Saccadic paradigms in restless legs syndrome with and without augmentation: An eye-tracking study

To determine whether saccadic eye movement paradigms can be used to detect impulsivity and executive dysfunction in patients with restless legs syndrome (RLS), particularly in those experiencing augmentation due to long-term dopaminergic therapy.

Forty-seven nondemented RLS patients were included in this study. Nineteen patients without augmentation or symptoms of impulse control disorders (RLS controls) were compared with 28 patients with augmentation (RLS + AUG) and 20 matched healthy controls (HC). All participants underwent an eye-tracking battery including prosaccade, antisaccade, and stop signal paradigms. Error rates and reaction times were compared between groups. Correlation analyses were performed to evaluate associations between saccadic performances between the different paradigms.

RLS + AUG patients demonstrated significantly higher error rates in all saccadic tasks compared with HC (p < .05) indicating impaired inhibitory control, while error rates of RLS controls were similar to those of HC (p > .1). Overall reaction times did not differ significantly, but evaluating correct antisaccade trials only, RLS + AUG patients had longer reaction times than HC (p = .030). Correlation analyses revealed moderate to strong positive associations between error rates of prosaccade, antisaccade, and stop signal tasks.

RLS + AUG exhibit deficits in oculomotor response inhibition, possibly indicating executive dysfunction and increased impulsivity likely related to long-term dopaminergic therapy. These preliminary results highlight the potential utility of eye tracking in clinical monitoring of dopaminergic therapy in RLS. Future longitudinal eye-tracking studies in a larger cohort are necessary to evaluate temporal dynamics of dopaminergic exposure, augmentation, and impulse control disorder symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).