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All sourcesNASA NTRSDOE OSTI
NASA NTRSDate not supplied

Oculometric Detection and Characterization of Sub-Clinical Visual/Visuomotor Impairment

It has long been known that qualitative abnormalities in eye movements can be used to diagnose overt brain pathologies (Diefendorf & Dodge, 1908; Fox & Holmes, 1926; Leigh & Zee, 2015). Here, we will examine the use of a set of quantitative measures of the human behavioral response (oculometrics) in a 5-minute radial ocular tracking task (Krukowski & Stone, 2005) with sufficient temporal, spatial, and directional uncertainty to minimize the contribution of a priori prediction or anticipation, and to emphasize the use of a posteriori visual processing of the stimulus trajectory (Liston & Stone, 2014). The derived oculometrics provide a largely independent, reliable set of metrics that are sensitive enough to detect mild sub-clinical impairment across a range of possible neural loci (Stone et al., 2019) with the pattern of impairment across the set providing specificity as to its nature (Tyson et al., 2023). We will review our earlier findings where oculometrics have been used to detect mild impairment due to traumatic brain injury, sleep loss, and low-dose alcohol (Liston et al., 2017; Stone et al., 2019; Tyson et al., 2021). We will also report on a recent clinical study of asymptomatic patients at risk of retinal pathology (Leung et al., 2022) and show that oculometrics can detect and characterize substantive loss of visual function in the absence of clinical indicators of pathology. We conclude that oculometric testing could be used as a routine non-invasive ophthalmological or neurological tool to aid in the early detection and diagnosis of neural injury, toxicity, or disease.

eye movements↗
NASA NTRS2024

Oculometric Biomarkers of Visuomotor Deficits in Clinically Asymptomatic Patients With Systemic Lupus Erythematosus Undergoing Long-Term Hydroxychloroquine Treatment

Introduction: This study examines a set of oculomotor measurements, or “oculometric” biomarkers, as potential early indicators of visual and visuomotor deficits due to retinal toxicity in asymptomatic Systemic Lupus Erythematosus (SLE) patients on long-term hydroxychloroquine (HCQ) treatment. The aim is to identify subclinical functional impairments that are otherwise undetectable by standard clinical tests and to link them to structural retinal changes. Methods: We measured oculomotor responses in a cohort of SLE patients on chronic HCQ therapy using a previously established behavioral task and analysis technique. We also examined the relationship between oculometrics, OCT measures of retinal thickness, and standard clinical perimetry measures of visual function in our patient group using Bivariate Pearson Correlation and a Linear Mixed-Effects Model (LMM). Results: Significant visual and visuomotor deficits were found in 12 asymptomatic SLE patients on long-term HCQ therapy compared to a cohort of 17 age-matched healthy controls. Notably, six oculometrics were significantly different. The median initial pursuit acceleration was 22%, steady-state pursuit gain 16%, proportion smooth 7%, and target speed responsiveness 31% lower, while catch-up saccade amplitude was 46% and fixation error 46% larger. Excluding the two patients with diagnosed mild toxicity, four oculometrics, all but fixation error and proportion smooth, remained significantly impaired compared to controls. Across our population of 12 patients (24 retinae), we found that pursuit latency, initial acceleration, steady-state gain, and fixation error were linearly related to retinal thickness even when age was accounted for, while standard measures of clinical function (Mean Deviation and Pattern Standard Deviation) were not. Discussion: Our data show that specific oculometrics are sensitive early biomarkers of functional deficits in SLE patients on HCQ that could be harnessed to assist in the early detection of HCQ-induced retinal toxicity and other visual pathologies, potentially providing early diagnostic value beyond standard visual field and OCT evaluations.

eye movements↗
NASA NTRSDate not supplied

Oculometric Surveillance of Neuro-Ocular Function

Future missions to the moon or Mars will require the crew to monitor and assess their health and performance more autonomously, with approaches easily useable and interpretable by non-clinicians. If an autonomous oculometric diagnostic-support system proves to be a reliable predictor of impending impairment of visual function in the case of primary ocular pathology on Earth, then it could also be applied in the future to the surveillance of crew to detect the potential progression of sensorimotor and neuro-ocular compromises during extended spaceflight missions, e.g., SANS, and thus guide earlier and more effective countermeasure intervention. Towards that goal, we intend to determine if a set of largely independent eye-movement metrics, called oculometrics, measured using a simple voluntary eye-tracking task that can be completed in just 5 minutes per eye, could provide clinically valid biomarkers of functional visual deficits due to primary ocular pathology. The premise is that oculometrics could be used to monitor slowly evolving ocular pathologies, potentially detecting them even before structural evidence appears in ocular imaging or other current state-of-the-art clinical measures. This study investigates how NASA’s patented oculometric assessment of visual and visuomotor function, shown to correlate with performance in a manual control task, will correlate with standard ophthalmological tests to confirm clinical and thus operational, validity.

