1
|
Reyes-Lopez M, Vaca-Palomares I, Dávila-Ortiz de Montellano DJ, White BJ, Brien DC, Coe BC, Munoz DP, Fernandez-Ruiz J. Saccades, pupil response and blink abnormalities in Huntington's disease patients during free viewing. Clin Neurophysiol 2024; 165:117-124. [PMID: 39013355 DOI: 10.1016/j.clinph.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 05/16/2024] [Accepted: 06/18/2024] [Indexed: 07/18/2024]
Abstract
OBJECTIVE Video-based eye tracking was used to investigate saccade, pupil, and blink abnormalities among patients with Huntington's disease (HD) who watched sequences of short videos. HD, an autosomal dominant neurodegenerative disorder resulting from a CAG mutation on chromosome 4, produces motor and cognitive impairments including slow or irregular eye movements, which have been studied using structured tasks. METHODS To explore how HD affects eye movements under instruction free conditions, we assessed 22 HD patients and their age matched controls in a 10-minute video-based free viewing task. RESULTS Patients with HD experienced a significant reduction in saccade exploration rate following video clip transitions, an increase in pupil reactions to luminance changes after clip transitions, and a significant higher blink rate throughout the task compared to the control group. CONCLUSIONS These results show that HD has a significant impact on how patients visually explore and respond to their environment under unconstrained and ecologically natural conditions. SIGNIFICANCE Eye tracking in HD patients revealed saccadic, pupil, and blink abnormalities in early HD patients, suggestive of brain circuitry abnormalities that probably involve brain stem deficits. Further research should explore the impact of these changes on the quality of life of the patients affected by the disease.
Collapse
Affiliation(s)
- Mariana Reyes-Lopez
- Ciencias Cognitivas y del Comportamiento, Facultad de Psicología, Universidad Nacional Autónoma de México, CDMX, Mexico
| | - Israel Vaca-Palomares
- Ciencias Cognitivas y del Comportamiento, Facultad de Psicología, Universidad Nacional Autónoma de México, CDMX, Mexico
| | | | - Brian J White
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Donald C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Juan Fernandez-Ruiz
- Instituto de Neuroetología, Universidad Veracruzana, Xalapa, Mexico; Departamento de Fisiología, Facultad de Medicina, Universidad Nacional Autónoma de México, CDMX, Mexico.
| |
Collapse
|
2
|
Yamada Y, Shinkawa K, Kobayashi M, Nemoto M, Ota M, Nemoto K, Arai T. Distinct eye movement patterns to complex scenes in Alzheimer's disease and Lewy body disease. Front Neurosci 2024; 18:1333894. [PMID: 38646608 PMCID: PMC11026598 DOI: 10.3389/fnins.2024.1333894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 03/22/2024] [Indexed: 04/23/2024] Open
Abstract
Background Alzheimer's disease (AD) and Lewy body disease (LBD), the two most common causes of neurodegenerative dementia with similar clinical manifestations, both show impaired visual attention and altered eye movements. However, prior studies have used structured tasks or restricted stimuli, limiting the insights into how eye movements alter and differ between AD and LBD in daily life. Objective We aimed to comprehensively characterize eye movements of AD and LBD patients on naturalistic complex scenes with broad categories of objects, which would provide a context closer to real-world free viewing, and to identify disease-specific patterns of altered eye movements. Methods We collected spontaneous viewing behaviors to 200 naturalistic complex scenes from patients with AD or LBD at the prodromal or dementia stage, as well as matched control participants. We then investigated eye movement patterns using a computational visual attention model with high-level image features of object properties and semantic information. Results Compared with matched controls, we identified two disease-specific altered patterns of eye movements: diminished visual exploration, which differentially correlates with cognitive impairment in AD and with motor impairment in LBD; and reduced gaze allocation to objects, attributed to a weaker attention bias toward high-level image features in AD and attributed to a greater image-center bias in LBD. Conclusion Our findings may help differentiate AD and LBD patients and comprehend their real-world visual behaviors to mitigate the widespread impact of impaired visual attention on daily activities.
