Strong age but weak sex effects in eye movement performance in the general adult population: Evidence from the Rhineland Study

Multimodal oculomotor assessment reveals prodromal markers of Parkinson's disease in non-manifesting LRRK2 G2019S mutation carriers

Oculomotor behaviour changes in patients with Parkinson's disease (PD) are a promising source of prodromal disease markers. Capitalizing on this phenomenon to facilitate early diagnosis requires oculomotor assessment in prodromal cohorts. We examined oculomotor behaviour in non-manifesting LRRK2 G2019S mutation carriers (LRRK2-NM), who have heightened PD risk.Seventeen LRRK2-NM participants, 47 patients with idiopathic PD, and 63 healthy age-matched control participants completed an interleaved pro- and antisaccade task while undergoing video-based eye-tracking. We analyzed between-group differences in saccade, pupil, blink, and fixation acquisition behaviour. Patients with PD showed previously demonstrated abnormalities (saccade hypometria, antisaccade errors). Relative to controls, LRRK2-NM participants and patients with PD both displayed increased short-latency prosaccades and reduced pupil velocity, plus altered fixation acquisition-less preemptive returning of gaze to the future fixation point location. Interestingly, the effect on blink probability was opposite-higher than controls in LRRK2-NM participants but lower in patients with PD. Future longitudinal studies must confirm the viability of these features as prodromal PD markers.

Pilot Study on Gaze Characteristics of Older Drivers While Watching Driving Movies

Objective: This study aims to clarify the gazing characteristics of older drivers while driving cars using a gaze analysis device. Methods: The participants included 16 older and 12 middle-aged drivers who drove cars daily. After conducting cognitive and attentional function tests, eye gaze while watching driving videos was measured using an eye tracker. Ten driving videos were prepared. In addition, a total of 34 hazard areas were analyzed. Results: The results of the gaze measurement parameters were statistically compared between the two groups. In the older group, the gaze analysis results indicated that while viewing driving videos, the search for areas close to the car was expanded. In addition, in several hazard areas, we observed a decrease in the number of drivers gazing at the driver, shortened total gazing time, delay in the timing of gazing, and decrease in the number of visits. Conclusions: Older drivers' eye movement is increased; however, it is characterized by gazing at unimportant areas, indicating an inefficient scanning pattern. Although these results do not indicate an obvious decline in driving ability among older drivers, the decline in hazard perception may become apparent in some situations. The data contain underpowered results and require revalidation in larger studies.

Blood-derived microRNAs are related to cognitive domains in the general population

INTRODUCTION

Blood-derived microRNAs (miRNAs) are potential candidates for detecting and preventing subclinical cognitive dysfunction. However, replication of previous findings and identification of novel miRNAs associated with cognitive domains, including their relation to brain structure and the pathways they regulate, are still lacking.

METHODS

We examined blood-derived miRNAs and miRNA co-expression clusters in relation to cognitive domains, structural magnetic resonance imaging measures, target gene expression, and genetic variants in 2869 participants of a population-based cohort.

RESULTS

Five previously identified and 14 novel miRNAs were associated with cognitive domains. Eleven of these were also associated with cortical thickness and two with hippocampal volume. Multi-omics analysis showed that certain identified miRNAs were genetically influenced and regulated genes in pathways like neurogenesis and synapse assembly.

DISCUSSION

We identified miRNAs associated with cognitive domains, brain regions, and neuronal processes affected by aging and neurodegeneration, making them promising candidate blood-based biomarkers or therapeutic targets of subclinical cognitive dysfunction.

HIGHLIGHTS

We investigated the association of blood-derived microRNAs with cognitive domains. Five previously identified and 14 novel microRNAs were associated with cognition. Eleven cognition-related microRNAs were also associated with cortical thickness. Identified microRNAs were linked to genes associated with neuronal functions. Results provide putative biomarkers or therapeutic targets of cognitive aging.

Attentional modulation of eye blinking is altered by sex, age, and task structure

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.

Automated Eye Tracking Enables Saccade Performance Evaluation of Patients with Concussion History

SIGNIFICANCE

Automated eye tracking could be used to evaluate saccade performance of patients with concussion history, providing quantitative insights about the degree of oculomotor impairment and potential vision rehabilitation strategies for this patient population.