eye movements↗
NASA NTRSDate not supplied

Oculometric Analysis of Saccadic Compensation for Visual Motion Processing Impairment due to Alcohol and Sleep Disruption

The Visuomotor Control Laboratory at Ames Research Center has developed a 5-minute ocular tracking test that computes 21 largely independent metrics of visuomotor performance, reflecting neural signal processing along a number of distinct pathways through cortex, brainstem, and cerebellum. Human sensorimotor performance is resilient to the challenges and stressors of many operational environments, in part, because overall performance is achieved through multiple parallel systems. Our multidimensional oculometrics allow us to examine impacts on these sub-components separately. To illustrate this, we contrasted the effects of two mild neural stressors, acute sleep-deprivation and low-dose alcohol. We have previously shown that, in both cases, oculometric analysis is a highly sensitive indicator of impairment. Here we quantified not only the observed impact on the performance of one sub-system, smooth pursuit, which uses high-level cortical processing of visual motion to track a moving object, but also the observed (partial) compensation by an evolutionarily older mid-brain and brainstem subsystem, saccades, which generates jumps in eye position to catch up with the target when smooth pursuit is inadequate. Specifically, we examined the dose-response (effect size vs. dose size) of the ground lost (pursuit deficit) and the ground recouped (saccadic compensation) across three separate studies – acute low-dose alcohol administration (16 subjects), acute sleep loss (12 subjects), and acute sleep loss with caffeine intervention (9 subjects). We computed the dose-response slopes using linear regression. The figure below shows that, in the case of acute sleep deprivation, the resulting slopes for ground lost and ground recouped (mean ± SE across subjects) were significantly different (paired t-test, t(11) = 5.17, p < 0.001), indicating poor saccadic compensation. However, when sleep loss was coupled with caffeine ingestion, ground lost was decreased and ground recouped increased such that the slopes were no longer different (t(8) = -0.05, p = 0.965). With alcohol, the two slopes were large albeit not significantly different (t(15) = 0.96, p = 0.351), indicating significant pursuit impairment but effective saccadic compensation. Our findings show that sleep deprivation and alcohol affect oculomotor performance differently. Low-dose alcohol effects appear predominantly cortical, with effective brainstem compensation. Sleep loss and circadian disruption however appears to affect both cortical and brainstem pathways with caffeine providing an effective countermeasure to both effects. Beyond the mere detection of impairment, our oculometric assessment allows us to characterize the nature of the deficit, to provide insight into the neural substrate, and to assess the effectiveness of countermeasures.

pursuit↗
NASA NTRSDate not supplied

Efficient Oculometric Assessment of Altered Neural Function

Eye movements have long been known to shed light on the locus and nature of serious brain injuries and pathologies. Recent scientific findings linking eye movements and higher-order psychometric performance and recent technical advances in eye-tracking precision have enabled the harnessing of an assortment of oculometrics as sensitive and reliable biomarkers of mild neural impairment across a wide range of stressors and brain regions. Oculometrics is, therefore, a promising new tool for the assessment of spaceflight effects on sensorimotor performance and on the effectiveness of candidate countermeasures, even with small sample populations

eye movements↗
NASA NTRSDate not supplied

An Oculometric Standard to Assess the Performance of the Ocular System for Long Duration Spaceflight

