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Guantay CD, Mena-García L, Tola-Arribas MÁ, Garea García-Malvar MJ, Para-Prieto M, González Fernández G, Mayo-Iscar A, Pastor JC. Accounting for Visual Field Abnormalities when Using Eye-tracking to Diagnose Reading Problems in Neurological Degeneration. J Eye Mov Res 2024; 17. [PMID: 39238769 PMCID: PMC11374131 DOI: 10.16910/jemr.17.2.2] [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] [Indexed: 09/07/2024] Open
Abstract
State-of-the-art eye trackers provide valuable information for diagnosing reading problems by measuring and interpreting people's gaze paths as they read through text. Abnormal conditions such as visual field defects, however, can seriously confound most of today's existing methods for interpreting reading gaze patterns. Our objective was to research how visual field defects impact reading gaze path patterns, so the effects of such neurological pathologies can be explicitly incorporated into more comprehensive reading diagnosis methodologies. A cross-sectional, non-randomized, pilot clinical study including 45 patients with various neurologic disorders and 30 normal controls was designed. Participants underwent ophthalmologic/neuropsychologic and eye-tracker examinations using two reading tests of words and numbers. The results showed that the use of the eye tracker showed that patients with brain damage and an altered visual field require more time to complete a reading-text test by fixating a greater number of times (p < 0.001); with longer fixations (p = 0.03); and a greater number of saccades in these patients (p = 0.04). Our study showed objective differences in eye movement characteristics in patients with neurological diseases and an altered visual field who complained of reading difficulties. These findings should be considered as a bias factor and deserve further investigation.
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Affiliation(s)
- Carla D Guantay
- Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Mena-García
- Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain
| | - Miguel Ángel Tola-Arribas
- Department of Neurology, Hospital Universitario Río Hortega, Valladolid, Spain
- Centro de Investigación Biomédica en Red en Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | | | - Marta Para-Prieto
- Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain
- Department of Ophthalmology, Hospital Clínico Universitario, Valladolid, Spain
| | | | - Agustín Mayo-Iscar
- Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain
- Department of Statistics and Operational Research and IMUVa, Universidad de Valladolid, Valladolid, Spain
| | - J Carlos Pastor
- Instituto Universitario de Oftalmobiología Aplicada (IOBA Eye Institute), Universidad de Valladolid, Valladolid, Spain
- Red de Investigación Cooperativa Orientada a Resultados en Salud (RICORS), Red de Enfermedades Inflamatorias (REI), Instituto de Salud Carlos III, Madrid, Spain
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2
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de Villers-Sidani É, Voss P, Bastien N, Cisneros-Franco JM, Hussein S, Mayo NE, Koch NA, Drouin-Picaro A, Blanchette F, Guitton D, Giacomini PS. Oculomotor analysis to assess brain health: preliminary findings from a longitudinal study of multiple sclerosis using novel tablet-based eye-tracking software. Front Neurol 2023; 14:1243594. [PMID: 37745656 PMCID: PMC10516298 DOI: 10.3389/fneur.2023.1243594] [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: 06/21/2023] [Accepted: 08/07/2023] [Indexed: 09/26/2023] Open
Abstract
A growing body of evidence supports the link between eye movement anomalies and brain health. Indeed, the oculomotor system is composed of a diverse network of cortical and subcortical structures and circuits that are susceptible to a variety of degenerative processes. Here we show preliminary findings from the baseline measurements of an ongoing longitudinal cohort study in MS participants, designed to determine if disease and cognitive status can be estimated and tracked with high accuracy based on eye movement parameters alone. Using a novel gaze-tracking technology that can reliably and accurately track eye movements with good precision without the need for infrared cameras, using only an iPad Pro embedded camera, we show in this cross-sectional study that several eye movement parameters significantly correlated with clinical outcome measures of interest. Eye movement parameters were extracted from fixation, pro-saccade, anti-saccade, and smooth pursuit visual tasks, whereas the clinical outcome measures were the scores of several disease assessment tools and standard cognitive tests such as the Expanded Disability Status Scale (EDSS), Brief International Cognitive Assessment for MS (BICAMS), the Multiple Sclerosis Functional Composite (MSFC) and the Symbol Digit Modalities Test (SDMT). Furthermore, partial least squares regression analyses show that a small set of oculomotor parameters can explain up to 84% of the variance of the clinical outcome measures. Taken together, these findings not only replicate previously known associations between eye movement parameters and clinical scores, this time using a novel mobile-based technology, but also the notion that interrogating the oculomotor system with a novel eye-tracking technology can inform us of disease severity, as well as the cognitive status of MS participants.
