Distinguishing between impairments of working memory and inhibitory control in cases of early dementia

Eye-tracking training improves visuospatial working memory of children with attention-deficit/hyperactivity disorder and autism spectrum disorder

Given the close connection between eye movement and frontal lobe functions and some evidence supporting the effect of eye-tracking training on enhancing cognitive performance mediated by the frontal lobe, this study aimed to explore if after-school eye-tracking training can improve the visuospatial working memory (VSWM) and cognitive flexibility performance in children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study is a non-randomized cluster trial. Forty children from eight primary schools were selected, half receiving eye-tracking training for 20 sessions over 9 months, while the other half served as a waitlist control. They were matched on demographic characteristics and baseline cognitive performance. Their VSWM and cognitive flexibility were assessed at the beginning and end of the study. Results showed that children who received eye-tracking training, but not those on a waitlist, exhibited significant improvements in the total score and working memory span of the VSWM tests, and the correct responses in cognitive flexibility tests. Specifically, VSWM performance at higher span levels (5 or above) yielded a greater improvement. The findings suggest that eye-tracking training can be a feasible and effective after-school program for improving working memory and cognitive flexibility performance in children with ADHD and ASD. This study was prospectively registered at ClinicalTrials.gov (https://clinicaltrials.gov/, trial number: NCT05428657).

An effective screening model for subjective cognitive decline in community-dwelling older adults based on gait analysis and eye tracking

Objective

To evaluate the effectiveness of multimodal features based on gait analysis and eye tracking for elderly people screening with subjective cognitive decline in the community.

Methods

In the study, 412 cognitively normal older adults aged over 65 years were included. Among them, 230 individuals were diagnosed with non-subjective cognitive decline and 182 with subjective cognitive decline. All participants underwent assessments using three screening tools: the traditional SCD9 scale, gait analysis, and eye tracking. The gait analysis involved three tasks: the single task, the counting backwards dual task, and the naming animals dual task. Eye tracking included six paradigms: smooth pursuit, median fixation, lateral fixation, overlap saccade, gap saccade, and anti-saccade tasks. Using the XGBoost machine learning algorithm, several models were developed based on gait analysis and eye tracking to classify subjective cognitive decline.

Results

A total of 161 gait and eye-tracking features were measured. 22 parameters, including 9 gait and 13 eye-tracking features, showed significant differences between the two groups (p < 0.05). The top three eye-tracking paradigms were anti-saccade, gap saccade, and median fixation, with AUCs of 0.911, 0.904, and 0.891, respectively. The gait analysis features had an AUC of 0.862, indicating better discriminatory efficacy compared to the SCD9 scale, which had an AUC of 0.762. The model based on single and dual task gait, anti-saccade, gap saccade, and median fixation achieved the best efficacy in SCD screening (AUC = 0.969).

Conclusion

The gait analysis, eye-tracking multimodal assessment tool is an objective and accurate screening method that showed better detection of subjective cognitive decline. This finding provides another option for early identification of subjective cognitive decline in the community.

Photobiomodulation regulates astrocyte activity and ameliorates scopolamine-induced cognitive behavioral decline

Introduction

The pathophysiological mechanism of Alzheimer's disease (AD) has not been clearly identified, and effective treatment methods have not yet been established. Scopolamine causes cholinergic dysfunction in the brain, including the accumulation of amyloid-beta plaques, thereby increasing oxidative stress and neuroinflammation, mimicking AD. Glial cells such as astrocytes have recently been identified as possible biomarkers for AD. Photobiomodulation (PBM) elicits a beneficial biological response in cells and tissues. PBM effects on the central nervous system (CNS) have been widely researched, including effects on astrocyte activity.

Methods

In the present study, PBM was performed using light at the near-infrared wavelength of 825 nm. The Morris water maze and Y-maze tests were employed to evaluate cognitive function decline in a scopolamine-induced memory dysfunction model and its improvement with PBM. In addition, alteration of the mitogen-activated protein kinase (MAPK) pathway and immunofluorescence expression levels of active astrocytes were observed in the hippocampus, which is one of the areas affected by AD, to evaluate the mechanism of action of PBM.

