Exploring oculomotor challenges in amyotrophic lateral sclerosis: a comprehensive review

Area of Science:

• Neuroscience
• Ophthalmology
• Neurology

Background:

• Amyotrophic lateral sclerosis (ALS) is increasingly recognized as a multisystem neurodegenerative disorder beyond its motor neuron origins.
• The oculomotor system is implicated in ALS, with dysfunction potentially reflecting broader disease processes.

Purpose of the Study:

• To review current evidence on oculomotor dysfunction in amyotrophic lateral sclerosis (ALS).
• To explore the relationship between eye-tracking (ET) metrics and motor/cognitive impairments in ALS.
• To highlight the utility of ET as a noninvasive tool for assessing ALS progression.

Main Methods:

• This study is a narrative review of existing literature.
• Key eye-tracking (ET) metrics examined include saccades, smooth pursuit, and fixation.
• Analysis focuses on the correlation between oculomotor function and disease-related impairments.

Main Results:

• Oculomotor impairments are evident in ALS patients and are more pronounced in those with bulbar-onset disease.
• Eye-tracking (ET) metrics can reflect both motor and extramotor neurodegeneration.
• Oculomotor dysfunction is linked to cognitive decline in ALS.

Conclusions:

• Eye-tracking (ET) offers a noninvasive method for assessing ALS progression and severity.
• Oculomotor metrics provide insights into the impact of ALS on multiple neural networks.
• These findings can inform refined patient assessment and care strategies, especially in advanced ALS stages.