Toward an Automatic Assessment of Cognitive Dysfunction in Relapsing–Remitting Multiple Sclerosis Patients Using Eye Movement Analysis

Abstract

Despite the importance of cognitive function in multiple sclerosis, it is poorly represented in the Expanded Disability Status Scale (EDSS), the commonly used clinical measure to assess disability, suggesting that an analysis of eye movement, which is generated by an extensive and well-coordinated functional network that is engaged in cognitive function, could have the potential to extend and complement this more conventional measure. We aimed to measure the eye movement of a case series of MS patients with relapsing–remitting MS to assess their cognitive status using a conventional gaze tracker. A total of 41 relapsing–remitting MS patients and 43 age-matched healthy controls were recruited for this study. Overall, we could not find a clear common pattern in the eye motor abnormalities. Vertical eye movement was more impaired in MS patients than horizontal movement. Increased latencies were found in the prosaccades and reflexive saccades of antisaccade tests. The smooth pursuit was impaired with more corrections (backup and catchup movements, p<0.01). No correlation was found between eye movement variables and EDSS or disease duration. Despite significant alterations in the behavior of the eye movements in MS patients, which are compatible with altered cognitive status, there is no common pattern of these alterations. We interpret this as a consequence of the patchy, heterogeneous distribution of white matter involvement in MS that provokes multiple combinations of impairment at different points in the different networks involved in eye motor control. Further studies are therefore required.

Application and progress of advanced eye movement examinations in cognitive impairment

“…However, these results have been hardly reproduced, which may be due to the heterogeneity of the distribution of white matter lesions in MS patients, and the eye movement abnormalities may be due to the involvement of the structure of the oculomotor loop in white matter lesion. The characteristics of the disease itself make it difficult to reproduce the experimental results in different laboratories, and are also related to the small sample size of most studies ( García Cena et al, 2022 ).…”

Automatic Video-Oculography System for Detection of Minimal Hepatic Encephalopathy Using Machine Learning Tools

“…Recently, more evidence has arisen in the literature related to the sensitivity and sensibility of eye movement to assist in cognitive impairment by measuring eye movements [14][15][16][17]. Additionally, authors have experience in the development of devices for measuring eye movement [18,19], as well as in feature extraction and analysis in people affected by a neurological disease [20][21][22][23].…”