Results

A reduction in the neuronal cell death in the hippocampus caused by scopolamine was observed with PBM. Moreover, alteration of a MAPK pathway-related marker and changes in glial fibrillary acidic protein (an active astrocyte marker) expression were observed in the PBM-treated group. Finally, significant correlations between functional and histological results were found, validating the results.

Discussion

These findings indicate the possibility of behavioral and histological improvement due to PBM in scopolamine-induced CNS alteration, which mimics AD. This improvement could be related to neuroinflammatory modulation and altered astrocyte activity.

Extended ambulatory assessment of executive function: within-person reliability of working memory and inhibitory control tasks

INTRODUCTION

Ambulatory assessment of executive function - particularly in the form working memory (WM) - is increasingly common. Few studies to date, however, have also incorporated ambulatory measures of inhibitory control. Critically, the extended within-person reliability of ambulatory tasks tapping each of these constructs has been largely overlooked.

METHOD

Participants (N = 283, Mage = 23.74 years, SD = 9.04) received notifications every 3 days (for 4 weeks) to undertake ambulatory assessment versions of the n-Back and Stop-Signal Tasks (SST) via the smartphone application CheckCog. Within-person reliability of these measures was explored.

RESULTS

Compliance ranged from 66% (for eight sessions) to 89% (for four sessions). Our results reveal significant changes in performance within the first two sessions for both the n-Back and SST, with performance remaining largely consistent across the remaining (two to eight) sessions. In terms of test-retest reliability, the ICC (C, 1) values ranged from .29 to .68 on the n-Back (with overall accuracy being .51) and .31-.73 on the SST (with stop-signal reaction time being .53).

CONCLUSION

The results of the current study contribute to the literature by demonstrating the reliability of brief measures of executive function - in the form of inhibitory control and WM - delivered using smartphones in participants' natural environments. Based on our findings, the CheckCog app reliability tracks baseline systematic changes in WM and response inhibition across multiple time points and for an extended period in healthy individuals.

Uncorrected errors and correct saccades in the antisaccade task distinguish between early-stage Alzheimer's disease dementia, amnestic mild cognitive impairment, and normal aging

Alzheimer's disease (AD) dementia is a degenerative illness that is characterized by a gradual decline in cognitive abilities. Amnestic mild cognitive impairment (aMCI) is seen as a precursor to AD. The changes in antisaccade performance that can be seen in MCI may provide important clues in the early detection of AD. Therefore, the antisaccade deficits in AD and aMCI remain a research question. This study aimed to examine antisaccade responses and the relationship between antisaccade and cognitive function in AD, aMCI, and healthy controls (HC). This study included 30 patients with early-stage AD, 34 with aMCI, and 32 HC. Patients with AD showed higher rates of uncorrected error, anticipatory saccades and corrected errors, as well as decreased correct saccade rates, and shortened saccade latency compared to aMCI and HC in this study. Patients with aMCI exhibited increased rates of express saccades relative to HC. The antisaccade task and cognitive domains were found to be significantly related. Our study showed that the rate of correct saccades has the capacity to distinguish AD from HC with 87% sensitivity and 86% specificity (AUC = 0.93, p < 0.001). In addition, the rate of uncorrected errors was found to be capable of distinguishing AD from HC with 84% sensitivity and 83% specificity (AUC = 0.91, p < 0.001). This study presented promising findings that these parameters can be used clinically to differentiate AD and aMCI from healthy older individuals.

Eyes on dementia: an overview of the interplay between eye movements and cognitive decline

The economic and disease burden of dementia is forecasted to continue increasing. Considering its cognitive effects, timely diagnosis is important in developing a stage-based treatment plan and gathering data to support advocacy efforts and plan healthcare and social services. Eye-tracking technology has emerged as an efficient diagnostic tool in clinical practice and experimental studies. This review aimed to comprehensively analyze various aspects of eye-tracking technology, including pupillometry parameters, eye movements, eye-tracking devices, and neuropsychological tools. We conducted a systematic review retrieving articles published in the last ten years from six databases. Our results provide a complex overview for each included form of dementia/cognitive decline in terms of patient characteristics (age, sex-disaggregated by included pathologies), inclusion and exclusion criteria, devices, and neuropsychological tools. We also summarized findings on fixation stability tasks, saccadic evaluation, pupillometry, scene perception, object recognition, spatial memory, eye-tracking video tasks, and visual search. The eye-tracking method has become more common in cognitive assessments.

