Eye Tracking During Visual Paired-Comparison Tasks: A Systematic Review and Meta-Analysis of the Diagnostic Test Accuracy for Detecting Cognitive Decline

Article type: Research Article

Authors: Boujelbane, Mohamed Ali^{a; b; c} | Trabelsi, Khaled^{a; d; e; †} | Salem, Atef^{a; b; c; †} | Ammar, Achraf^{a; c; f; g; *} | Glenn, Jordan M.^h | Boukhris, Omar^{e; i} | AlRashid, Maha M.^j | Jahrami, Haitham^{k; l; ‡} | Chtourou, Hamdi^{a; b; e; ‡}

Affiliations: [a] High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia | [b] Research Unit, Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia | [c] Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, Mainz, Germany | [d] Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia | [e] SIESTA Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia | [f] Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia | [g] Interdisciplinary Laboratory in Neurosciences, Physiology, and Psychology: Physical Activity, Health, and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France | [h] Department of Health, Exercise Science Research Center Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA | [i] Sport, Performance, and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia | [j] Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia | [k] Ministry of Health, Manama, Bahrain | [l] Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain

Correspondence: [*] Correspondence to: Achraf Ammar, Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany. E-mail acammar@uni-mainz.de.

Note: [†] These authors contributed equally to this work.

Note: [†] These authors contributed equally to this work.

Abstract: Background:Alzheimer’s disease and mild cognitive impairment (MCI) progress silently, making early diagnosis challenging, especially in less educated populations. The visual paired comparison (VPC) task, utilizing eye-tracking movement (ETM) technology, offers a promising alternative for early detection of memory decline. Objective:This systematic review and meta-analysis evaluated the efficacy of the VPC task, utilizing ETM as a tool for assessing age-related cognitive changes. Methods:A comprehensive search across five databases and grey literature focused on healthy and impaired memory participants assessed through the ETM-based VPC task. The primary outcomes were novelty preference scores and eye movement metrics. The risk of bias of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Random-effects meta-analyses calculated Hedges’ g effect size. Sensitivity and specificity of the VPC were meta-analytically pooled. Results:The systematic review included 12 articles, involving 1,022 participants (aged 18 to 90 years, with education ranging from 6.5 to 20.0 years), with a low risk of bias and minimal applicability concerns across all items. Five studies contributed to the meta-analysis, revealing a significant effect favoring the VPC task for recognition memory detection (k = 9, g = –1.03). Pooled sensitivity and specificity analyses demonstrated VPC effectiveness as a recognition memory assessment tool (0.84 and 0.75, respectively). Conclusions:The VPC task, utilizing ETM, may serve as a biomarker for early memory decline detection. Its use as a digital eye-tracking tool presents a possible alternative to traditional tests, warranting further research for application in neurodegenerative disease diagnosis.

Keywords: Alzheimer’s disease, cognition, dementia, eye movements, novelty preference score, sensitivity, specificity

DOI: 10.3233/JAD-240028

Journal: Journal of Alzheimer's Disease, vol. 99, no. 1, pp. 207-221, 2024