Correlations Between Traditional Disability and Oculometric Measures in Multiple Sclerosis
Sarah Levy1, Ilana Katz Sand1, Omer Berkman2, Eitan Raveh2, Edmund Ben-Ami2, Rivka Kreitman2, James Sumowski1
1Neurology, Icahn School of Medicine at Mount Sinai, 2NeuraLight
Objective:
To investigate relationships between oculometric measures (OMs) and traditional outcome measures of physical and cognitive dysfunction in multiple sclerosis (MS).
Background:
Oculomotor disturbances are common in MS but are not quantitatively evaluated in clinical practice. OMs are characteristics of eye movements captured while performing a visual task, e.g., latency of saccadic and anti-saccadic metrics. Physical and cognitive deficits are prevalent among persons with MS, including disease-related oculomotor dysfunction. Recently, we have implemented a novel software-based platform enabling the extraction of OMs using a laptop and webcam.
Design/Methods:

Thirty-minute oculometric evaluation using the software-based platform (NeuraLight, Israel) was performed in patients with relapse-onset MS (n=57; 36 females, age 41±25). Physical disability was assessed by an MS-specific neurologic exam (EDSS) and quantitative measures of cognitive and sensorimotor function (SDMT and NHPT, respectively). Pearson correlations assessed the relationship between OMs and test scores.

Results:

Patients with higher EDSS scores had worse performance on OMs, including greater saccadic latency (ms, Pro-saccades: r=0.5, Anti-saccades: r=0.49, p<0.0001), higher initial gain during saccades (%, Pro-saccades: r=0.47, Anti-saccades: r=0.59, p<0.0001), and increased variation of gaze during fixation (r=0.57, p<0.0001). Patients with worse NHPT had prolonged saccadic latency (ms, Pro-saccades: r=0.46, Anti-saccades: R=0.5, p<0.001) and higher error rate of anti-saccades (%, r=0.36, p<0.01). Correlations were also found between worse SDMT and greater saccadic latency (ms, Pro-saccades: r=-0.31, Anti-saccades: r=-0.38, p<0.05), initial gain (%, Anti-saccades: r=-0.45, p<0.001) and variation of gaze during fixation (r=-0.44, p<0.001).

Conclusions:

OMs captured using a novel software-based platform were found to be associated with worse physical and cognitive function, suggesting that they can be used as an adjunct tool in MS clinical assessment. Future studies need to engage larger cohorts with sub-groups to further investigate these results for phenotyping of patients with MS.

10.1212/WNL.0000000000206429