Collapse
Affiliation(s)
- Yasunori Yamada
- Digital Health, IBM Research, Tokyo, Japan
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | - Masatomo Kobayashi
- Digital Health, IBM Research, Tokyo, Japan
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Miyuki Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Miho Ota
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Kiyotaka Nemoto
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Tetsuaki Arai
- Department of Psychiatry, Division of Clinical Medicine, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
| |
Collapse
|
3
|
Pitigoi IC, Coe BC, Calancie OG, Brien DC, Yep R, Riek HC, Kirkpatrick RH, Noyes BK, White BJ, Blohm G, Munoz DP. Attentional modulation of eye blinking is altered by sex, age, and task structure. eNeuro 2024; 11:ENEURO.0296-23.2024. [PMID: 38331578 PMCID: PMC10915461 DOI: 10.1523/eneuro.0296-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/15/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024] Open
Abstract
Spontaneous eye blinking is gaining popularity as a proxy for higher cognitive functions, as it is readily modulated by both environmental demands and internal processes. Prior studies were impoverished in sample size, sex representation and age distribution, making it difficult to establish a complete picture of the behavior. Here we present eye-tracking data from a large cohort of normative participants (n=604, 393 F, aged 5-93 years) performing two tasks: one with structured, discrete trials (interleaved pro/anti-saccade task; IPAST) and one with a less structured, continuous organization in which participants watch movies (free-viewing; FV). Sex- and age-based analyses revealed that females had higher blink rates between the ages of 22 and 58 years in the IPAST, and 22 and 34 years in FV. We derived a continuous measure of blink probability to reveal behavioral changes driven by stimulus appearance in both paradigms. In the IPAST, blinks were suppressed near stimulus appearance, particularly on correct anti-saccade trials, which we attribute to the stronger inhibitory control required for anti-saccades compared to pro-saccades. In FV, blink suppression occurred immediately after scene changes, and the effect was sustained on scenes where gaze clustered among participants (indicating engagement of attention). Females were more likely than males to blink during appearance of novel stimuli in both tasks, but only within the age bin of 18-44 years. The consistency of blink patterns in each paradigm endorses blinking as a sensitive index for changes in visual processing and attention, while sex and age differences drive interindividual variability.Significance Statement Eye-tracking is becoming useful as a non-invasive tool for detecting preclinical markers of neurological and psychiatric disease. Blinks are understudied despite being an important supplement to saccade and pupil eye-tracking metrics. The present study is a crucial step in developing a healthy baseline for blink behavior to compare to clinical groups. While many prior blink studies suffered from small sample sizes with relatively low age- and sex-diversity (review by Jongkees & Colzato, 2016), our large cohort of healthy participants has permitted a more detailed analysis of sex and age effects in blink behavior. Furthermore, our analysis techniques are robust to temporal changes in blink probability, greatly clarifying the relationship between blinking, visual processing, and inhibitory control mechanisms on visual tasks.
Collapse
Affiliation(s)
- Isabell C Pitigoi
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Brian C Coe
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Olivia G Calancie
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Donald C Brien
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Rachel Yep
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Heidi C Riek
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Ryan H Kirkpatrick
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Blake K Noyes
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Brian J White
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Gunnar Blohm
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| | - Douglas P Munoz
- Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada K7L 3N6
| |
Collapse
|
4
|
Sidoroff V, Carbone F, Ellmerer P, Bair S, Hoffmann A, Maran T, Krismer F, Mahlknecht P, Mair K, Raccagni C, Ndayisaba JP, Seppi K, Wenning GK, Djamshidian A. Emotion Recognition in Multiple System Atrophy: An Exploratory Eye-Tracking Study. J Mov Disord 2024; 17:38-46. [PMID: 37748924 PMCID: PMC10846972 DOI: 10.14802/jmd.23090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/25/2023] [Accepted: 09/24/2023] [Indexed: 09/27/2023] Open
Abstract
OBJECTIVE Emotional processing is a core feature of social interactions and has been well studied in patients with idiopathic Parkinson's disease (PD), albeit with contradictory. RESULTS . However, these studies excluded patients with atypical parkinsonism, such as multiple system atrophy (MSA). The objective of this exploratory study was to provide better insights into emotion processing in patients with MSA using eye tracking data. METHODS We included 21 MSA patients, 15 PD patients and 19 matched controls in this study. Participants performed a dynamic and a static emotion recognition task, and gaze fixations were analyzed in different areas of interest. Participants underwent neuropsychological testing and assessment of depression and alexithymia. RESULTS MSA patients were less accurate in recognizing anger than controls (p = 0.02) and had overall fewer fixations than controls (p = 0.001). In the static task, MSA patients had fewer fixations (p < 0.001) and a longer time to first fixation (p = 0.026) on the eye region. Furthermore, MSA patients had a longer fixation duration overall than PD patients (p = 0.004) and longer fixations on the nose than controls (p = 0.005). Alexithymia scores were higher in MSA patients compared to controls (p = 0.038). CONCLUSION This study demonstrated impaired recognition of anger in MSA patients compared to HCs. Fewer and later fixations on the eyes along with a center bias suggest avoidance of eye contact, which may be a characteristic gaze behavior in MSA patients.
