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Simultaneous Eye Tracking and Single-Neuron Recordings in Human Epilepsy Patients

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Differentiating unipolar and bipolar depression using multi-task eye-movement features.

Rongrong Zhong¹, Yuezhou Zhang², Xiaohui Wu³

¹Clinical Research Center & Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Biostatistics & Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom; College of Psychiatry and Clinical Psychology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Psychiatry Research

|March 7, 2026

Summary

Eye-tracking reveals distinct eye movement patterns differentiating bipolar depression (BPD) from unipolar depression (UPD). These findings support eye-tracking as a tool for diagnosing mood disorders.

Keywords:

Bipolar depression Diagnosis Eye-tracking Machine learning Unipolar depression

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Area of Science:

Neuroscience
Psychiatry
Ophthalmology

Background:

Differentiating bipolar depression (BPD) from unipolar depression (UPD) is challenging due to overlapping symptoms.
Eye-tracking offers a potential objective method to distinguish between these mood disorders.

Purpose of the Study:

To investigate eye-movement differences between individuals with UPD, BPD, and healthy controls (HCs).
To assess the utility of eye-tracking metrics in classifying these groups.

Main Methods:

Collected eye-movement data from 228 participants (60 UPD, 56 BPD, 112 HCs) across four tasks.
Extracted 155 eye-movement features and analyzed using ANCOVA and machine learning.
Utilized fixation stability, free-viewing, visual search, and smooth pursuit tasks.

Main Results:

Identified 53 significant eye-movement features differentiating the groups.
BPD showed shorter fixation durations and altered attention to emotional stimuli (less to happy, more to threatening images).
Machine learning models achieved high classification accuracy (AUCs ranging from 0.78 to 0.88).

Conclusions:

Eye-movement patterns provide unique signatures for both UPD and BPD.
Eye-tracking is a promising, objective, and scalable tool for differentiating mood disorders.