Saccadic Eye Movements in Patients with Mild Cognitive Impairment: A Longitudinal Study

Saccadic eye movements are one of the sensitive and noninvasive methods to help monitor the cognitive course of mild cognitive impairment (MCI). The study aimed to evaluate both pro and anti-saccade longitudinally and the relationship between cognitive functions and eye movements in MCI subgroups and healthy controls (HCs) at a two-year follow-up. This study revealed that the anti-saccade anticipatory responses decreased in amnestic MCI (aMCI). Correct vertical pro-saccades increased in non-amnestic MCI (naMCI), while the express saccades decreased. Our study demonstrated that longer than two years of follow-up is necessary to monitor the course of MCI. Findings of the relationships between longitudinal changes of saccades and cognitive measurements demonstrated the usability of eye movements in evaluating the process of MCI.

Acetylcholine deficit causes dysfunctional inhibitory control in an aging-dependent manner

Inhibitory control is a key executive function that limits unnecessary thoughts and actions, enabling an organism to appropriately execute goal-driven behaviors. The efficiency of this inhibitory capacity declines with normal aging or in neurodegenerative dementias similar to memory or other cognitive functions. Acetylcholine signaling is crucial for executive function and also diminishes with aging. Acetylcholine's contribution to the aging- or dementia-related decline in inhibitory control, however, remains elusive. We addressed this in Drosophila using a Go/No-Go task that measures inhibition capacity. Here, we report that inhibition capacity declines with aging in wild-type flies, which is mitigated by lessening acetylcholine breakdown and augmented by reducing acetylcholine biosynthesis. We identified the mushroom body (MB) γ neurons as a chief neural site for acetylcholine's contribution to the aging-associated inhibitory control deficit. In addition, we found that the MB output neurons MBON-γ2α'1 having dendrites at the MB γ2 and α'1 lobes and axons projecting to the superior medial protocerebrum and the crepine is critical for sustained movement suppression per se. This study reveals, for the first time, the central role of acetylcholine in the aging-associated loss of inhibitory control and provides a framework for further mechanistic studies.

Saccadic Eye Movement in Mild Cognitive Impairment and Alzheimer's Disease: A Systematic Review and Meta-Analysis

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.

Executive function deficits in mild cognitive impairment: evidence from saccade tasks

OBJECTIVES

Early detection of mild cognitive impairment (MCI) is necessary to prevent irreversible brain damage caused by incipient Alzheimer's disease. It has been showing that amnestic MCI (a-MCI) subjects exhibit subtle deficits in executive function that can be tested using saccade eye movements. Eye-tracking technology is a sensitive method to measure cognitive impairments in dementia and MCI.

METHODS

In this study, we used eye-tracking technology to explore saccade impairments to distinguish between a-MCI and the variants of reference controls. 21 patients with AD, 40 patients with a-MCI, and 59 normal participants were recruited in current study. We measured saccade reaction time, saccade errors, saccade omission, and uncorrected saccades using anti-saccade and pro-saccade tasks with 'gap' and 'overlap' procedures. These parameters were used as markers of executive function and visual attention deficits.Results: The findings revealed that more errors, more omissions, and fewer corrections characterized the saccade behavior of the a-MCI group compared to the reference group. These eye-tracking characteristics can be considered as inhibitory control and working memory deficits in a-MCI subjects. Our results thus demonstrate the applicability of the anti-saccade task as a cognitive marker in a-MCI.

CONCLUSION

The work provides further support for eye-tracking as a useful diagnostic biomarker in the assessment of executive function in aging with cognitive impairments.

