Clinical value of video oculomotor evaluation in the differential diagnosis of multiple system atrophy and Parkinson's disease.

BACKGROUND: Multiple system atrophy (MSA) is a neurodegenerative disease that progresses rapidly and has a poor prognosis. This study aimed to assess the value of video oculomotor evaluation (VOE) in the differential diagnosis of MSA and Parkinson's disease (PD). METHODS: In total, 28 patients with MSA, 31 patients with PD, and 30 age- and sex-matched healthy controls (HC) were screened and included in this study. The evaluation consisted of a gaze-holding test, smooth pursuit eye movement (SPEM), random saccade, and optokinetic nystagmus (OKN). RESULTS: The MSA and PD groups had more abnormalities and decreased SPEM gain than the HC group (64.29%, 35.48%, 10%, p < .001). The SPEM gain in the MSA group was significantly lower than that in the PD group at specific frequencies. Patients with MSA and PD showed prolonged latencies in all saccade directions compared with those with HC. However, the two diseases had no significant differences in the saccade parameters. The OKN gain gradually decreased from the HC to the PD and the MSA groups (p < .05). Compared with the PD group, the gain in the MSA group was further decreased in the OKN test at 30°/s (Left, p = .010; Right p = .016). Receiver operating characteristic curves showed that the combination of oculomotor parameters with age and course of disease could aid in the differential diagnosis of patients with MSA and PD, with a sensitivity of 89.29% and a specificity of 70.97%. CONCLUSIONS: The combination of oculomotor parameters and clinical data may aid in the differential diagnosis of MSA and PD. Furthermore, VOE is vital in the identification of neurodegenerative diseases.

Infants' reorienting efficiency depends on parental autistic traits and predicts future socio-communicative behaviors.

Attentional reorienting is dysfunctional not only in children with autism spectrum disorder (ASD), but also in infants who will develop ASD, thus constituting a potential causal factor of future social interaction and communication abilities. Following the research domain criteria framework, we hypothesized that the presence of subclinical autistic traits in parents should lead to atypical infants' attentional reorienting, which in turn should impact on their future socio-communication behavior in toddlerhood. During an attentional cueing task, we measured the saccadic latencies in a large sample (total enrolled n = 89; final sample n = 71) of 8-month-old infants from the general population as a proxy for their stimulus-driven attention. Infants were grouped in a high parental traits (HPT; n = 23) or in a low parental traits (LPT; n = 48) group, according to the degree of autistic traits self-reported by their parents. Infants (n = 33) were then longitudinally followed to test their socio-communicative behaviors at 21 months. Results show a sluggish reorienting system, which was a longitudinal predictor of future socio-communicative skills at 21 months. Our combined transgenerational and longitudinal findings suggest that the early functionality of the stimulus-driven attentional network-redirecting attention from one event to another-could be directly connected to future social and communication development.

Jointly looking to the past and the future in visual working memory.

Working memory enables us to bridge past sensory information to upcoming future behaviour. Accordingly, by its very nature, working memory is concerned with two components: the past and the future. Yet, in conventional laboratory tasks, these two components are often conflated, such as when sensory information in working memory is encoded and tested at the same location. We developed a task in which we dissociated the past (encoded location) and future (to-be-tested location) attributes of visual contents in working memory. This enabled us to independently track the utilisation of past and future memory attributes through gaze, as observed during mnemonic selection. Our results reveal the joint consideration of past and future locations. This was prevalent even at the single-trial level of individual saccades that were jointly biased to the past and future. This uncovers the rich nature of working memory representations, whereby both past and future memory attributes are retained and can be accessed together when memory contents become relevant for behaviour.

Evidence of elevated situational awareness for active duty soldiers during navigation of a virtual environment.