PURPOSE

To evaluate the saccade performance of patients with concussion history based on automated eye-tracking test results.

METHODS

We conducted a retrospective study of patients with concussion history, primarily from sports participation, who underwent oculomotor testing based on an eye-tracking technology at the Duke Eye Center vision rehabilitation clinic between June 30, 2017, and January 10, 2022. Patients' saccade test results were reviewed, including saccade fixation and saccade speed/accuracy ratio. The outcomes were compared with age-matched normative population data derived from healthy individuals. Multiple linear regression analyses were performed to identify factors associated with saccade performance among patients with concussion history.

RESULTS

On hundred fifteen patients with concussion history were included in the study. Patients with concussion, on average, had fewer fixations on self-paced horizontal and vertical saccade tests and lower horizontal and vertical saccade speed/accuracy ratios compared with normative ranges. Among patients with concussion history, multiple linear regression analyses showed that older age was associated with fewer fixations on horizontal and vertical saccade tests, whereas male sex was associated with more fixations on horizontal and vertical saccade tests (all P < .01). In addition, older age was associated with lower horizontal saccade speed/accuracy ratio, after adjusting for sex, number of concussion(s), and time from most recent concussion to oculomotor testing ( P < .001).

CONCLUSIONS

Patients with concussion history had lower saccade performance based on eye tracking compared with healthy individuals. We additionally identified risk factors for lower saccade performance among patients with concussion history. These findings support the use of saccade test results as biomarkers for concussion and have implications for post-concussion rehabilitation strategies.

Motor synchronization and impulsivity in pediatric borderline personality disorder with and without attention-deficit hyperactivity disorder: an eye-tracking study of saccade, blink and pupil behavior

Shifting motor actions from reflexively reacting to an environmental stimulus to predicting it allows for smooth synchronization of behavior with the outside world. This shift relies on the identification of patterns within the stimulus - knowing when a stimulus is predictable and when it is not - and launching motor actions accordingly. Failure to identify predictable stimuli results in movement delays whereas failure to recognize unpredictable stimuli results in early movements with incomplete information that can result in errors. Here we used a metronome task, combined with video-based eye-tracking, to quantify temporal predictive learning and performance to regularly paced visual targets at 5 different interstimulus intervals (ISIs). We compared these results to the random task where the timing of the target was randomized at each target step. We completed these tasks in female pediatric psychiatry patients (age range: 11-18 years) with borderline personality disorder (BPD) symptoms, with (n = 22) and without (n = 23) a comorbid attention-deficit hyperactivity disorder (ADHD) diagnosis, against controls (n = 35). Compared to controls, BPD and ADHD/BPD cohorts showed no differences in their predictive saccade performance to metronome targets, however, when targets were random ADHD/BPD participants made significantly more anticipatory saccades (i.e., guesses of target arrival). The ADHD/BPD group also significantly increased their blink rate and pupil size when initiating movements to predictable versus unpredictable targets, likely a reflection of increased neural effort for motor synchronization. BPD and ADHD/BPD groups showed increased sympathetic tone evidenced by larger pupil sizes than controls. Together, these results support normal temporal motor prediction in BPD with and without ADHD, reduced response inhibition in BPD with comorbid ADHD, and increased pupil sizes in BPD patients. Further these results emphasize the importance of controlling for comorbid ADHD when querying BPD pathology.

Brief moderate-intensity aerobic exercise improves the executive function of Chinese undergraduates regardless of mobile phone addiction: Evidence from the antisaccade task

Introduction

Previous studies have shown that brief moderate-intensity aerobic exercise can improve the executive function of healthy adults. The present study sought to examine and compare the effects of brief moderate-intensity aerobic exercise on the executive functions of undergraduates with and without mobile phone addiction.

Method

Thirty-two healthy undergraduates with mobile phone addiction were recruited and randomly assigned to either an exercise or control group. Likewise, 32 healthy undergraduates without mobile phone addiction were recruited and randomly assigned to either an exercise or control group. Participants were asked to perform moderate-intensity aerobic exercise for 15 minutes for the exercise groups. The executive functions of all participants were assessed via the antisaccade task twice (i.e., pre-test and post-test).

Results

The results showed that the saccade latency, variability of saccade latency, and error rate decreased significantly from pre-test to post-test for all participants. More importantly, after the 15-min moderate-intensity aerobic exercise intervention, participants in the exercise groups showed significantly shorter saccade latency than their counterparts in the control groups, regardless of whether they are with mobile phone addiction.

