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Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study

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Abstract

Amyotrophic lateral sclerosis (ALS) primarily affects motor and speech abilities. In addition, cognitive functions are impaired in a subset of patients. There is a need to establish an eye movement-based method of neuropsychological assessment suitable for severely physically impaired patients with ALS. Forty-eight ALS patients and thirty-two healthy controls matched for age, sex and education performed a hand and speech motor-free version of the Raven’s coloured progressive matrices (CPM) and the D2-test which had been especially adapted for eye-tracking control. Data were compared to a classical motor-dependent paper–pencil version. The association of parameters of the eye-tracking and the paper–pencil version of the tests and the differences between and within groups were studied. Subjects presented similar results in the eye-tracking and the corresponding paper–pencil versions of the CPM and D2-test: a correlation between performance accuracy for the CPM was observed for ALS patients (p < 0.001) and controls (p < 0.001) and in the D2-test for controls (p = 0.048), whereas this correlation did not reach statistical significance for ALS patients (p = 0.096). ALS patients performed worse in the CPM than controls in the eye-tracking (p = 0.053) and the paper–pencil version (p = 0.042). Most importantly, eye-tracking versions of the CPM (p < 0.001) and the D2-test (p = 0.024) reliably distinguished between more and less cognitively impaired patients. Eye-tracking-based neuropsychological testing is a promising approach for assessing cognitive deficits in patients who are unable to speak or write such as patients with severe ALS.

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Acknowledgments

The authors would like to thank Ralf Kühne for technical support. This work was funded by the Deutsche Forschungsgemeinschaft (DFG) and the Bundesministerium für Bildung und Forschung (BMBF #01GM1103A). This is an EU Joint Programme—Neurodegenerative Disease Research (JPND) project. The project is supported through the following organizations under the aegis of JPND—e.g. Germany, Bundesministerium für Bildung und Forschung (BMBF, FKZ), Sweden, Vetenskaprådet Sverige, Poland, Narodowe Centrum Badań i Rozwoju (NCBR).

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study was approved by the Ethics Committee of the University of Ulm (Statement No. 19/12) and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Informed consent

All participants gave informed consent to the study.

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    Authors and Affiliations

    1. Department of Neurology, University of Ulm, Oberer Eselsberg 45, 89081, Ulm, Germany

      Jürgen Keller, Martin Gorges, Hannah T. Horn, Helena E. A. Aho-Özhan, Elmar H. Pinkhardt, Ingo Uttner, Jan Kassubek, Albert C. Ludolph & Dorothée Lulé

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    1. Jürgen Keller
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    2. Martin Gorges
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    3. Hannah T. Horn
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    5. Elmar H. Pinkhardt
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    7. Jan Kassubek
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    8. Albert C. Ludolph
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    9. Dorothée Lulé
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    Correspondence to Dorothée Lulé.

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    J. Keller, M. Gorges contributed equally.

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    Keller, J., Gorges, M., Horn, H.T. et al. Eye-tracking controlled cognitive function tests in patients with amyotrophic lateral sclerosis: a controlled proof-of-principle study. J Neurol 262, 1918–1926 (2015). https://doi.org/10.1007/s00415-015-7795-3

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    • DOI: https://doi.org/10.1007/s00415-015-7795-3

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