Collapse
Affiliation(s)
- Victoria Sidoroff
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Federico Carbone
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Ellmerer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Stefanie Bair
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Thomas Maran
- Department of Strategic Management & Leadership, University of Innsbruck, Innsbruck Austria
- Entrepreneurship and Innovation, Free University of Bozen-Bolzano, Bozen-Bolzano, Italy
| | - Florian Krismer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Mahlknecht
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katherina Mair
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Cecilia Raccagni
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
- Department of Neurology, Provincial Hospital of Bolzano Teaching Hospital of Paracelsus Medical Private University Bolzano-Bozen, Bolzano, Italy
| | | | - Klaus Seppi
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Gregor K. Wenning
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Atbin Djamshidian
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| |
Collapse
|
5
|
Antoniades CA, Spering M. Eye movements in Parkinson's disease: from neurophysiological mechanisms to diagnostic tools. Trends Neurosci 2024; 47:71-83. [PMID: 38042680 DOI: 10.1016/j.tins.2023.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/13/2023] [Accepted: 11/01/2023] [Indexed: 12/04/2023]
Abstract
Movement disorders such as Parkinson's disease (PD) impact oculomotor function - the ability to move the eyes accurately and purposefully to serve a multitude of sensory, cognitive, and secondary motor tasks. Decades of neurophysiological research in monkeys and behavioral studies in humans have characterized the neural basis of healthy oculomotor control. This review links eye movement abnormalities in persons living with PD to the underlying neurophysiological mechanisms and pathways. Building on this foundation, we highlight recent progress in using eye movements to gauge symptom severity, assess treatment effects, and serve as potential precision biomarkers. We conclude that whereas eye movements provide insights into PD mechanisms, based on current evidence they appear to lack sufficient sensitivity and specificity to serve as a standalone diagnostic tool. Their full potential may be realized when combined with other disease indicators in big datasets.
Collapse
Affiliation(s)
- Chrystalina A Antoniades
- Nuffield Department of Clinical Neurosciences, Medical Sciences Division, University of Oxford, Oxford, UK.
| | - Miriam Spering
- Department of Ophthalmology & Visual Sciences and Djavad Mowafaghian Center for Brain Health, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
6
|
Wright IH, Sekar A, Jensen MT, Hodgson M, Bancroft MJ, Koohi N, Lees AJ, Morris HR, Kaski D. Reflexive and volitional saccadic eye movements and their changes in age and progressive supranuclear palsy. J Neurol Sci 2022; 443:120482. [PMID: 36356484 DOI: 10.1016/j.jns.2022.120482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/03/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND AND OBJECTIVES Saccades, rapid movements of the eyes towards a visual or remembered target, are useful in understanding the healthy brain and the pathology of neurological conditions such as progressive supranuclear palsy (PSP). We set out to investigate the parameters of horizontal reflexive and volitional saccades, both visually guided and memory-guided, over a 1 min epoch in healthy individuals and PSP patients. METHODS An experimental paradigm tested reflexive, volitional visually guided, and volitional memory-guided saccades in young healthy controls (n = 14; 20-31 years), PSP patients (n = 11; 46-75 years) and older age-matched healthy controls (n = 6; 56-71 years). The accuracy and velocity of saccades was recorded using an EyeBrain T2® video eye tracker and analyses performed using the MyEyeAnalysis® software. Two-way analysis of variance (ANOVA) was used to identify significant effects (p < 0.01) between young and older controls to investigate the effects of ageing upon saccades, and between PSP patients and age-matched controls to study the effects of PSP upon saccades. RESULTS In both healthy individuals and PSP patients, volitional saccades are slower and less accurate than reflexive saccades. In PSP patients, accuracy is lower across all saccade types compared to age-matched controls, but velocity is lower only for reflexive saccades. Crucially, there is no change in accuracy or velocity of consecutive saccades over short (one-minute) timescales in controls or PSP patients. CONCLUSIONS Velocity and accuracy of saccades in PSP does not decrease over one-minute timescales, contrary to that previously observed in Parkinson's Disease (PD), suggesting a potential clinical biomarker for the distinction of PSP from PD.
Collapse
Affiliation(s)
- Isaac Hempstead Wright
- Centre for Vestibular and Behavioural Neurosciences, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Akila Sekar
- Centre for Vestibular and Behavioural Neurosciences, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Marte Theilmann Jensen
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Megan Hodgson
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Matthew J Bancroft
- Centre for Vestibular and Behavioural Neurosciences, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK
| | - Nehzat Koohi
- Centre for Vestibular and Behavioural Neurosciences, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK; The Ear Institute, University College London, London, UK
| | - Andrew J Lees
- Reta Lila Weston Institute of Neurological Studies, University College London, London, UK
| | - Huw R Morris
- Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Diego Kaski
- Centre for Vestibular and Behavioural Neurosciences, Department of Clinical and Movement Neurosciences, UCL Queen Square Institute of Neurology, London, UK; The Ear Institute, University College London, London, UK.
| |
Collapse
|