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Affiliation(s)
- Étienne de Villers-Sidani
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Patrice Voss
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | | | - J. Miguel Cisneros-Franco
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | | | - Nancy E. Mayo
- Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada
| | - Nils A. Koch
- Innodem Neurosciences, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | | | | | - Daniel Guitton
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Paul S. Giacomini
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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3
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de Villers-Sidani É, Voss P, Guitton D, Cisneros-Franco JM, Koch NA, Ducharme S. A novel tablet-based software for the acquisition and analysis of gaze and eye movement parameters: a preliminary validation study in Parkinson's disease. Front Neurol 2023; 14:1204733. [PMID: 37396780 PMCID: PMC10310943 DOI: 10.3389/fneur.2023.1204733] [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: 04/13/2023] [Accepted: 05/25/2023] [Indexed: 07/04/2023] Open
Abstract
The idea that eye movements can reflect certain aspects of brain function and inform on the presence of neurodegeneration is not a new one. Indeed, a growing body of research has shown that several neurodegenerative disorders, such as Alzheimer's and Parkinson's Disease, present characteristic eye movement anomalies and that specific gaze and eye movement parameters correlate with disease severity. The use of detailed eye movement recordings in research and clinical settings, however, has been limited due to the expensive nature and limited scalability of the required equipment. Here we test a novel technology that can track and measure eye movement parameters using the embedded camera of a mobile tablet. We show that using this technology can replicate several well-known findings regarding oculomotor anomalies in Parkinson's disease (PD), and furthermore show that several parameters significantly correlate with disease severity as assessed with the MDS-UPDRS motor subscale. A logistic regression classifier was able to accurately distinguish PD patients from healthy controls on the basis of six eye movement parameters with a sensitivity of 0.93 and specificity of 0.86. This tablet-based tool has the potential to accelerate eye movement research via affordable and scalable eye-tracking and aid with the identification of disease status and monitoring of disease progression in clinical settings.
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Affiliation(s)
- Étienne de Villers-Sidani
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Patrice Voss
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Daniel Guitton
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - J. Miguel Cisneros-Franco
- Innodem Neurosciences, Montreal, QC, Canada
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Nils A. Koch
- Innodem Neurosciences, Montreal, QC, Canada
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
| | - Simon Ducharme
- Montreal Neurological Institute, McGill University, Montreal, QC, Canada
- Douglas Mental Health University Institute, Montreal, QC, Canada
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4
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Working Memory Phenotypes in Early Multiple Sclerosis: Appraisal of Phenotype Frequency, Progression and Test Sensitivity. J Clin Med 2022; 11:jcm11102936. [PMID: 35629061 PMCID: PMC9148093 DOI: 10.3390/jcm11102936] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 12/04/2022] Open
Abstract
Working memory (WM) impairments are common and debilitating symptoms of multiple sclerosis (MS), often emerging early in the disease. Predominantly, WM impairments are considered in a binary manner, with patients considered either impaired or not based on a single test. However, WM is comprised of different activated subcomponents depending upon the type of information (auditory, visual) and integration requirements. As such, unique WM impairment phenotypes occur. We aimed to determine the most frequent WM phenotypes in early MS, how they progress and which WM test(s) provide the best measure of WM impairment. A total of 88 participants (63 early relapsing–remitting MS: RRMS, 25 healthy controls) completed five WM tests (visual–spatial, auditory, episodic, executive) as well as the symbol digit modalities test as a measure of processing speed. RRMS patients were followed-up for two years. Factors affecting WM (age/gender/intelligence/mood) and MS factors (disease duration/disability) were also evaluated. Some 61.9% of RRMS patients were impaired on at least one WM subcomponent. The most subcomponents impaired were visual,–spatial and auditory WM. The most common WM phenotypes were; (1) visual–spatial sketchpad + episodic buffer + phonological loop + central executive, (2) visual–spatial sketchpad + central executive. The test of visual–spatial WM provided the best diagnostic accuracy for detecting WM impairment and progression. The SDMT did not achieve diagnostic accuracy greater than chance. Although this may be unsurprising, given that the SDMT is a measure of cognitive processing speed in MS, this does highlight the limitation of the SDMT as a general screening tool for cognitive impairment in early MS.