U.S. service members maintain constant situational awareness (SA) due to training and experience operating in dynamic and complex environments. Work examining how military experience impacts SA during visual search of a complex naturalistic environment, is limited. Here, we compare Active Duty service members and Civilians' physiological behavior during a navigational visual search task in an open-world virtual environment (VE) while cognitive load was manipulated. We measured eye-tracking and electroencephalogram (EEG) outcomes from Active Duty (N = 21) and Civilians (N = 15) while they navigated a desktop VE at a self-regulated pace. Participants searched and counted targets (N = 15) presented among distractors, while cognitive load was manipulated with an auditory Math Task. Results showed Active Duty participants reported significantly greater/closer to the correct number of targets compared to Civilians. Overall, Active Duty participants scanned the VE with faster peak saccade velocities and greater average saccade magnitudes compared to Civilians. Convolutional Neural Network (CNN) response (EEG P-300) was significantly weighted more to initial fixations for the Active Duty group, showing reduced attentional resources on object refixations compared to Civilians. There were no group differences in fixation outcomes or overall CNN response when comparing targets versus distractor objects. When cognitive load was manipulated, only Civilians significantly decreased their average dwell time on each object and the Active Duty group had significantly fewer numbers of correct answers on the Math Task. Overall, the Active Duty group explored the VE with increased scanning speed and distance and reduced cognitive re-processing on objects, employing a different, perhaps expert, visual search strategy indicative of increased SA. The Active Duty group maintained SA in the main visual search task and did not appear to shift focus to the secondary Math Task. Future work could compare how a stress inducing environment impacts these groups' physiological or cognitive markers and performance for these groups.

Oculomotor behavior can be adjusted on the basis of artificial feedback signals indicating externally caused errors.

Whether a saccade is accurate and has reached the target cannot be evaluated during its execution, but relies on post-saccadic feedback. If the eye has missed the target object, a secondary corrective saccade has to be made to align the fovea with the target. If a systematic post-saccadic error occurs, adaptive changes to the oculomotor behavior are made, such as shortening or lengthening the saccade amplitude. Systematic post-saccadic errors are typically attributed internally to erroneous motor commands. The corresponding adaptive changes to the motor command reduce the error and the need for secondary corrective saccades, and, in doing so, restore accuracy and efficiency. However, adaptive changes to the oculomotor behavior also occur if a change in saccade amplitude is beneficial for task performance, or if it is rewarded. Oculomotor learning thus is more complex than reducing a post-saccadic position error. In the current study, we used a novel oculomotor learning paradigm and investigated whether human participants are able to adapt their oculomotor behavior to improve task performance even when they attribute the error externally. The task was to indicate the intended target object among several objects to a simulated human-machine interface by making eye movements. The participants were informed that the system itself could make errors. The decoding process depended on a distorted landing point of the saccade, resulting in decoding errors. Two different types of visual feedback were added to the post-saccadic scene and we compared how participants used the different feedback types to adjust their oculomotor behavior to avoid errors. We found that task performance improved over time, regardless of the type of feedback. Thus, error feedback from the simulated human-machine interface was used for post-saccadic error evaluation. This indicates that 1) artificial visual feedback signals and 2) externally caused errors might drive adaptive changes to oculomotor behavior.

Post-Saccadic Oscillations of the Pupil and Lens Reduce Fixation Stability in Retinitis Pigmentosa and Age-Related Macular Degeneration.

Purpose: Post-saccadic oscillations (PSOs) reflect movements of gaze that result from motion of the pupil and lens relative to the eyeball rather than eyeball rotations. Here, we analyzed the characteristics of PSOs in subjects with age-related macular degeneration (AMD), retinitis pigmentosa (RP), and normal vision (NV). Our aim was to assess the differences in PSOs between people with vision loss and healthy controls because PSOs affect retinal image stability after each saccade. Methods: Participants completed a horizontal saccade task and their gaze was measured using a pupil-based eye tracker. Oscillations occurring in the 80 to 200 ms post-saccadic period were described with a damped oscillation model. We compared the amplitude, decay time constant, and frequency of the PSOs for the three different groups. We also examined the correlation between these PSO parameters and the amplitude, peak velocity, and final deceleration of the preceding saccades. Results: Subjects with vision loss (AMD, n = 6, and RP, n = 5) had larger oscillation amplitudes, longer decay constants, and lower frequencies than subjects with NV (n = 7). The oscillation amplitudes increased with increases in saccade deceleration in all three groups. The other PSO parameters, however, did not show consistent correlations with either saccade amplitude or peak velocity. Conclusions: Post-saccadic fixation stability in AMD and RP is reduced due to abnormal PSOs. The differences with respect to NV are not due to differences in saccade kinematics, suggesting that anatomic and neuronal variations affect the suspension of the iris and the lens in the patients' eyes.

