Cortico-Ocular Coupling Analysis for Developmental and Behavioral Disorders: A Review

Developmental and behavioral disorders (DBD) have a significant impact on children's neurological activity and behavioral performance. Early diagnosis and treatment are known to be beneficial for improving DBD outcomes, yet existing unimodal neurophysiological assessment tools for DBD yield significant heterogeneity in results, highlighting the urgent need for exploring novel assessment tools. Cortico-ocular coupling (COC) refers to the information interaction between the cerebral cortex and eyes, and COC analysis is a technique for quantitatively measuring the correlation of neural oscillations and eye movements as biomarkers for assessment and mechanism disclosure. This review focuses on COC analysis for DBD from four perspectives: neural substrates, research paradigms, analysis methods, and applications. First, this review provides a comprehensive overview of the neural substrates and evocation paradigms related to COC analysis, aiming at helping target brain region selection, experimental result analysis, and paradigm design. The neural substrates and evocation paradigms are categorized according to functional domains, including social functioning, attention, cognition, early visual processing, and motor function. Then, this review summarizes the EEG and eye-tracking features, the analysis methods, and the validation datasets involved in COC analysis, aiming at helping implement COC analysis. Next, this review presents the applications of COC analysis in DBD, proving the validity and advance of COC analysis. In the end, the limitations, challenges, and future directions of COC analysis are discussed.