Secondary Prevention of Dementia: Combining Risk Factors and Scalable Screening Technology

Alzheimer's disease (AD) is a progressive neurodegenerative disorder that is the most common cause of dementia. Over a third of dementia cases are estimated to be due to potentially modifiable risk factors, thus offering opportunities for both identification of those most likely to be in early disease as well as secondary prevention. Diabetes, hypertension and chronic kidney failure have all been linked to increased risk for AD and dementia and through their high prevalence are particularly apt targets for initiatives to reduce burden of AD. This can take place through targeted interventions of cardiovascular risk factors (shown to improve cognitive outcomes) or novel disease modifying treatments in people with confirmed AD pathology. The success of this approach to secondary prevention depends on the availability of inexpensive and scalable methods for detecting preclinical and prodromal dementia states. Developments in blood-based biomarkers for Alzheimer's disease are rapidly becoming a viable such method for monitoring large at-risk groups. In addition, digital technologies for remote monitoring of cognitive and behavioral changes can add clinically relevant data to further improve personalisation of prevention strategies. This review sets the scene for this approach to secondary care of dementia through a review of the evidence for cardiovascular risk factors (diabetes, hypertension and chronic kidney disease) as major risk factors for AD. We then summarize the developments in blood-based and cognitive biomarkers that allow the detection of pathological states at the earliest possible stage. We propose that at-risk cohorts should be created based on the interaction between cardiovascular and constitutional risk factors. These cohorts can then be monitored effectively using a combination of blood-based biomarkers and digital technologies. We argue that this strategy allows for both risk factor reduction-based prevention programmes as well as for optimisation of any benefits offered by current and future disease modifying treatment through rapid identification of individuals most likely to benefit from them.

Active visual inhibition is preserved in the presence of a distracter: A cross-cultural, ageing and dementia study

The current study investigated a novel visual distracter task as a potential diagnostic marker for the detection of cognitive impairment and the extent to which this compares in healthy ageing across two cultures. The Inhibition of a Recent Distracter Effect (IRD) refers to the inhibition of a saccadic eye movement towards a target that is presented at the location of a previous distracter. Two studies compared the IRD across a large cross-cultural sample comprising of young (N = 75), old European participants (N = 119), old south Asian participants (N = 83), participants with Dementia due to Alzheimer's disease (N = 65) and Mild cognitive impairment (N = 91). Significantly longer saccadic reaction times on the target to distracter trials, in comparison to the target to target trials were evident in all groups and age cohorts. Importantly, the IRD was also preserved in participants with Alzheimer's Disease and mild cognitive impairment demonstrating that the IRD is robust across cultures, age groups and clinical populations. Eye-tracking is increasingly used as a dual diagnostic and experimental probe for the investigation of cognitive control in Alzheimer's disease. As a promising methodology for the early diagnosis of dementia, it is important to understand the cognitive operations in relation to eye-tracking that are well preserved as well as those that are abnormal. Paradigms should also be validated across ethnicity/culture, clinical groups and age cohorts.

Age differences in resting state EEG and their relation to eye movements and cognitive performance

Prior research has focused on EEG differences across age or EEG differences across cognitive tasks/eye tracking. There are few studies linking age differences in EEG to age differences in behavioural performance which is necessary to establish how neuroactivity corresponds to successful and impaired ageing. Eighty-six healthy participants completed a battery of cognitive tests and eye-tracking measures. Resting state EEG (n = 75, 31 young, 44 older adults) was measured for delta, theta, alpha and beta power as well as for alpha peak frequency. Age deficits in cognition were aligned with the literature, showing working memory and inhibitory deficits along with an older adult advantage in vocabulary. Older adults showed poorer eye movement accuracy and response times, but we did not replicate literature showing a greater age deficit for antisaccades than for prosaccades. We replicated EEG literature showing lower alpha peak frequency in older adults but not literature showing lower alpha power. Older adults also showed higher beta power and less parietal alpha power asymmetry than young adults. Interaction effects showed that better prosaccade performance was related to lower beta power in young adults but not in older adults. Performance at the trail making test part B (measuring task switching and inhibition) was improved for older adults with higher resting state delta power but did not depend on delta power for young adults. It is argued that individuals with higher slow-wave resting EEG may be more resilient to age deficits in tasks that utilise cross-cortical processing.