Bidirectional brain-body interactions during natural story listening.

Narratives can synchronize neural and physiological signals between individuals, but the relationship between these signals, and the underlying mechanism, is unclear. We hypothesized a top-down effect of cognition on arousal and predicted that auditory narratives will drive not only brain signals but also peripheral physiological signals. We find that auditory narratives entrained gaze variation, saccade initiation, pupil size, and heart rate. This is consistent with a top-down effect of cognition on autonomic function. We also hypothesized a bottom-up effect, whereby autonomic physiology affects arousal. Controlled breathing affected pupil size, and heart rate was entrained by controlled saccades. Additionally, fluctuations in heart rate preceded fluctuations of pupil size and brain signals. Gaze variation, pupil size, and heart rate were all associated with anterior-central brain signals. Together, these results suggest bidirectional causal effects between peripheral autonomic function and central brain circuits involved in the control of arousal.

Common structure of saccades and microsaccades in visual perception.

We obtain large amounts of external information through our eyes, a process often considered analogous to picture mapping onto a camera lens. However, our eyes are never as still as a camera lens, with saccades occurring between fixations and microsaccades occurring within a fixation. Although saccades are agreed to be functional for information sampling in visual perception, it remains unknown if microsaccades have a similar function when eye movement is restricted. Here, we demonstrated that saccades and microsaccades share common spatiotemporal structures in viewing visual objects. Twenty-seven adults viewed faces and houses in free-viewing and fixation-controlled conditions. Both saccades and microsaccades showed distinctive spatiotemporal patterns between face and house viewing that could be discriminated by pattern classifications. The classifications based on saccades and microsaccades could also be mutually generalized. Importantly, individuals who showed more distinctive saccadic patterns between faces and houses also showed more distinctive microsaccadic patterns. Moreover, saccades and microsaccades showed a higher structure similarity for face viewing than house viewing and a common orienting preference for the eye region over the mouth region. These findings suggested a common oculomotor program that is used to optimize information sampling during visual object perception.

The olivary input to the cerebellum dissociates sensory events from movement plans.

Neurons in the inferior olive are thought to anatomically organize the Purkinje cells (P-cells) of the cerebellum into computational modules, but what is computed by each module? Here, we designed a saccade task in marmosets that dissociated sensory events from motor events and then recorded the complex and simple spikes of hundreds of P-cells. We found that when a visual target was presented at a random location, the olive reported the direction of that sensory event to one group of P-cells, but not to a second group. However, just before movement onset, it reported the direction of the planned movement to both groups, even if that movement was not toward the target. At the end of the movement if the subject experienced an error but chose to withhold the corrective movement, only the first group received information about the sensory prediction error. We organized the P-cells based on the information content of their olivary input and found that in the group that received sensory information, the simple spikes were suppressed during fixation, then produced a burst before saccade onset in a direction consistent with assisting the movement. In the second group, the simple spikes were not suppressed during fixation but burst near saccade deceleration in a direction consistent with stopping the movement. Thus, the olive differentiated the P-cells based on whether they would receive sensory or motor information, and this defined their contributions to control of movements as well as holding still.

Peripheral vision and crowding in mental maze-solving.

Solving a maze effectively relies on both perception and cognition. Studying maze-solving behavior contributes to our knowledge about these important processes. Through psychophysical experiments and modeling simulations, we examine the role of peripheral vision, specifically visual crowding in the periphery, in mental maze-solving. Experiment 1 measured gaze patterns while varying maze complexity, revealing a direct relationship between visual complexity and maze-solving efficiency. Simulations of the maze-solving task using a peripheral vision model confirmed the observed crowding effects while making an intriguing prediction that saccades provide a conservative measure of how far ahead observers can perceive the path. Experiment 2 confirms that observers can judge whether a point lies on the path at considerably greater distances than their average saccade. Taken together, our findings demonstrate that peripheral vision plays a key role in mental maze-solving.

