2026 American Academy of Neurology Abstract Website

Aiman Altaf¹, Anika Reza¹, Rebecca Stafford², Michalina Jadick¹, Yasmeen Elshafey³, Charles Chen¹, Cameron Hill¹, Allyson Reinert², Stephen Schmugge⁴, Samuel Tate⁴, Huimin Cheng⁵, David Greer¹, Min Shin⁶, Charlene Ong²
¹Boston University Chobanian & Avedisian School of Medicine, ²Boston Medical Center, ³Boston University, ⁴University of North Carolina at Charlotte, ⁵Boston University School of Public Health, ⁶University of North Caroline at Charlotte

Objective:

To evaluate whether quantitative eye movements measured using electrooculography (EOG) are associated with discharge neurologic outcomes in cardiac arrest patients with disorders of consciousness.

Background:

Cardiac arrest frequently leads to devastating neurologic outcomes, yet current prognostic tools frequently fail to distinguish recovery potential. EOG is a low-cost, non-invasive tool routinely used in post-arrest care. While decreased reflexive and voluntary eye movements have been linked with poor neurologic outcomes, the prognostic utility of quantitative eye movements measured using EOG is unestablished.

Design/Methods:

We performed a retrospective, single-center cohort study including adults who experienced cardiac arrest and underwent EOG in the intensive care unit between 2016 and 2023. The primary exposure was average hourly eye movements at 48-96 hours post-arrest, quantified using an automated EOG algorithm. The primary outcome was modified Rankin Scale (mRS) score at discharge, dichotomized as poor (mRS >4) vs. good (mRS ≤4). Associations between eye movements and outcome were evaluated using logistic regression.

Results:

A total of 169 patients were included. The median age was 55 [43, 61] and 105 (62.1%) were male. At discharge, 23 patients (13.7%) had mRS ≤4. At 48-96 hours post-arrest, patients with good outcome had higher average hourly eye movements than those with poor outcome (478.4 ± 331.0 vs. 180.8 ± 210.0; Wilcoxon rank-sum test, p<0.001). After adjusting for age and sex, each one-SD (SD=463) increase in average hourly eye movements at 48-96 hours post-arrest was associated with increased odds of good outcome (OR=1.93, 95% CI 1.20-3.27). A sensitivity analysis using data 0-24 hours post-arrest showed a similar but not statistically significant trend (OR=1.88, 95% CI 0.81-4.02).

Conclusions:

Higher average hourly eye movements at 48-96 hours post-cardiac arrest were associated with greater odds of good neurologic outcome at discharge. Quantitative EOG may serve as a practical, real-time biomarker for early prognostication, guiding care in this vulnerable population.