Associations of Eye-Tracking Metrics With Cognitive Outcomes in Children With Opsoclonus-Myoclonus Ataxia Syndrome

Eye tracking may be a useful tool to screen for abnormalities in children with opsoclonus-myoclonus-ataxia syndrome (OMAS). Our objectives were to (1) evaluate differences in cognitive metrics and free-viewing eye tracking metrics between children with a diagnosis of OMAS and age- and sex-matched healthy controls; and (2) investigate correlations between both metrics.

Participants (2-16 years old) with a diagnosis of OMAS (n = 9) and healthy controls (n = 14) completed a free-viewing eye-tracking task (EyeLink 1000 Plus) and cognitive testing (5 cognitive domains; NIH Toolbox). We quantified saccades and ran correlational analyses with corrected cognitive testing scores.

Children with a diagnosis of OMAS demonstrated suppressed saccade rates and longer fixation durations. Higher mean saccade rates were positively associated with better performance on the Dimensional Change Card Sort task (P = 0.011) and the List Sorting Working Memory Test (P = 0.001), while longer fixation durations were negatively associated with performance on both the Dimensional Change Card Sort task (P = 0.001) and the List Sorting Working Memory Test (P = 0.014).

Reduced saccade rates and longer fixation durations in the free-viewing eye-tracking task were associated with worse cognitive functioning related to set-shifting and working memory. The study introduces a potential new screening tool to increase accessibility for younger patients with OMAS to some proxy for formal cognitive testing.