Visual search for real-world scenes in patients with Alzheimer's disease and amnestic mild cognitive impairment.

BACKGROUND: Visual attention-related processes that underlie visual search behavior are impaired in both the early stages of Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI), which is considered a risk factor for AD. Although traditional computer-based array tasks have been used to investigate visual search, information on the visual search patterns of AD and MCI patients in real-world environments is limited. AIM: The objective of this study was to evaluate the differences in visual search behaviors among individuals with AD, aMCI, and healthy controls (HCs) in real-world scenes. MATERIALS AND METHODS: A total of 92 participants were enrolled, including 28 with AD, 32 with aMCI, and 32 HCs. During the visual search task, participants were instructed to look at a single target object amid distractors, and their eye movements were recorded. RESULTS: The results indicate that patients with AD made more fixations on distractors and fewer fixations on the target, compared to patients with aMCI and HC groups. Additionally, AD patients had longer fixation durations on distractors and spent less time looking at the target than both patients with aMCI and HCs. DISCUSSION: These findings suggest that visual search behavior is impaired in patients with AD and can be distinguished from aMCI and healthy individuals. For future studies, it is important to longitudinally monitor visual search behavior in the progression from aMCI to AD. CONCLUSION: Our study holds significance in elucidating the interplay between impairments in attention, visual processes, and other underlying cognitive processes, which contribute to the functional decline observed in individuals with AD and aMCI.

Uncorrected errors and correct saccades in the antisaccade task distinguish between early-stage Alzheimer's disease dementia, amnestic mild cognitive impairment, and normal aging.

Alzheimer's disease (AD) dementia is a degenerative illness that is characterized by a gradual decline in cognitive abilities. Amnestic mild cognitive impairment (aMCI) is seen as a precursor to AD. The changes in antisaccade performance that can be seen in MCI may provide important clues in the early detection of AD. Therefore, the antisaccade deficits in AD and aMCI remain a research question. This study aimed to examine antisaccade responses and the relationship between antisaccade and cognitive function in AD, aMCI, and healthy controls (HC). This study included 30 patients with early-stage AD, 34 with aMCI, and 32 HC. Patients with AD showed higher rates of uncorrected error, anticipatory saccades and corrected errors, as well as decreased correct saccade rates, and shortened saccade latency compared to aMCI and HC in this study. Patients with aMCI exhibited increased rates of express saccades relative to HC. The antisaccade task and cognitive domains were found to be significantly related. Our study showed that the rate of correct saccades has the capacity to distinguish AD from HC with 87% sensitivity and 86% specificity (AUC = 0.93, p < 0.001). In addition, the rate of uncorrected errors was found to be capable of distinguishing AD from HC with 84% sensitivity and 83% specificity (AUC = 0.91, p < 0.001). This study presented promising findings that these parameters can be used clinically to differentiate AD and aMCI from healthy older individuals.

Visual search in Alzheimer's disease and amnestic mild cognitive impairment: An eye-tracking study.

INTRODUCTION: Visual search impairment is a potential cognitive marker for Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). The aim of this study is to compare eye movements during visual tracking in AD and aMCI patients versus healthy controls (HCs). METHODS: A prospective cohort study included 32 AD and 37 aMCI patients, and 33 HCs. Each participant was asked to look at the target object in a visual stimulus containing one target and eight distractors, and eye movements were recorded with EyeLink 1000 Plus. RESULTS: AD patients had fewer fixations and shorter target fixation duration than aMCI patients and HCs. Fixation durations were also shorter in aMCI patients compared to HCs. Also, AD patients were more fixated on distractors than HCs. DISCUSSION: Our findings revealed that visual search is impaired in the early stages of AD and even aMCI, highlighting the importance of addressing visual processes in the Alzheimer's continuum. HIGHLIGHTS: AD patients looked to distractors more and longer than the target compared to aMCI patients and older healthy individuals. aMCI patients had an impaired visual search pattern compared to healthy controls, just like patients with AD. The visual search task differentiated AD and aMCI patients from healthy individuals without dementia.

Eye movement patterns during viewing face images with neutral expressions in patients with early-stage Alzheimer's disease and amnestic mild cognitive impairment.