Changes in the human brain, due to spaceflight, have been a challenge to the space program since its inception; a challenge that is becoming more acute as extended International Space Station (ISS) missions become routine, a return to crewed lunar exploration is about to begin, and a multi-year crewed trip to Mars is being planned. Determining the extent to which neurophysiological adaptations may adversely impact performance in operational tasks, assessing the full-time course of these changes, and identifying/mitigating any potential long-term health consequences are crucial steps required to enable safe crew-autonomous, long-duration, deep-space missions. Vision is the predominant perceptual sense used to guide cognition and motor control in humans. Thus, it is critical for the success of any future, long-duration mission to understand how long-term exposure to microgravity and to other stressors of spaceflight and their interactions, impact visual function. This is an especially challenging task given the small and disparate samples from which we have been and will be able to collect human performance data. NASA has recently been carefully tracking spaceflight-induced ophthalmic changes, driven in large part by the fluid shifts related to microgravity. In particular, a recent study of Optical Coherence Tomography (OCT) postflight measures revealed that more than two-thirds of US crew members experience significant increases in retinal thickness after 6month or longer ISS missions. Space Associated Neuro-ocular Syndrome (SANS) also includes visual acuity decrements and other ocular structural changes that could adversely impact in-flight performance as missions become longer. However, the impact of spaceflight on the visual system is not limited to the retina. Recent comparisons of pre-and post-flight brain images have revealed structural changes throughout the brain that implicate visual, visuomotor, and visual-cognitive pathways, consistent with observed functional impacts (e.g., decreased speed/accuracy/timing of fine goal-oriented movements). Current limitations on inflight testing make it very difficult to determine when and under what conditions SANS and other disruptions of human neurological subsystems arise. Currently, one cannot anticipate the time course and extent of impairment and recovery. This study addresses this knowledge gap by creating an integrated framework of the relevant existing literature on visual and oculomotor function during spaceflight with an eye towards complementing current structural measures of visuomotor impairment with new oculometric standard measures. Using eye-movement based visual function assessment and diagnostics would provide a valuable enhancement of crew health and performance monitoring in support of deepspace exploration.

Vision↗
NASA NTRS1984

Oculometric indices of simulator and aircraft motion

The effects on eye scan behavior of both simulator and aircraft motion and sensitivity of an oculometric measure to motion effects was demonstrated. It was found that fixation time is sensitive to motion effects. Differences between simulator motion and no motion conditions during a series of simulated ILS approaches were studied. The mean fixation time for the no motion condition was found to be significantly longer than for the motion conditions. Eye scan parameters based on data collected in flight, and in fixed base simulation were investigated. Motion effects were evident when the subject was viewing a display supplying attitude and flight path information. The nature of the information provided by motion was examined. The mean fixation times for the no motion condition were significantly longer than for either motion condition, while the two motion conditions did not differ. It is shown that motion serves an alerting function, providing a cue or clue to the pilot that something happened. It is suggested that simulation without motion cues may represent an understatement of the true capacity of the pilot.

Comstock, J. R.↗
NASA NTRS2019

Oculometric Assessment of Mild Neural Impairment

For over 100 years, neurologists have used eye movements to identify neural impairment, disease, or injury. Prior to the age of modern imaging, qualitative assessment of eye movements was a critical, routine component of diagnosis and remains today a routine law-enforcement tool for detecting impaired driving due to drugs or alcohol. We will describe the application of a simple 5-minute oculomotor tracking task coupled with a broad range of quantitative analyses of high-resolution oculomotor measurements for the sensitive detection of sub-clinical neural impairment and for the potential differentiation of various causes. Specifically, we will show that there are distinct patterns of impairment across our set of oculometric parameters observed with brain trauma, sleep and circadian disruption, and alcohol consumption. Such differences could form the basis of a self-administered medical monitoring or diagnostic support tool.

Stone, Lee↗
NASA NTRS2014

Oculometric Assessment of Dynamic Visual Processing

Eye movements are the most frequent (~3 per second), shortest-latency (~150-250 ms), and biomechanically simplest (1 joint, no inertial complexities) voluntary motor behavior in primates, providing a model system to assess sensorimotor disturbances arising from trauma, fatigue, aging, or disease states (e.g., Diefendorf and Dodge, 1908). We developed a 15-minute behavioral tracking protocol consisting of randomized stepramp radial target motion to assess several aspects of the behavioral response to dynamic visual motion, including pursuit initiation, steadystate tracking, direction-tuning, and speed-tuning thresholds. This set of oculomotor metrics provide valid and reliable measures of dynamic visual performance (Stone and Krauzlis, 2003; Krukowski and Stone, 2005; Stone et al, 2009; Liston and Stone, 2014), and may prove to be a useful assessment tool for functional impairments of dynamic visual processing.

smooth pursuit↗
NASA NTRSDate not supplied

Correlated Changes in Retinal Thickness and Visuomotor Function in Asymptomatic Plaquenil Toxicity Patients