Discussion

This result is consistent with previous studies demonstrating that brief moderate-intensity aerobic exercise can improve one’s executive function. Furthermore, the absence of significant interaction among Time, Group, and Intervention implies that the effects of brief moderate-intensity aerobic exercise on executive function are comparable between participants with and without mobile phone addiction. The present study supports the previous conclusion that brief moderate-intensity aerobic exercise can improve one’s executive function effectively, and extends it to the population with mobile phone addiction. In summary, the present study has some implications for understanding of the relationship between exercise, executive function, and mobile phone addiction.

Polygenic risk scores for schizophrenia are associated with oculomotor endophenotypes

BACKGROUND

Schizophrenia is a heterogeneous disorder with substantial heritability. The use of endophenotypes may help clarify its aetiology. Measures from the smooth pursuit and antisaccade eye movement tasks have been identified as endophenotypes for schizophrenia in twin and family studies. However, the genetic basis of the overlap between schizophrenia and these oculomotor markers is largely unknown. Here, we tested whether schizophrenia polygenic risk scores (PRS) were associated with oculomotor performance in the general population.

METHODS

Analyses were based on the data of 2956 participants (aged 30-95) of the Rhineland Study, a community-based cohort study in Bonn, Germany. Genotyping was performed on Omni-2.5 exome arrays. Using summary statistics from a recent meta-analysis based on the two largest schizophrenia genome-wide association studies to date, we quantified genetic risk for schizophrenia by creating PRS at different p value thresholds for genetic markers. We examined associations between PRS and oculomotor performance using multivariable regression models.

RESULTS

Higher PRS were associated with higher antisaccade error rate and latency, and lower antisaccade amplitude gain. PRS showed inconsistent patterns of association with smooth pursuit velocity gain and were not associated with saccade rate during smooth pursuit or performance on a prosaccade control task.

CONCLUSIONS

There is an overlap between genetic determinants of schizophrenia and oculomotor endophenotypes. Our findings suggest that the mechanisms that underlie schizophrenia also affect oculomotor function in the general population.

Physically active undergraduates perform better on executive-related oculomotor control: Evidence from the antisaccade task and pupillometry

Previous studies have shown that exercise can improve executive function in young and older adults. However, it remains controversial whether a sufficient amount of physical activity leads to higher-level executive function. To examine the effect of physical activity on executive function, we used eye-tracking technology and the antisaccade task in 41 young undergraduates with various levels of physical activity. Moreover, we also investigated their differences in cognitive ability by examining their pupil size during the antisaccade task. Eye-tracking results showed that physically active individuals showed shorter saccade latency and higher accuracy in the antisaccade task than their physically inactive counterparts. Furthermore, the former showed larger pupil size during the preparatory period of antisaccade. These findings suggest that individuals with higher-level physical activity have higher-level executive function. The larger pupil sizes of physically active individuals may imply that their locus coeruleus-norepinephrine system and executive-related prefrontal cortex are more active, which contributes to their higher-level cognitive ability.

Eye tracking: empirical foundations for a minimal reporting guideline

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").

Associations of genetic liability for Alzheimer's disease with cognition and eye movements in a large, population-based cohort study

To identify cognitive measures that may be particularly sensitive to early cognitive decline in preclinical Alzheimer's disease (AD), we investigated the relation between genetic risk for AD and cognitive task performance in a large population-based cohort study. We measured performance on memory, processing speed, executive function, crystallized intelligence and eye movement tasks in 5182 participants of the Rhineland Study, aged 30 to 95 years. We quantified genetic risk for AD by creating three weighted polygenic risk scores (PRS) based on the genome-wide significant single-nucleotide polymorphisms coming from three different genetic association studies. We assessed the relation of AD PRS with cognitive performance using generalized linear models. Three PRS were associated with lower performance on the Corsi forward task, and two PRS were associated with a lower probability of correcting antisaccade errors, but none of these associations remained significant after correction for multiple testing. Associations between age and trail-making test A (TMT-A) performance were modified by AD genetic risk, with individuals at high genetic risk showing the strongest association. We conclude that no single measure of our cognitive test battery robustly captures genetic liability for AD as quantified by current PRS. However, Corsi forward performance and the probability of correcting antisaccade errors may represent promising candidates whose ability to capture genetic liability for AD should be investigated further. Additionally, our finding on TMT-A performance suggests that processing speed represents a sensitive marker of AD genetic risk in old age and supports the processing speed theory of age-related cognitive decline.