The Disengagement of Visual Attention: An Eye-Tracking Study of Cognitive Impairment, Ethnicity and Age

Various studies have shown that Alzheimer’s disease (AD) is associated with an impairment of inhibitory control, although we do not have a comprehensive understanding of the associated cognitive processes. The ability to engage and disengage attention is a crucial cognitive operation of inhibitory control and can be readily investigated using the “gap effect” in a saccadic eye movement paradigm. In previous work, various demographic factors were confounded; therefore, here, we examine separately the effects of cognitive impairment in Alzheimer’s disease, ethnicity/culture and age. This study included young (N = 44) and old (N = 96) European participants, AD (N = 32), mildly cognitively impaired participants (MCI: N = 47) and South Asian older adults (N = 94). A clear reduction in the mean reaction times was detected in all the participant groups in the gap condition compared to the overlap condition, confirming the effect. Importantly, this effect was also preserved in participants with MCI and AD. A strong effect of age was also evident, revealing a slowing in the disengagement of attention during the natural process of ageing.

The Effects of Previous Error and Success in Alzheimer's Disease and Mild Cognitive Impairment

This work investigated in Alzheimer’s disease dementia (AD), whether the probability of making an error on a task (or a correct response) was influenced by the outcome of the previous trials. We used the antisaccade task (AST) as a model task given the emerging consensus that it provides a promising sensitive and early biological test of cognitive impairment in AD. It can be employed equally well in healthy young and old adults, and in clinical populations. This study examined eye-movements in a sample of 202 participants (42 with dementia due to AD; 65 with mild cognitive impairment (MCI); 95 control participants). The findings revealed an overall increase in the frequency of AST errors in AD and MCI compared to the control group, as predicted. The errors on the current trial increased in proportion to the number of consecutive errors on the previous trials. Interestingly, the probability of errors was reduced on the trials that followed a previously corrected error, compared to the trials where the error remained uncorrected, revealing a level of adaptive control in participants with MCI or AD dementia. There was an earlier peak in the AST distribution of the saccadic reaction times for the inhibitory errors in comparison to the correct saccades. These findings revealed that the inhibitory errors of the past have a negative effect on the future performance of healthy adults as well as people with a neurodegenerative cognitive impairment.

Eye tracking - The overlooked method to measure cognition in neurodegeneration?

Eye tracking (ET) studies are becoming increasingly popular due to rapid methodological and technological advances as well as the development of cost efficient and portable eye trackers. Although historically ET has been mostly employed in psychophysics or developmental cognition studies, there is also promising scope to use ET for movement disorders and measuring cognitive processes in neurodegeneration. Particularly, ET can be a powerful tool for cognitive and neuropsychological assessments of patients with pathologies affecting motor and verbal abilities, as tasks can be adapted without requiring motor (except eye movements) or verbal responses. In this review, we will examine the existing evidence of ET methods in neurodegenerative conditions and its potential clinical impact for cognitive assessment. We highlight that current evidence for ET is mostly focused on diagnostics of cognitive impairments in neurodegenerative disorders, where it is debatable whether it has any more sensitivity or specificity than existing cognitive assessments. By contrast, there is currently a lack of ET studies in more advanced disease stages, when patients' motor and verbal functions can be significantly affected, and standard cognitive assessments are challenging or often not possible. We conclude that ET is a promising method not only for cognitive diagnostics but more importantly, for potential cognitive disease tracking in progressive neurodegenerative conditions.

Abnormalities of saccadic eye movements in dementia due to Alzheimer's disease and mild cognitive impairment

Background: There is increasing evidence that people in the early stages of Alzheimer's disease (AD) have subtle impairments in cognitive inhibition that can be detected by using relatively simple eye-tracking paradigms, but these subtle impairments are often missed by traditional cognitive assessments. People with mild cognitive impairment (MCI) are at an increased likelihood of dementia due to AD. No study has yet investigated and contrasted the MCI subtypes in relation to eye movement performance. Methods: In this work we explore whether eye-tracking impairments can distinguish between patients with the amnesic and the non-amnesic variants of MCI. Participants were 68 people with dementia due to AD, 42 had a diagnosis of aMCI, and 47 had a diagnosis of naMCI, and 92 age-matched cognitively healthy controls. Results: The findings revealed that eye-tracking can distinguish between the two forms of MCI. Conclusions: The work provides further support for eye-tracking as a useful diagnostic biomarker in the assessment of dementia.