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5
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Quantification of smooth pursuit dysfunction in multiple sclerosis. Mult Scler Relat Disord 2021; 54:103073. [PMID: 34214878 DOI: 10.1016/j.msard.2021.103073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 05/31/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Smooth pursuit dysfunction is common in MS, but rarely quantified and may be missed on exam. METHODS NeuroFitONE™ smooth pursuit performance measures were compared between MS (n = 20) and healthy control (n = 19) participants. RESULTS Compared to controls, MS patients had lower proportion of smooth pursuit (0.63 vs. 0.73; p = 0.047), increased directional (10.1 vs. 8°; p = 0.014) and speed noise (4.3 vs. 3.1°/sec; p = 0.021) and reduced initiation acceleration (96.83 vs. 115.33°/sec2; p = 0.061). Significant univariate correlations with clinical scores (EDSS, T25-FW) were observed. CONCLUSION Smooth pursuit dysfunction in MS can be readily quantified and distinguishes MS eyes from healthy controls.
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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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7
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Sharp A, Turgeon C, Johnson AP, Pannasch S, Champoux F, Ellemberg D. Congenital Deafness Leads to Altered Overt Oculomotor Behaviors. Front Neurosci 2020; 14:273. [PMID: 32327967 PMCID: PMC7153650 DOI: 10.3389/fnins.2020.00273] [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: 10/28/2019] [Accepted: 03/10/2020] [Indexed: 11/23/2022] Open
Abstract
The human brain is highly cross-modal, and sensory information may affect a wide range of behaviors. In particular, there is evidence that auditory functions are implicated in oculomotor behaviors. Considering this apparent auditory-oculomotor link, one might wonder how the loss of auditory input from birth might have an influence on these motor behaviors. Eye movement tracking enables to extract several components, including saccades and smooth pursuit. One study suggested that deafness can alter saccades processing. Oculomotor behaviors have not been examined further in the deaf. The main goal of this study was to examine smooth pursuit following deafness. A pursuit task paradigm was used in this experiment. Participants were instructed to move their eyes to follow a target as it moved. The target movements have a possibility of four different trajectories (horizontal, vertical, elliptic clockwise, and elliptic counter-clockwise). Results indicate a significant reduction in the ability to track a target in both elliptical conditions showing that more complex motion processing differs in deaf individuals. The data also revealed significantly more saccades per trial in the vertical, anti-clockwise, and, to a lesser extent, the clockwise elliptic condition. This suggests that auditory deprivation from birth leads to altered overt oculomotor behaviors.
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Affiliation(s)
- Andréanne Sharp
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
| | - Christine Turgeon
- Department of Biomedical Sciences, University of Montreal, Montreal, QC, Canada
| | | | - Sebastian Pannasch
- Applied Cognitive Research/Psychology III, Technische Universitaet Dresden, Dresden, Germany
| | - François Champoux
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montreal, QC, Canada
| | - Dave Ellemberg
- Department of Kinesiology, University of Montreal, Montreal, QC, Canada
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8
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Gil-Casas A, Piñero DP, Molina-Martin A. Binocular, Accommodative and Oculomotor Alterations In Multiple Sclerosis: A Review. Semin Ophthalmol 2020; 35:103-115. [PMID: 32228341 DOI: 10.1080/08820538.2020.1744671] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Multiple sclerosis (MS) is an acquired demyelinating and inflammatory neurodegenerative disease affecting the central nervous system (CNS). Clinical and subclinical ocular disturbances occur in almost all patients with MS. The objective of this narrative review was to collect and summarize the available scientific information on oculomotor, accommodative and binocular alterations that have been reported in MS. A systematic search strategy with the following descriptors was carried out: multiple sclerosis, ocular motility disorders, internuclear ophthalmoplegia, nystagmus, vergences, fixation, pupil reflex, accommodation and stereopsis. According to the search, some oculomotor alterations were found to be commonly reported in MS, such as alterations in saccades and nystagmus. In contrast, accommodative, vergence and stereopsis alterations have not been comprehensively studied despite their relevance, with only minimal evidence showing a potential negative impact of the disease on these aspects. In conclusion, oculomotor impairment is a common component of disability in MS patients and should be considered when managing this type of patients. More research is still needed to know the real impact of this disease on binocular vision and accommodation.