Interleaved Pro/Anti-saccade Behavior Across the Lifespan

The capacity for inhibitory control is an important cognitive process that undergoes dynamic changes over the course of the lifespan. Robust characterization of this trajectory, considering age continuously and using flexible modeling techniques, is critical to advance our understanding of the neural mechanisms that differ in healthy aging and neurological disease. The interleaved pro/anti-saccade task (IPAST), in which pro- and anti-saccade trials are randomly interleaved within a block, provides a simple and sensitive means of assessing the neural circuitry underlying inhibitory control. We utilized IPAST data collected from a large cross-sectional cohort of normative participants (n = 604, 5-93 years of age), standardized pre-processing protocols, generalized additive modeling, and change point analysis to investigate the effect of age on saccade behavior and identify significant periods of change throughout the lifespan. Maturation of IPAST measures occurred throughout adolescence, while subsequent decline began as early as the mid-20s and continued into old age. Considering pro-saccade correct responses and anti-saccade direction errors made at express (short) and regular (long) latencies was crucial in differentiating developmental and aging processes. We additionally characterized the effect of age on voluntary override time, a novel measure describing the time at which voluntary processes begin to overcome automated processes on anti-saccade trials. Drawing on converging animal neurophysiology, human neuroimaging, and computational modeling literature, we propose potential frontal-parietal and frontal-striatal mechanisms that may mediate the behavioral changes revealed in our analysis. We liken the models presented here to "cognitive growth curves" which have important implications for improved detection of neurological disease states that emerge during vulnerable windows of developing and aging.

Processing speed, but not working memory or global cognition, is associated with pupil diameter during fixation

Mean pupil size during fixation has been suggested to reflect interindividual differences in working memory and fluid intelligence. However, due to small samples with limited age range (17-35 years) and suboptimal light conditions in previous studies, these associations are still controversial and it is unclear whether they are observed at older ages. Therefore, we assessed whether interindividual differences in cognitive performance are reflected in pupil diameter during fixation and whether these associations are age-dependent. We analyzed pupillometry and cognition data of 4560 individuals aged 30-95 years of the community-based Rhineland Study. Pupillometry data were extracted from a one-minute fixation task. The cognitive test battery included tests of oculomotor control, working memory, episodic verbal memory, processing speed, executive function, and crystallized intelligence. For data analysis, we used multivariable regression models. Working memory and global cognition were not associated with pupil diameter during fixation. Better processing speed performance was associated with larger pupil diameter during fixation. Associations between cognition and pupil diameter during fixation hardly varied with age, but pupil diameter during fixation declined linearly with age (adjusted decline: 0.33 mm per 10 years of age). There were no significant sex differences in pupil size. We conclude that interindividual differences in mean pupil diameter during fixation may partly reflect interindividual differences in the speed of processing and response generation. We could not confirm that interindividual differences in working memory and fluid intelligence are reflected in pupil size during fixation; however, our sample differed in age range from previous studies.

Eye Movement Patterns Can Distinguish Schizophrenia From the Major Affective Disorders and Healthy Control Subjects

Background and hypothesis

No objective tests are currently available to help diagnosis of major psychiatric disorders. This study evaluates the potential of eye movement behavior patterns to predict schizophrenia subjects compared to those with major affective disorders and control groups.

Study design

Eye movements were recorded from a training set of UK subjects with schizophrenia (SCZ; n = 120), bipolar affective disorder (BPAD; n = 141), major depressive disorder (MDD; n = 136), and healthy controls (CON; n = 142), and from a hold-out set of 133 individuals with proportional group sizes. A German cohort of SCZ (n = 60) and a Scottish cohort of CON subjects (n = 184) acted as a second semi-independent test set. All patients met DSMIV and ICD10 criteria for SCZ, BPAD, and MDD. Data from 98 eye movement features were extracted. We employed a gradient boosted (GB) decision tree multiclass classifier to develop a predictive model. We calculated the area under the curve (AUC) as the primary performance metric.