Differentiation of peripheral and non-peripheral etiologies in children with vertigo/dizziness: The video-head impulse test and suppression head impulse paradigm.

OBJECTIVES: To identify the etiology of vertigo/dizziness and determine the effectiveness of the video-head impulse test (vHIT) and the suppression head impulse paradigm (SHIMP) tests in distinguishing between peripheral and non-peripheral etiologies in children who presented to the otolaryngology department with complaints of vertigo/dizziness. METHODS: The vHIT and SHIMP tests were applied to the children. The vestibulo-ocular reflex (VOR) gain and saccade parameters were compared. RESULTS: In 27 children presenting with vertigo/dizziness, the most common etiological factor was inner ear malformation (IEM) (n = 6/27, 22.2%), followed by cochlear implant surgery (11.1%) and migraine (11.1%). Vestibular hypofunction was indicated by the vHIT results at a rate of 60% (9/15 children) and SHIMP results at 73.3% (11/15 children) among the children with a peripheral etiology, while these rates were 8.3% (1/12 children) and 25% (3/12 children), respectively, in the non-peripheral etiology group. SHIMP-VOR and vHIT-VOR gain values had a moderate positive correlation (p = 0.01, r = 0.349). While there were overt/covert saccades in the vHIT, anti-compensatory saccade (ACSs) were not observed in the SHIMP test (p = 0.041). The rates of abnormal vHIT-VOR gain (p = 0.001), over/covert saccades (p = 0.019), abnormal vHIT response (p = 0.014), ACSs (p = 0.001), and abnormal SHIMP response (p = 0.035) were significantly higher in the peripheral etiology group. CONCLUSIONS: IEM was the most common etiological cause, and the rate of vestibular hypofunction was higher in these children with peripheral vertigo. vHIT and SHIMP are effective and useful vestibular tests for distinguishing peripheral etiology from non-peripheral etiology in the pediatric population with vertigo/dizziness. These tests can be used together or alone, but the first choice should be the SHIMP test, considering its short application time (approximately 4-5 min) and simplicity.

Smooth pursuit inhibition reveals audiovisual enhancement of fast movement control.

The sudden onset of a visual object or event elicits an inhibition of eye movements at latencies approaching the minimum delay of visuomotor conductance in the brain. Typically, information presented via multiple sensory modalities, such as sound and vision, evokes stronger and more robust responses than unisensory information. Whether and how multisensory information affects ultra-short latency oculomotor inhibition is unknown. In two experiments, we investigate smooth pursuit and saccadic inhibition in response to multisensory distractors. Observers tracked a horizontally moving dot and were interrupted by an unpredictable visual, auditory, or audiovisual distractor. Distractors elicited a transient inhibition of pursuit eye velocity and catch-up saccade rate within ∼100 ms of their onset. Audiovisual distractors evoked stronger oculomotor inhibition than visual- or auditory-only distractors, indicating multisensory response enhancement. Multisensory response enhancement magnitudes were equal to the linear sum of responses to component stimuli. These results demonstrate that multisensory information affects eye movements even at ultra-short latencies, establishing a lower time boundary for multisensory-guided behavior. We conclude that oculomotor circuits must have privileged access to sensory information from multiple modalities, presumably via a fast, subcortical pathway.

Fast saccades to faces during the feedforward sweep.

Saccadic choice tasks use eye movements as a response method, typically in a task where observers are asked to saccade as quickly as possible to an image of a prespecified target category. Using this approach, face-selective saccades have been observed within 100 ms poststimulus. When taking into account oculomotor processing, this suggests that faces can be detected in as little as 70 to 80 ms. It has therefore been suggested that face detection must occur during the initial feedforward sweep, since this latency leaves little time for feedback processing. In the current experiment, we tested this hypothesis using backward masking-a technique shown to primarily disrupt feedback processing while leaving feedforward activation relatively intact. Based on minimum saccadic reaction time, we found that face detection benefited from ultra-fast, accurate saccades within 110 to 160 ms and that these eye movements are obtainable even under extreme masking conditions that limit perceptual awareness. However, masking did significantly increase the median SRT for faces. In the manual responses, we found remarkable detection accuracy for faces and houses, even when participants indicated having no visual experience of the test images. These results provide evidence for the view that the saccadic bias to faces is initiated by coarse information used to categorize faces in the feedforward sweep but that, in most cases, additional processing is required to quickly reach the threshold for saccade initiation.