We have previously shown that a 5-minute eye-movement test can capture a number of largely independent “oculometric” parameters of human visual/visuomotor function (Liston & Stone, 2014). This test has been successfully used to characterize mild neural impairment due to traumatic brain injury, sleep and circadian disruption, and alcohol consumption (Liston et al., 2017; Stone et al, 2019; Tyson et al, 2021). Here, we extend this approach to study patients at risk of progressive posterior-segment illness to see how oculometrics relate to standard clinical ophthalmological measures. Five female patients (<20:40 BCVA, 34-60 years old) undergoing hydroxychloroquine treatment (2-7mg/kg/day for 10-23 years for rheumatologic illness) have participated thus far. Under monocular viewing conditions in randomized order, they tracked a moving spot undergoing radial step-ramp motion in one of 90 randomized directions, at one of 5 randomized speeds, starting at random times (for details, see Stone et al, 2019). We computed nine independent oculometrics (latency, initial acceleration, steady-state gain, proportion smooth, saccadic rate, saccadic amplitude, direction noise, speed responsiveness, and speed noise). Spectral-domain optical coherence tomography (Zeiss, Dublin, CA) was used to measure the average thickness of the nine Early Treatment Diabetic Retinopathy Study macular sectors from the internal limiting membrane to the retinal pigmented epithelium. We used Pearson’s correlation between retinal thickness and our oculometrics with t-statistics to test separate one-sided hypotheses across 10 retinae. Our preliminary analysis found significant changes in several different aspects of visuomotor performance. Most notably, latency increased, initial acceleration decreased, and steady-state pursuit gain decreased as retinal thickness decreased (r2 = 0.364, 0.579, and 0.692; one-tailed P = 0.032, 0.005, and 0.001, respectively). Speed responsiveness appeared to decrease, but this effect was marginal for our current sample (r2 = 0.253, P = 0.069). Lastly, direction discrimination and saccadic behavior appeared unchanged. We conclude that oculometrics may provide sensitive measures of changes in retinal thickness. More importantly, oculometrics have the potential to detect impairment before it becomes evident with standard clinical imaging tools, while also providing insight into the behavioral implications of any resulting deficits in visual/visuomotor function.

eye movements↗
NASA NTRS2019

Distinct Pattern of Oculomotor Impairment Associated with Acute Sleep Loss and Circadian Misalignment

Sleep loss and circadianmisalignment have long been known to impair human cognitive and motor performance with significant societal and health consequences. It is well known that human reaction time to a visual cue is impaired following sleep loss and circadian misalignment, but it has remained unclear how more complex visuomotor control behaviour is altered under these conditions. In this study, we measured 14 parameters of the voluntary ocular tracking response of 12 human participants (six females) to systematically examine the effects of sleep loss and circadianmisalignment using a constant routine 24 h acute sleep-deprivation paradigm. The combination of state-of-the-art oculometric and sleep-research methodologies allowed us to document, for the first time, large changes in many components of pursuit, saccades and visual motion processing as a function of time awake and circadian phase. Further, we observed a pattern of impairment across our set of oculometric measures that is qualitatively different from that observed previously with other mild neural impairments. We conclude that dynamic vision and visuomotor control exhibit a distinct pattern of impairment linked with time awake and circadian phase. Therefore, a sufficiently broad set of oculometric measures could provide a sensitive and specific behavioural biomarker of acute sleep loss and circadian misalignment. We foresee potential applications of such oculometric biomarkers assisting in the assessment of readiness-to-perform higher risk tasks and in the characterization of sub-clinical neural impairment in the face of a multiplicity of potential risk factors, including disrupted sleep and circadian rhythms.

Stone, Leland S.↗
NASA NTRS2000

Motion coherence affects human perception and pursuit similarly

Pursuit and perception both require accurate information about the motion of objects. Recovering the motion of objects by integrating the motion of their components is a difficult visual task. Successful integration produces coherent global object motion, while a failure to integrate leaves the incoherent local motions of the components unlinked. We compared the ability of perception and pursuit to perform motion integration by measuring direction judgments and the concomitant eye-movement responses to line-figure parallelograms moving behind stationary rectangular apertures. The apertures were constructed such that only the line segments corresponding to the parallelogram's sides were visible; thus, recovering global motion required the integration of the local segment motion. We investigated several potential motion-integration rules by using stimuli with different object, vector-average, and line-segment terminator-motion directions. We used an oculometric decision rule to directly compare direction discrimination for pursuit and perception. For visible apertures, the percept was a coherent object, and both the pursuit and perceptual performance were close to the object-motion prediction. For invisible apertures, the percept was incoherently moving segments, and both the pursuit and perceptual performance were close to the terminator-motion prediction. Furthermore, both psychometric and oculometric direction thresholds were much higher for invisible apertures than for visible apertures. We constructed a model in which both perception and pursuit are driven by a shared motion-processing stage, with perception having an additional input from an independent static-processing stage. Model simulations were consistent with our perceptual and oculomotor data. Based on these results, we propose the use of pursuit as an objective and continuous measure of perceptual coherence. Our results support the view that pursuit and perception share a common motion-integration stage, perhaps within areas MT or MST.