BACKGROUND: Alzheimer's disease (AD) neuropathology affects the brain regions responsible for visuospatial skills. Accumulating evidence points to visual difficulties involving face processing in AD and amnestic mild cognitive impairment (aMCI). No study has so far examined eye movement patterns when viewing faces with neutral expressions in patients with AD. AIM: The objective of this study aimed to examine the eye movements of patients with early-stage AD, aMCI, and healthy controls (HC) during viewing face images. MATERIALS&METHODS: Thirty-one AD, 37 aMCI, and 33 HC were included in the study. Eye movements in facial stimuli were recorded with the EyeLink 1000 Plus eye-tracker. RESULTS: Our findings showed that AD patients looked less at the eye area of interest than the nose and mouth areas of interest compared to aMCI and HC. Regardless of the group, all participants looked at the eye and nose areas of interest more and longer in the mouth area of interest. In addition, the first fixation duration to the eye area of interest of all participants was shorter than that of the nose and mouth. DISCUSSION: Consistent with our study, studies in healthy adults revealed eye movement patterns that focused more on the eyes and nose. AD patients are unable to pay attention to the salient parts of faces, tending to focus instead on the non-informative parts. CONCLUSION: Our study is the first to reveal eye movement differences in face processing in AD.

Antisaccade and memory-guided saccade in individuals at ultra-high-risk for bipolar disorder.

BACKGROUND: Ultra-high-risk for bipolar disorder (UHR-BD) is an important paradigm to investigate the potential early-stage biomarkers of bipolar disorder, including eye-tracking abnormalities and cognitive functions. Antisaccade (AS) described as looking in the opposite direction of the target, and memory-guided saccade (MGS), identified as maintaining fixation, and remembering the location of the target, were used in this study. The aim of this study was to evaluate the differences in saccadic eye movements between UHR-BD and healthy controls (HCs) via AS-MGS. METHODS: The study included 28 UHR-BD and 29 HCs. Participants were selected using a structured clinical interview for prodromal symptoms of BD. AS-MGS were measured with parameters like uncorrected errors, anticipatory saccades, and latency. Eye movements were recorded with the EyeLink 1000-Plus eye-tracker. RESULTS: In the AS, the number of correct saccades was significantly decreased in UHR-BD (p = 0.020). Anticipatory (p = 0.009) and express saccades (p = 0.040) were increased in UHR-BD. In the MGS paradigm, the correct saccades were reduced in UHR-BD (p = 0.031). In addition, anticipatory (p = 0.004) and express saccades (p = 0.012) were significantly increased in cue-screen in UHR-BD. CONCLUSIONS: To our knowledge, this is the first study to evaluate cognitive functions with eye movements in individuals at UHR-BD. The current findings showed that eye movement functions, particularly in saccadic parameters related to inhibition and spatial perception, may be affected in the UHR-BD group. Therefore, assessment of oculomotor functions may provide observation of clinical and cognitive functions in the early-stage of bipolar disorder. However, further research is needed because the potential effects of medication may affect saccadic results.

Examination of eye movements during visual scanning of real-world images in Alzheimer's disease and amnestic mild cognitive impairment.

Available evidence shows that Alzheimer's disease (AD) patients display inefficiencies in visual scanning of their surroundings, directing their attention towards non-relevant aspects of scenes. Not much is known about eye movements during visual scanning in individuals with amnestic mild cognitive impairment (aMCI). Notably, a consensus has yet to be reached on this issue. Furthermore, prior research has indicated the existence of visual attention deficits in individuals diagnosed with AD and aMCI. The objective of this study was to examine the visual scanning patterns of individuals diagnosed with AD, aMCI, and healthy controls (HC) when viewing various scenes. Thirty patients with AD, 32 aMCI, and 32 HC were included in the study. A set of 30 real-life scene images were presented to the participants in the visual scanning task. Participants' eye events were monitored using the EyeLink 1000 Plus in this task. The results indicate a significant reduction in total fixation duration, number of scanned areas, fixation counts, and saccade counts in AD as compared to those with aMCI and HC. The research did not reveal any significant statistical differences in eye parameters between the aMCI and HC groups. This study found abnormalities in visual scanning in AD compared to aMCI and HC. Visual scanning patterns of aMCI patients were not different from HC. Previous studies have specifically shown visual attention difficulties in AD and MCI. Our findings may be related to visual attention difficulties in AD. In addition, this study is the first to examine visual scanning behaviour with real-world images in AD and aMCI.