Study results

Estimates of AUC in one-versus-all comparisons were: SCZ (0.85), BPAD (0.78), MDD (0.76), and CON (0.85). Estimates on part-external validation were SCZ (0.89) and CON (0.65). In all cases, there was good specificity but only moderate sensitivity. The best individual discriminators included free viewing, fixation duration, and smooth pursuit tasks. The findings appear robust to potential confounders such as age, sex, medication, or mental state at the time of testing.

Conclusions

Eye movement patterns can discriminate schizophrenia from major mood disorders and control subjects with around 80% predictive accuracy.

Differences on Prosaccade Task in Skilled and Less Skilled Female Adolescent Soccer Players

Although the relationship between cognitive processes and saccadic eye movements has been outlined, the relationship between specific cognitive processes underlying saccadic eye movements and skill level of soccer players remains unclear. Present study used the prosaccade task as a tool to investigate the difference in saccadic eye movements in skilled and less skilled Chinese female adolescent soccer players. Fifty-six healthy female adolescent soccer players (range: 14–18years, mean age: 16.5years) from Fujian Youth Football Training Base (Fujian Province, China) took part in the experiment. In the prosaccade task, participants were instructed to fixate at the cross at the center of the screen as long as the target appeared peripherally. They were told to saccade to the target as quickly and accurately as possible once it appeared. The results indicated that skilled soccer players exhibited shorter saccade latency (p=0.031), decreased variability of saccade latency (p=0.013), and higher spatial accuracy of saccade (p=0.032) than their less skilled counterparts. The shorter saccade latency and decreased variability of saccade latency may imply that the attentional system of skilled soccer player is superior which leads to smaller attention fluctuation and less attentional lapse. Additionally, higher spatial accuracy of saccade may imply potential structural differences in brain underlying saccadic eye movement between skilled and less skilled soccer players. More importantly, the results of the present study demonstrated that soccer players’ cognitive capacities vary as a function of their skill levels. The limitations of the present study and future directions of research were discussed.

Ten German versions of Rey's auditory verbal learning test: Age and sex effects in 4,000 adults of the Rhineland Study

INTRODUCTION

Detecting early pathological cognitive decline is critical for dementia and aging-related research and clinical diagnostics. Rey's Auditory Verbal Learning Test (AVLT) is commonly used to measure episodic verbal memory. The test requires participants to learn a list of 15 words over several trials. Since multiple testing is often required to detect cognitive decline, but repeating the same test can bias results, we developed 10 German AVLT word lists.

METHOD

We randomly assigned the lists to 4,000 participants (aged 30-94 years) from a population-based cohort to test their comparability, as well as aging effects and sex differences.

RESULTS

Nine lists were highly comparable, with only one being slightly more difficult. Recall performance decreased on average by 0.6-1.1 words per trial per decade of age. Perseveration errors decreased with increasing age. Women remembered on average between 0.8 and 1.5 words per trial more than men, regardless of age. Women also outperformed men in the sum of Trials 1-5, learning over trials, retroactive inhibition, and false-positive and interference errors. Proactive inhibition remained stable across age and was unaffected by sex.

CONCLUSION

This German AVLT version presents comparable lists including detailed age and sex references and therefore allows test repetition excluding training effects. These versions are a valuable resource for research and clinical application.

Orbicularis Oculi Muscle Size and Function: Exploring the Influence of Aging and Exercise Training

The orbicularis oculi muscle is the sphincter muscle of the eyelids that blinks and closes the eyes. In this review, our aim was threefold: (1) to introduce the performance characteristics of blinking activity in young and older adults, (2) to discuss the influence of aging on the orbicularis oculi muscle in healthy adults, and (3) to provide information about the effect of facial exercise training on the orbicularis oculi muscle. To achieve the purpose of this review, a search using two electronic databases (PubMed and Scopus) and a search engine (Google Scholar) was conducted. The amplitude and peak velocity of spontaneously blinking behavior, which is an index of muscle function of the orbicularis oculi, appear to be affected by aging. The muscle thickness of the orbicularis oculi tends to be low in older adults, but there are issues that need to be examined further, such as differences in sex and measurement positions. There was no study on the effect of exercise training; however, the results of a highly trained man indicate that the orbicularis oculi muscles might elicit muscle hypertrophy through non-traditional resistance exercise.