Imagine your eyes are detectives, searching for clues about the health of your brain. Scientists have discovered that by tracking eye movements during visual tasks, they can detect early signs of cognitive decline in patients with Alzheimer’s disease. Just like detectives following a trail, researchers recorded the patterns of gaze exploration and pupil size changes in Alzheimer’s patients and compared them to a control group. They found that Alzheimer’s patients had reduced fixation on important regions of interest, took longer to complete visual search tasks, and had decreased pupil modulation during these tasks. These findings suggest impaired attentional allocation, inefficient visual processing, and dysfunction of the locus coeruleus in Alzheimer’s patients. By combining multiple visual tasks, researchers were able to accurately detect cognitive decline at an early stage with high sensitivity and specificity. This exciting research opens up new possibilities for early detection and evaluation of Alzheimer’s disease. Grab your detective glasses and dive into the full article to learn more about how eyes hold the key to understanding the brain!

BackgroundPatients with Alzheimer’s disease (AD) are known to exhibit visuospatial processing impairment, as reflected in eye movements from the early stages of the disease. We investigated whether the pattern of gaze exploration during visual tasks could be useful for detecting cognitive decline at the earliest stage.MethodsSixteen AD patients (age: 79.1 ± 7.9 years, Mini Mental State Examination [MMSE] score: 17.7 ± 5.3, mean ± standard deviation) and 16 control subjects (age: 79.4 ± 4.6, MMSE score: 26.9 ± 2.4) participated. In the visual memory task, subjects memorized presented line drawings for later recall. In the visual search tasks, they searched for a target Landolt ring of specific orientation (serial search task) or color (pop-out task) embedded among arrays of distractors. Using video-oculography, saccade parameters, patterns of gaze exploration, and pupil size change during task performance were recorded and compared between AD and control subjects.ResultsIn the visual memory task, the number of informative regions of interest (ROIs) fixated was significantly reduced in AD patients compared to control subjects. In the visual search task, AD patients took a significantly longer time and more saccades to detect the target in the serial but not in pop-out search. In both tasks, there was no significant difference in the saccade frequency and amplitude between groups. On-task pupil modulation during the serial search task was decreased in AD. The number of ROIs fixated in the visual memory task and search time and saccade numbers in the serial search task differentiated both groups of subjects with high sensitivity, whereas saccade parameters of pupil size modulation were effective in confirming normal cognition from cognitive decline with high specificity.DiscussionReduced fixation on informative ROIs reflected impaired attentional allocation. Increased search time and saccade numbers in the visual search task indicated inefficient visual processing. Decreased on-task pupil size during visual search suggested decreased pupil modulation with cognitive load in AD patients, reflecting impaired function of the locus coeruleus. When patients perform the combination of these tasks to visualize multiple aspects of visuospatial processing, cognitive decline can be detected at an early stage with high sensitivity and specificity and its progression be evaluated.

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