Yoga and aerobic exercise in epilepsy: Study protocol for a randomized controlled trial.

BACKGROUND: There has been a growing interest in demonstrating the health benefits of exercise among people with epilepsy in recent years. Although exercise is recommended for people with epilepsy, there is uncertainty concerning the effects of yoga and aerobic exercise on multiple health outcomes in epilepsy. PURPOSE: The aim of this trial was to examine the effects of yoga and aerobic exercise training on physical activity, seizure frequency, health-related physical fitness, mental, emotional, and psychological health status, and quality of life. METHODS: This study was designed as a single-center, 8-week, randomized controlled trial in a three-arm parallel group. Participants will be randomly allocated to yoga, aerobic exercise, or wait-list control groups. The primary outcome is physical activity/sedentary behavior measured by the ActiGraph GT9X accelerometer and seizure frequency. Secondary outcomes include functional capacity, lower extremity strength, balance, body composition, waist and hip circumference, cognition, depression, anxiety, perceived stress, fatigue, sleep quality, and quality of life. The outcomes will be evaluated at baseline and at 8 weeks of follow-up. IMPLICATIONS OF PHYSIOTHERAPY PRACTICE: This study is the first randomized controlled trial comparing the effects of yoga and aerobic exercise among people with epilepsy. The findings of this study could provide important information about the effects of yoga and aerobic exercise training on a variety of health conditions in people with epilepsy. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT05066880, registered October 4, 2021.

Saccadic Eye Movements in Patients with Mild Cognitive Impairment: A Longitudinal Study.

Saccadic eye movements are one of the sensitive and noninvasive methods to help monitor the cognitive course of mild cognitive impairment (MCI). The study aimed to evaluate both pro and anti-saccade longitudinally and the relationship between cognitive functions and eye movements in MCI subgroups and healthy controls (HCs) at a two-year follow-up. This study revealed that the anti-saccade anticipatory responses decreased in amnestic MCI (aMCI). Correct vertical pro-saccades increased in non-amnestic MCI (naMCI), while the express saccades decreased. Our study demonstrated that longer than two years of follow-up is necessary to monitor the course of MCI. Findings of the relationships between longitudinal changes of saccades and cognitive measurements demonstrated the usability of eye movements in evaluating the process of MCI.

Cognitive function in Meniere's disease.

Meniere's disease is an otological disease characterized by various symptoms that include episodic peripheral vertigo, sensorineural hearing loss, tinnitus, and aural fullness, all of which deteriorate the maintenance of daily activities. We aimed to investigate cognitive function in Meniere's disease patients and compare their results to those of healthy controls. Eighteen patients diagnosed with definite Meniere's disease without any psychiatric, neurological or otological comorbidity, and 30 healthy controls with normal cognitive functions were included in the study. General cognitive status, attention, verbal memory, visual memory, executive and visuospatial function were measured by detailed neuropsychological tests in both groups. In the patients with Meniere's disease, pure-tone hearing thresholds, and speech discrimination scores were also measured. Patients with Meniere's disease showed lower levels of performance in the trail making test, Oktem verbal memory processes, Rey Complex Figure Test, Wisconsin Card Sorting Test, semantic and phonemic fluency than did healthy controls. In other words, there were deficits in attention, recognition and recall in verbal memory, recall in visual memory, visual spatial construction, and planning skills in patients with Meniere's disease. Education years and depression scores of participants had a significant effect on cognitive function in all groups. This study is an update and confirmation of the findings of studies showing cognitive impairment in patients with Meniere's disease. In addition to previous findings, this study found a decrease in executive function performance in patients with Meniere's disease compared to healthy controls. Unlike previous studies, this study comprehensively addressed all cognitive functions and included a control group. Our results emphasize that executive functions, which are high-level cognitive processes, may affect the compliance of patients with Meniere's disease treatment and follow-up processes.