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Affiliation(s)
- Amparo Gil-Casas
- Clínica Optométrica, Foundation Lluís Alcanyís, University of Valencia, Valencia, Spain
| | - David P Piñero
- Optics and Visual Perception Group (GOPV). Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Ainhoa Molina-Martin
- Optics and Visual Perception Group (GOPV). Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
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Mcilreavy L, Freeman TCA, Erichsen JT. Two-Dimensional Analysis of Smooth Pursuit Eye Movements Reveals Quantitative Deficits in Precision and Accuracy. Transl Vis Sci Technol 2019; 8:7. [PMID: 31588372 PMCID: PMC6753966 DOI: 10.1167/tvst.8.5.7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 06/23/2019] [Indexed: 01/30/2023] Open
Abstract
Purpose Small moving targets are followed by pursuit eye movements, with success ubiquitously defined by gain. Gain quantifies accuracy, rather than precision, and only for eye movements along the target trajectory. Analogous to previous studies of fixation, we analyzed pursuit performance in two dimensions as a function of target direction, velocity, and amplitude. As a subsidiary experiment, we compared pursuit performance against that of fixation. Methods Eye position was recorded from 15 observers during pursuit. The target was a 0.4° dot that moved across a large screen at 8°/s or 16°/s, either horizontally or vertically, through peak-to-peak amplitudes of 8°, 16°, or 32°. Two-dimensional eye velocity was expressed relative to the target, and a bivariate probability density function computed to obtain accuracy and precision. As a comparison, identical metrics were derived from fixation data. Results For all target directions, eye velocity was less precise along the target trajectory. Eye velocities orthogonal to the target trajectory were more accurate during vertical pursuit than horizontal. Pursuit accuracy and precision along and orthogonal to the target trajectory decreased at the higher target velocity. Accuracy along the target trajectory decreased with smaller target amplitudes. Conclusions Orthogonal to the target trajectory, pursuit was inaccurate and imprecise. Compared to fixation, pursuit was less precise and less accurate even when following the stimulus that gave the best performance. Translational Relevance This analytical approach may help the detection of subtle deficits in slow phase eye movements that could be used as biomarkers for disease progression and/or treatment.
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Affiliation(s)
- Lee Mcilreavy
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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Kraus L, Kremmyda O, Bremova-Ertl T, Barceló S, Feil K, Strupp M. An algorithm as a diagnostic tool for central ocular motor disorders, also to diagnose rare disorders. Orphanet J Rare Dis 2019; 14:193. [PMID: 31395076 PMCID: PMC6688379 DOI: 10.1186/s13023-019-1164-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 07/22/2019] [Indexed: 12/15/2022] Open
Abstract
Background Recently an increasing number of digital tools to aid clinical work have been published. This study’s aim was to create an algorithm which can assist physicians as a “digital expert” with the differential diagnosis of central ocular motor disorders, in particular in rare diseases. Results The algorithm’s input consists of a maximum of 60 neurological and oculomotor signs and symptoms. The output is a list of the most probable diagnoses out of 14 alternatives and the most likely topographical anatomical localizations out of eight alternatives. Positive points are given for disease-associated symptoms, negative points for symptoms unlikely to occur with a disease. The accuracy of the algorithm was evaluated using the two diagnoses and two brain zones with the highest scores. In a first step, a dataset of 102 patients (56 males, 48.0 ± 22 yrs) with various central ocular motor disorders and underlying diseases, with a particular focus on rare diseases, was used as the basis for developing the algorithm iteratively. In a second step, the algorithm was validated with a dataset of 104 patients (59 males, 46.0 ± 23 yrs). For 12/14 diseases, the algorithm showed a sensitivity of between 80 and 100% and the specificity of 9/14 diseases was between 82 and 95% (e.g., 100% sensitivity and 75.5% specificity for Niemann Pick type C, and 80% specificity and 91.5% sensitivity for Gaucher’s disease). In terms of a topographic anatomical diagnosis, the sensitivity was between 77 and 100% for 4/8 brain zones, and the specificity of 5/8 zones ranged between 79 and 99%. Conclusion This algorithm using our knowledge of the functional anatomy of the ocular motor system and possible underlying diseases is a useful tool, in particular for the diagnosis of rare diseases associated with typical central ocular motor disorders, which are often overlooked. Electronic supplementary material The online version of this article (10.1186/s13023-019-1164-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ludwig Kraus
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany.
