuro-ophthalmology. However, up to date, very few quantitative standardized tests of eye movements' quality exist, limiting this assessment to confrontational tests reliant on subjective interpretation. Furthermore, quantitative tests relying on eye movement properties, such as pursuit gain and saccade dynamics are often insufficient to capture the complexity of the underlying disorders and are often (too) long and tiring. In this study, we present SONDA (Standardized Oculomotor and Neurological Disorder Assessment): this test is based on analyzing eye tracking recorded during a short and intuitive continuous tracking task. We tested patients affected by Multiple Sclerosis (MS) and Parkinson's Disease (PD) and find that: (1) the saccadic dynamics of the main sequence alone are not sufficient to separate patients from healthy controls; (2) the combination of spatio-temporal and statistical properties of saccades and saccadic dynamics enables an identification of oculomotor abnormalities in both MS and PD patients. We conclude that SONDA constitutes a powerful screening tool that allows an in-depth evaluation of (deviant) oculomotor behavior in a few minutes of non-invasive testing.
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Affiliation(s)
- Alessandro Grillini
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Remco J Renken
- Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne C L Vrijling
- Royal Dutch Visio, Center of Expertise for Blind and Partially Sighted People, Huizen, Netherlands
| | - Joost Heutink
- Royal Dutch Visio, Center of Expertise for Blind and Partially Sighted People, Huizen, Netherlands.,Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, Netherlands
| | - Frans W Cornelissen
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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12
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Eye Movements in Response to Pain-Related Feelings in the Presence of Low and High Cognitive Loads. Behav Sci (Basel) 2020; 10:bs10050092. [PMID: 32443887 PMCID: PMC7287850 DOI: 10.3390/bs10050092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/08/2020] [Accepted: 05/15/2020] [Indexed: 11/21/2022] Open
Abstract
The affective dimension of pain contributes to pain perception. Cognitive load may influence pain-related feelings. Eye tracking has proven useful for detecting cognitive load effects objectively by using relevant eye movement characteristics. In this study, we investigated whether eye movement characteristics differ in response to pain-related feelings in the presence of low and high cognitive loads. A set of validated, control, and pain-related sounds were applied to provoke pain-related feelings. Twelve healthy young participants (six females) performed a cognitive task at two load levels, once with the control and once with pain-related sounds in a randomized order. During the tasks, eye movements and task performance were recorded. Afterwards, the participants were asked to fill out questionnaires on their pain perception in response to the applied cognitive loads. Our findings indicate that an increased cognitive load was associated with a decreased saccade peak velocity, saccade frequency, and fixation frequency, as well as an increased fixation duration and pupil dilation range. Among the oculometrics, pain-related feelings were reflected only in the pupillary responses to a low cognitive load. The performance and perceived cognitive load decreased and increased, respectively, with the task load level and were not influenced by the pain-related sounds. Pain-related feelings were lower when performing the task compared with when no task was being performed in an independent group of participants. This might be due to the cognitive engagement during the task. This study demonstrated that cognitive processing could moderate the feelings associated with pain perception.
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13
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Imaoka Y, Flury A, de Bruin ED. Assessing Saccadic Eye Movements With Head-Mounted Display Virtual Reality Technology. Front Psychiatry 2020; 11:572938. [PMID: 33093838 PMCID: PMC7527608 DOI: 10.3389/fpsyt.2020.572938] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/18/2020] [Indexed: 12/16/2022] Open
Abstract
As our society is ageing globally, neurodegenerative disorders are becoming a relevant issue. Assessment of saccadic eye movement could provide objective values to help to understand the symptoms of disorders. HTC Corporation launched a new virtual reality (VR) headset, VIVE Pro Eye, implementing an infrared-based eye tracking technique together with VR technology. The purpose of this study is to evaluate whether the device can be used as an assessment tool of saccadic eye movement and to investigate the technical features of eye tracking. We developed a measurement system of saccadic eye movement with a simple VR environment on Unity VR design platform, following an internationally proposed standard saccade measurement protocol. We then measured the saccadic eye movement of seven healthy young adults to analyze the oculo-metrics of latency, peak velocity, and error rate of pro- and anti-saccade tasks: 120 trials in each task. We calculated these parameters based on the saccade detection algorithm that we have developed following previous studies. Consequently, our results revealed latency of 220.40 ± 43.16 ms, peak velocity of 357.90 ± 111.99°/s, and error rate of 0.24 ± 0.41% for the pro-saccade task, and latency of 343.35 ± 76.42 ms, peak velocity of 318.79 ± 116.69°/s, and error rate of 0.66 ± 0.76% for the anti-saccade task. In addition, we observed pupil diameter of 4.30 ± 1.15 mm (left eye) and 4.29 ± 1.08 mm (right eye) for the pro-saccade task, and of 4.21 ± 1.04 mm (left eye) and 4.22 ± 0.97 mm (right eye) for the anti-saccade task. Comparing between the descriptive statistics of previous studies and our results suggests that VIVE Pro Eye can function as an assessment tool of saccadic eye movement since our results are in the range of or close to the results of previous studies. Nonetheless, we found technical limitations especially about time-related measurement parameters. Further improvements in software and hardware of the device and measurement protocol, and more measurements with diverse age-groups and people with different health conditions are warranted to enhance the whole assessment system of saccadic eye movement.
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Affiliation(s)
- Yu Imaoka
- Motor Control & Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andri Flury
- Motor Control & Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Motor Control & Learning Laboratory, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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