Oculomotor and Inhibitory Control in Dyslexia

Previous research has suggested that people with dyslexia may have an impairment of inhibitory control. The oculomotor system is vulnerable to interference at various levels of the system, from high level cognitive control to peripheral neural pathways. Therefore, in this work we examined two forms of oculomotor inhibition and two forms of oculomotor interference at high and low levels of the control system. This study employed a prosaccade, antisaccade, and a recent distractor eye movement task (akin to a spatial negative priming) in order to explore high level cognitive control and the inhibition of a competing distractor. To explore low-level control we examined the frequency of microsaccades and post-saccade oscillations. The findings demonstrated that dyslexics have an impairment of volitional inhibitory control, reflected in the antisaccade task. In contrast, inhibitory control at the location of a competing distractor was equivalent in the dyslexic and non-dyslexic groups. There was no difference in the frequency of microsaccades between the two groups. However, the dyslexic group generated larger microsaccades prior to the target onset in the prosaccade and the antisaccade tasks.The groups did not differ in the frequency or in the morphology of the post-saccade oscillations. These findings reveal that the word reading and attentional difficulties of dyslexic readers cannot be attributed to an impairment in the inhibition of a visual distractor or interference from low-level oculomotor instability. We propose that the inhibitory impairment in dyslexia occurs at a higher cognitive level, perhaps in relation to the process of attentional disengagement.

Ameliorative Effect of Silymarin on Scopolamine-induced Dementia in Rats

AIM:

This study aims to elucidate the possible ameliorative effect of silymarin on scopolamine-induced dementia using the object recognition test (ORT) in rats.

METHODS:

The study was extended to demonstrate the role of cholinergic activity, oxidative stress, neuroinflammation, brain neurotransmitters and histopathological changes in the anti-amnestic effect of silymarin in demented rats. Wistar rats were pre-treated with silymarin (200, 400, 800 mg/kg) or donepezil (10 mg/kg) orally for 14 consecutive days. Dementia was induced after the last drug administration by a single intraperitoneal dose of scopolamine (16 mg/kg). Then behavioural, biochemical, histopathological, and immunohistochemical analyses were then performed.

RESULTS:

Rats pre-treated with silymarin counteracted scopolamine-induced non-spatial working memory impairment in the ORT and decreased acetylcholinesterase (AChE) activity, reduced malondialdehyde (MDA), elevated reduced glutathione (GSH), restored gamma-aminobutyric acid (GABA) and dopamine (DA) contents in the cortical and hippocampal brain homogenates. Silymarin reversed scopolamine-induced histopathological changes. Immunohistochemical analysis showed that silymarin mitigated protein expression of the glial fibrillary acidic protein (GFAP) and nuclear factor kappa-B (NF-κB) in the brain cortex and hippocampus. All these effects of silymarin were similar to that of the standard anti-amnestic drug, donepezil.

CONCLUSION:

This study reveals that the ameliorative effect of silymarin on scopolamine-induced dementia in rats using the ORT maybe in part mediated by, enhancement of cholinergic activity, anti-oxidant and anti-inflammatory activities as well as mitigation in brain neurotransmitters and histopathological changes.

Computational Techniques for Eye Movements Analysis towards Supporting Early Diagnosis of Alzheimer's Disease: A Review

An opportune early diagnosis of Alzheimer's disease (AD) would help to overcome symptoms and improve the quality of life for AD patients. Research studies have identified early manifestations of AD that occur years before the diagnosis. For instance, eye movements of people with AD in different tasks differ from eye movements of control subjects. In this review, we present a summary and evolution of research approaches that use eye tracking technology and computational analysis to measure and compare eye movements under different tasks and experiments. Furthermore, this review is targeted to the feasibility of pioneer work on developing computational tools and techniques to analyze eye movements under naturalistic scenarios. We describe the progress in technology that can enhance the analysis of eye movements everywhere while subjects perform their daily activities and give future research directions to develop tools to support early AD diagnosis through analysis of eye movements.