Repetition blindness in a saccadic persistence of vision display.

A form of repetition blindness in visually unimpaired individuals was found for objects presented during saccades. Observers were asked to draw their percepts after making saccades across an LED strip that "painted" an image on their retinas by presenting sequential columns of a bitmap at a speed to match a 30-degree saccade. During experimental trials, repetitions of a single letter (either "A," "X," "H," or "V") were presented across saccades. Although an average of six letters were presented across each saccade, observers typically indicated perceiving only a single instance of the letter in their drawings. This inability to perceive multiple instances of a letter was not due to a limited region of attentional processing, as it only attained for multiple instances along the axis of the saccade-horizontal saccades did not affect perception of multiple letters along the vertical axis. This effect is likely due to selective suppression of visual areas during saccades.

Pre-saccadic shifts of attention in individuals diagnosed with schizophrenia.

INTRODUCTION: Pathophysiological theories of schizophrenia (SZ) symptoms posit an abnormality in using predictions to guide behavior. One such prediction is based on imminent movements, via corollary discharge signals (CD) that relay information about planned movement kinematics to sensory brain regions. Empirical evidence suggests a reduced influence of sensorimotor predictions in individuals with SZ within multiple sensory systems, including in the visual system. One function of CD in the visual system is to selectively enhance visual sensitivity at the location of planned eye movements (pre-saccadic attention), thus enabling a prediction of the to-be-foveated stimulus. We expected pre-saccadic attention shifts to be less pronounced in individuals with SZ than in healthy controls (HC), resulting in unexpected sensory consequences of eye movements, which may relate to symptoms than can be explained in the context of altered allocation of attention. METHODS: We examined this question by testing 30 SZ and 30 HC on a pre-saccadic attention task. On each trial participants made a saccade to a cued location in an array of four stimuli. A discrimination target that was either congruent or incongruent with the cued location was briefly presented after the cue, during saccade preparation. Pre-saccadic attention was quantified by comparing accuracy on congruent trials to incongruent trials within the interval preceding the saccade. RESULTS: Although SZs were less accurate overall, the magnitude of the pre-saccadic attention effect generally did not differ across groups nor show a convincing relationship with symptom severity. We did, however, observe that SZ had reduced pre-saccadic attention effects when the discrimination target (probe) was presented at early stages of saccade planning, when pre-saccadic attention effects first emerged in HC. CONCLUSION: These findings suggest generally intact pre-saccadic shifts of attention in SZ, albeit slightly delayed. Results contribute to our understanding of altered sensory predictions in people with schizophrenia.

Audiological and Vestibular Measurements in Chronic Renal Failure Patients Receiving Hemodialysis Treatment.

BACKGROUND: The aim was to evaluate the changes in the audiovestibular system in adult patients with the diagnosis of chronic renal failure who were treated with hemodialysis. METHODS: Thirty-five patients diagnosed with chronic renal failure and receiving hemodialysis treatment 3 days a week and 35 healthy individuals were tested with pure tone audiometry, video head impulse test, and post-head shake nystagmus test. Dizziness Handicap Inventory was applied to all participants. RESULTS: The Dizziness Handicap Inventory scores of the patient groups are higher than the control groups (P=.001). In the video head impulse test, there is no statistically significant difference between the patient and control groups in terms of gain asymmetry. 17.1% of the patients had both left and right lateral saccades (P=.03). A statistically significant difference was also found after the post-head shake test (P=.025). In the patient group, an inverse relationship between the presence of left anterior right posterior saccades and blood urea nitrogen-creatinine ratio and a direct relationship between the presence of right anterior left posterior saccades and creatinine elevation were determined. The presence of saccades in the video head impulse test increased significantly as the disease duration of hemodialysis patients increased. CONCLUSION: It was determined that the overt and covert saccades in the video head impulse test increased significantly as the creatinine increased and the duration of the disease increased in the patients with chronic renal failure. The common clinical usage of video head impulse test in monitoring the vestibular side effects of creatinine elevation and disease duration in chronic renal failure patients may be possible with future studies.

