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Eye-Tracking Technologies for Cognitive Assessment After Acquired Brain Injury: Systematic Review.

Andrea Calderone¹, Rosaria De Luca¹, Francesco Corallo¹

¹Department of Neurorehabilitation, IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C.da Casazza, Messina, 98124, Italy.

JMIR Rehabilitation and Assistive Technologies

|June 2, 2026

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This summary is machine-generated.

Eye tracking shows promise for assessing cognitive function after acquired brain injury (ABI), offering process-level insights. However, current evidence is limited, and it cannot yet replace traditional neuropsychological tests.

Area of Science:

Neuroscience
Rehabilitation Medicine
Cognitive Psychology

Background:

Acquired brain injury (ABI) often leads to persistent cognitive dysfunction.
Conventional neuropsychological assessments have limitations in individuals with motor or communication impairments.
Eye tracking offers an objective, low-burden method to assess cognitive processes via gaze behavior.

Purpose of the Study:

To systematically review and synthesize evidence on eye-tracking paradigms for cognitive assessment in ABI.
To summarize findings based on cognitive domain, specific eye-tracking paradigm, and clinical interpretability.

Main Methods:

Conducted a PRISMA 2020-compliant systematic review of studies using eye tracking as a primary cognitive assessment in ABI.
Searched multiple databases (PubMed, Web of Science, Scopus, etc.) up to April 2025.

Keywords:

acquired brain injury cognitive assessment eye-tracking technology neurocognitive impairment neurorehabilitation oculomotor biomarkers saccadic eye movements traumatic brain injury

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Included 27 studies (N=872) and performed a narrative synthesis due to heterogeneity.

Main Results:

Antisaccade paradigms revealed differences in inhibitory control and executive function.
Predictive tracking and smooth pursuit paradigms captured attentional alterations.
Virtual reality and gaze-based interfaces showed potential for specific ABI populations (e.g., neglect, disorders of consciousness), but evidence quality was generally low.

Conclusions:

Eye tracking shows potential as an adjunctive tool for quantifying cognition-relevant behaviors post-ABI, especially for inhibitory control and predictive attention.
Current evidence is insufficient to support routine replacement of conventional assessments or broad diagnostic claims.
Future research needs standardized paradigms, external validation, longitudinal designs, and reporting on feasibility and safety for clinical integration.