Eye Gaze and Aging: Selective and Combined Effects of Working Memory and Inhibitory Control

Eye-tracking is increasingly studied as a cognitive and biological marker for the early signs of neuropsychological and psychiatric disorders. However, in order to make further progress, a more comprehensive understanding of the age-related effects on eye-tracking is essential. The antisaccade task requires participants to make saccadic eye movements away from a prepotent stimulus. Speculation on the cause of the observed age-related differences in the antisaccade task largely centers around two sources of cognitive dysfunction: inhibitory control (IC) and working memory (WM). The IC account views cognitive slowing and task errors as a direct result of the decline of inhibitory cognitive mechanisms. An alternative theory considers that a deterioration of WM is the cause of these age-related effects on behavior. The current study assessed IC and WM processes underpinning saccadic eye movements in young and older participants. This was achieved with three experimental conditions that systematically varied the extent to which WM and IC were taxed in the antisaccade task: a memory-guided task was used to explore the effect of increasing the WM load; a Go/No-Go task was used to explore the effect of increasing the inhibitory load; a ‘standard’ antisaccade task retained the standard WM and inhibitory loads. Saccadic eye movements were also examined in a control condition: the standard prosaccade task where the load of WM and IC were minimal or absent. Saccade latencies, error rates and the spatial accuracy of saccades of older participants were compared to the same measures in healthy young controls across the conditions. The results revealed that aging is associated with changes in both IC and WM. Increasing the inhibitory load was associated with increased reaction times in the older group, while the increased WM load and the inhibitory load contributed to an increase in the antisaccade errors. These results reveal that aging is associated with changes in both IC and WM.

Cognitive Correlates of Perseverations in Individuals with Memory Impairment

OBJECTIVE

This study examines which cognitive measure best accounts for perseverations in individuals with memory impairment.

METHOD

The sample included 85 individuals, of whom 21 had subjective memory concerns, 27 had mild cognitive impairment, and 37 had Alzheimer's disease. Participants produced responses on a semantic category fluency task and on the ideational fluency (IF) task from the Cambridge Cognitive Examination-Revised. Measures of word finding, working memory, and abstract thinking were also assessed.

RESULTS

Significant group differences in percentage of perseverations emerged on both tasks. No cognitive measure accounted for the percentage of perseverations on the semantic fluency task. A measure of abstract thinking was the best predictor of the percentage of perseverations on the IF task, followed by a measure of working memory.

CONCLUSIONS

The underlying cognitive mechanisms that lead to perseverations differ across tasks, with perseverations on the IF task reflecting both conceptual deficits and working memory limitations.

Chocolate, Air Pollution and Children's Neuroprotection: What Cognition Tools should be at Hand to Evaluate Interventions?

Millions of children across the world are exposed to multiple sources of indoor and outdoor air pollutants, including high concentrations of fine particulate matter (PM_2.5) and ozone (O₃). The established link between exposure to PM_2.5, brain structural, volumetric and metabolic changes, severe cognitive deficits (1.5-2 SD from average IQ) in APOE 4 heterozygous females with >75 − < 94% BMI percentiles, and the presence of Alzheimer's disease (AD) hallmarks in urban children and young adults necessitates exploration of ways to protect these individuals from the deleterious neural effects of pollution exposure. Emerging research suggests that cocoa interventions may be a viable option for neuroprotection, with evidence suggesting that early cocoa interventions could limit the risk of cognitive and developmental concerns including: endothelial dysfunction, cerebral hypoperfusion, neuroinflammation, and metabolic detrimental brain effects. Currently, however, it is not clear how early we should implement consumption of cocoa to optimize its neuroprotective effects. Moreover, we have yet to identify suitable instruments for evaluating cognitive responses to these interventions in clinically healthy children, teens, and young adults. An approach to guide the selection of cognitive tools should take into account neuropsychological markers of cognitive declines in patients with Alzheimer's neuropathology, the distinct patterns of memory impairment between early and late onset AD, and the key literature associating white matter integrity and poor memory binding performance in cases of asymptomatic familial AD. We highlight potential systemic and neural benefits of cocoa consumption. We also highlight Working Memory Capacity (WMC) and attention control tasks as opened avenues for exploration in the air pollution scenario. Exposures to air pollutants during brain development have serious brain consequences in the short and long term and reliable cognition tools should be at hand to evaluate interventions.