Saccadic movements during an exploratory visual search task in patients with glaucomatous visual field loss.

PURPOSE: To evaluate the saccadic movements of patients with visual field loss due to primary open-angle glaucoma. METHODS: Thirteen patients with good visual acuity (0.2 logMAR or better) (seven patients with primary open-angle glaucoma 65 ± 13 years) and six controls (51 ± 6 years) yielded a comprehensive ophthalmological examination, including Humphrey Visual Field tests (SITA-Standard 24-2), and performed a monocular, exploratory digital visual search task that quantifies the duration for finding the number "4" on a random array of digits distributed on the screen. After individual adjustments of the angle and distance positioning, the screen was spatially matched with the 24-2 visual field, and divided into five areas for analysis. During the task, saccades were simultaneously recorded in the same eye with a video-based eye tracker. RESULTS: The patients with primary open-angle glaucoma showed a significantly higher number of saccades/screen (median ± interquartile range, 59.00 ± 29.00 vs. 32.50 ± 19.75 saccades (p=0.027) and visual search time per screen (38.50 ± 60.14 vs. 23.75 ± 8.90 seconds (p=0.035) than the controls did. Although the univariate analysis indicated a significant correlation with visual field mean deviation (coefficient=26.19 (p=0.02), only the visual search time/screen was significantly associated with the number of saccades/screen in the multivariate regression model (coefficient=0.55 (p<0.001). Overall, no significant correlation was observed between the sectorial number of saccades and the sensitivity of the five visual field areas. CONCLUSIONS: The patients with primary open-angle glaucoma show impaired search performance and showed a higher number of saccades needed to find stimuli when performing the exploratory visual task.

Exploring Gaze Dynamics in Virtual Reality through Multiscale Entropy Analysis.

This study employs Multiscale Entropy (MSE) to analyze 5020 binocular eye movement recordings from 407 college-aged participants, as part of the GazeBaseVR dataset, across various virtual reality (VR) tasks to understand the complexity of user interactions. By evaluating the vertical and horizontal components of eye movements across tasks such as vergence, smooth pursuit, video viewing, reading, and random saccade, collected at 250 Hz using an ET-enabled VR headset, this research provides insights into the predictability and complexity of gaze patterns. Participants were recorded up to six times over a 26-month period, offering a longitudinal perspective on eye movement behavior in VR. MSE's application in this context aims to offer a deeper understanding of user behavior in VR, highlighting potential avenues for interface optimization and user experience enhancement. The results suggest that MSE can be a valuable tool in creating more intuitive and immersive VR environments by adapting to users' gaze behaviors. This paper discusses the implications of these findings for the future of VR technology development, emphasizing the need for intuitive design and the potential for MSE to contribute to more personalized and comfortable VR experiences.

Saccades to partially occluded objects: Perceptual completion mediates oculomotor control.

Oculomotor behavior typically consists of directing gaze to objects in complex scenes for the purpose of extracting detailed perceptual information. Here, we probed the nature of the visual representations over which saccades to objects are computed. We contrasted an image-based oculomotor control hypothesis, holding that saccades are computed solely over information explicit in the retinal image, and an object-based oculomotor control hypothesis, holding that saccades are computed over object representations reflecting the three-dimensional structure of the scene. We recorded saccade landing positions to partially occluded objects in a naturalistic search task. In Experiment 1, saccade landing positions were biased toward the center of the perceptually completed object. Experiment 2 demonstrated that the bias held even when it would have been strategically advantageous to avoid it. Experiment 3 demonstrated that the bias was not due to image-level differences generated by the presence of occluders. The results indicate that saccade motor programs are computed, at least in part, over object-level representations reflecting the completion of occluded surfaces.