The influence of stimulus eccentricity on prosaccade outcomes in patients with Alzheimer's Disease dementia at an early stage and amnestic mild cognitive impairment.

INTRODUCTION: Prosaccade task is a widely used objective method to evaluate reflexive saccade and visual attention. The study aimed to investigate prosaccade stimulus eccentricity, compare prosaccade parameters in patients with Alzheimer's disease dementia (AD), amnestic mild cognitive impairment (aMCI), and neurotypical adults (NA), and examine the relationship between prosaccade and neuropsychological tests. METHODS: Thirty patients with AD, 34 with aMCI, and 32 NA were included in the study. Eye movements were recorded with the EyeLink 1000 Plus in the prosaccade task, and this study evaluated cognitive function with comprehensive neuropsychological tests assessing attention, memory, executive function, visuospatial function, and language domains. RESULTS: The correct saccade rates of patients with AD were significantly lower than NA in the 5° and 10° stimulus eccentricities. Patients with AD had significantly longer latencies in the 10° stimulus eccentricity than those with aMCI and NA. Patients with aMCI did not differ in prosaccade performance compared to NA. Prosaccade parameters were significantly correlated with all cognitive domains. As the amplitude of the stimuli increased, the rate of correct saccades decreased, while the express saccade rate, latency, amplitude, and peak velocity increased. CONCLUSION: Our findings that correct saccade rates and latency may be distinguishing parameters of early AD are promising. This study also found that stimulus eccentricity affects prosaccade measures in AD, MCI, and NA.

Deficits in saccadic eye movements differ between subtypes of patients with mild cognitive impairment.

Introduction: Mild cognitive impairment (MCI) is known to be heterogeneous in its cognitive features and course of progression. Whilst memory impairment is characteristic of amnestic MCI (aMCI), cognitive deficits other than memory can occur in both aMCI and non-amnestic MCI (naMCI) and accurate assessment of the subtypes of MCI is difficult for clinicians without the application of extensive neuropsychological testing. In this study, we examine metrics derived from recording of reflexive and voluntary saccadic eye movements as a potential alternative method for discriminating between subtypes and assessing cognitive functions in MCI.Method: A total of 29 MCI patients and 29 age- and education-matched healthy controls (HCs) participated in the cross-sectional study. We recorded horizontal and vertical pro-saccades and anti-saccade responses. All the participants also completed a comprehensive neuropsychological tests battery.Results: Significant differences in saccadic eye movement were found between the subtypes of MCI and HCs. Patients with aMCI had a higher percentage of short latency "express" saccades than HCs. We found strong associations between saccadic reaction times and cognitive domains, including executive functions and attention. The mini-mental state examination (MMSE) was also found to correlate with uncorrected errors in the anti-saccade task.Conclusions: The increased proportion of saccades in the express latency range in aMCI may be indicative of problems with cognitive inhibitory control in these patients. A focus on this and other saccade metrics in the preclinical and prodromal stages of dementia may help to predict the clinical progression of the disease and direct interventions for the management of MCI. The clinical significance of saccadic eye movement impairments in MCI is not yet fully understood and should be investigated in further studies using larger samples.

A new tool to assess amnestic mild cognitive impairment in Turkish older adults: virtual supermarket (VSM).

The purpose of this study was to investigate cognitive functioning by administering the Virtual Supermarket (VSM) test in patients with amnestic mild cognitive impairment (aMCI, N = 37) and age and education-matched healthy controls (HCs, N = 52). An extensive neuropsychological test battery and the VSM were administered to all participants. The aMCI group exhibited lower performance and required more time to complete the VSM compared to HCs. Also, aMCI-Multiple Domain (aMCI-MD) patients performed worse in the "Correct Types", "Correct Quantities", "Bought Unlisted", "Correct Money" variables compared to HCs. Moreover, aMCI-SD patients displayed lower performance in "Bought Unlisted" and "Correct Money" variables compared to HCs. The VSM variables correlated with established neuropsychological test scores. The VSM test was found to discriminate between aMCI and HCs with a correct classification rate (CCR) of 81%. This is a preliminary study showing that the VSM is a valid, brief and user-friendly test. .