| | - Olympia Kremmyda
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Tatiana Bremova-Ertl
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany.,Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Sebastià Barceló
- Syntax for Science, Parc Bit, Edif. Disset A2, 07121, Palma de Mallorca, Spain
| | - Katharina Feil
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany
| | - Michael Strupp
- Department of Neurology and German Center for Vertigo and Balance Disorders, Ludwig-Maximilians University, Munich, Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany
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11
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Yousef A, Devereux M, Gourraud PA, Jonzzon S, Suleiman L, Waubant E, Green A, Graves JS. Subclinical Saccadic Eye Movement Dysfunction in Pediatric Multiple Sclerosis. J Child Neurol 2019; 34:38-43. [PMID: 30463467 DOI: 10.1177/0883073818807787] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Efferent visual dysfunction in children could lead to impaired quality of life at home and school. Eye-tracking can detect subtle efferent dysfunction missed on bedside examination but has not been validated in the pediatric multiple sclerosis population. OBJECTIVE We sought to determine the feasibility of eye-tracking in children and associations with multiple sclerosis. METHODS Participants meeting criteria for pediatric multiple sclerosis without acute efferent vision abnormalities and healthy controls were recruited. Multiple sclerosis participants underwent a clinical assessment and saccade and antisaccade testing paradigms. Intraclass correlation coefficients were generated for intertest repeatability. Adjusting for age and intereye correlations, generalized estimating equations compared latencies with case status, Expanded Disability Status Scale and Symbol Digit Modalities Test (SDMT) scores. RESULTS We eye-tracked 15 children with multiple sclerosis (n = 30 eyes, mean age 15.6 ± 2.1, mean disease duration 3.9 years, median Expanded Disability Status Scale 1.5) compared to 6 healthy controls (n = 12 eyes, age 14.3 ± .95). The intraclass correlation coefficient for repeated trials was 0.85. Adjusting for age, saccadic latency was 60 milliseconds (ms) longer for cases than controls (95% confidence interval = 26.4, 93.8; P = .0005). For antisaccadic latency, we observed a similar trend of 60 ms longer for cases than controls ( P = .06). CONCLUSION Eye-tracking is a short noninvasive examination, and high intertest repeatability supports use of eye-tracking technology in pediatric multiple sclerosis. Longer saccadic latencies were seen in children with multiple sclerosis despite short disease duration and low Expanded Disability Status Scale scores.
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Affiliation(s)
- Andrew Yousef
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Michael Devereux
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Pierre-Antoine Gourraud
- 2 Université de Nantes, INSERM, Centre de Recherche en Transplantation et Immunologie, Nantes, France.,3 CHU de Nantes, Institut de Transplantation Urologie Néphrologie (ITUN), Nantes, France
| | - Soren Jonzzon
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Leena Suleiman
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Emmanuelle Waubant
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Ari Green
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Jennifer S Graves
- 1 Department of Neurology, University of California San Francisco, San Francisco, CA, USA.,4 Department of Neuroscience, University of California San Diego, San Diego, CA, USA
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