NASA Center ARC↗
NASA NTRS2017

Comprehensive Oculomotor Behavioral Response Assessment (COBRA)

An eye movement-based methodology and assessment tool may be used to quantify many aspects of human dynamic visual processing using a relatively simple and short oculomotor task, noninvasive video-based eye tracking, and validated oculometric analysis techniques. By examining the eye movement responses to a task including a radially-organized appropriately randomized sequence of Rashbass-like step-ramp pursuit-tracking trials, distinct performance measurements may be generated that may be associated with, for example, pursuit initiation (e.g., latency and open-loop pursuit acceleration), steady-state tracking (e.g., gain, catch-up saccade amplitude, and the proportion of the steady-state response consisting of smooth movement), direction tuning (e.g., oblique effect amplitude, horizontal-vertical asymmetry, and direction noise), and speed tuning (e.g., speed responsiveness and noise). This quantitative approach may provide fast and results (e.g., a multi-dimensional set of oculometrics and a single scalar impairment index) that can be interpreted by one without a high degree of scientific sophistication or extensive training.

Stone, Leland S.↗
NASA NTRS2019

Low-Dose Caffeine Administration During Acute Sleep Deprivation Eliminates Visual Motion Processing Impairment, but Does Not Improve Saccadic Rate

Oculomotor tracking performance changes according to time awake. A constant routine (CR) study demonstrated that increasing time awake 1) reduces the precision of visual motion processing, 2) decreases steady-state closed-loop pursuit performance and 3) decreases peak saccadic velocity. We aimed to determine the contribution of homeostatic sleep pressure on these oculometric changes by administering low-dose caffeine over one night of sleep deprivation. Participants completed two weeks of at-home 8.5 hours sleep per day, followed by an approximately 24-hour laboratory CR in semi-recumbent posture under less than 4 lux of light. The visual tracking task was performed every two hours after waking and hourly overnight. Low-dose caffeine of 0.3 milligrams per kilogram was administered hourly during the biological night. Nine participants (5F) completed the study. Caffeine dosing: 1) prevented the impairment of visual motion processing, 2) reduced by approximately half the impairment of closed-loop pursuit performance (gain, minus 0.47 percent per hour, significance of slope change: p (probability) less than 0.006; proportion smooth, minus 0.35 percent per hour, p less than 0.005), and 3) had an insignificant (p less than 0.39) effect on the impairment of saccadic peak velocity (slope, minus 1.13 percent per hour; intercept, minus 0.62 percent per hour). These results suggest that visual motion processing and some proportion of closed-loop pursuit performance are impaired due to homeostatic mechanisms during sleep deprivation.

Sleep↗
NASA NTRS1985

Visual information transfer. Part 1: Assessment of specific information needs. Part 2: Parameters of appropriate instrument scanning behavior

The present study explored eye scan behavior as a function of level of subject training. Oculometric (eye scan) measures were recorded from each of ten subjects during training trials on a CRT based flight simulation task. The task developed for the study incorporated subtasks representative of specific activities performed by pilots, but which could be performed at asymptotic levels within relatively short periods of training. Changes in eye scan behavior were examined as initially untrained subjects developed skill in the task. Eye scan predictors of performance on the task were found. Examination of eye scan in proximity to selected task events revealed differences in the distribution of looks at the instruments as a function of level of training.

Comstock, J. R., Jr.↗
NASA NTRS1986

Analytical techniques of pilot scanning behavior and their application

The state of the art of oculometric data analysis techniques and their applications in certain research areas such as pilot workload, information transfer provided by various display formats, crew role in automated systems, and pilot training are documented. These analytical techniques produce the following data: real-time viewing of the pilot's scanning behavior, average dwell times, dwell percentages, instrument transition paths, dwell histograms, and entropy rate measures. These types of data are discussed, and overviews of the experimental setup, data analysis techniques, and software are presented. A glossary of terms frequently used in pilot scanning behavior and a bibliography of reports on related research sponsored by NASA Langley Research Center are also presented.

Harris, R. L., Sr.↗
NASA NTRS1984

The effects of simulator and aircraft motion on eye scan behavior

In a series of three experiments on the effects on eye-scan behavior of both simuator and aircraft motion, the sensitivity of an oculometric measure to motion effects was demonstrated. 'Fixation time', defined as the time the eyes spend at a particular location before moving on (saccade) to another fixation point, was found to be sensitive to motion effects in each of the experiments conducted. The results of the present study support the hypothesis that motion serves an alerting function, providing a 'cue' or 'clue' to the pilot that 'something happened'. The results do not support the hypothesis that direction of motion is conveyed through the type of motion information employed in these experiments.

Comstock, J. R., Jr.↗