Exploratory eye movement dysfunction as a discriminator for schizophrenia: A large sample study using a newly developed digital computerized system

Dept. of Neuropsychiatry, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo 173-8610, Japan.
European Archives of Psychiatry and Clinical Neuroscience (Impact Factor: 3.53). 02/2009; 259(3):186-94. DOI: 10.1007/s00406-008-0850-7
Source: PubMed


In our previous studies, we identified that exploratory eye movement (EEM) dysfunction appears to be specific to schizophrenia. The availability of a biological marker specific to schizophrenia would be useful for clinical diagnosis of schizophrenia. Consequently, we performed the discriminant analysis between schizophrenics and non-schizophrenics on a large sample using the EEM test data and examined an application of the EEM for clinical diagnosis of schizophrenia. EEM performances were recorded in 251 schizophrenics and 389 non-schizophrenics (111 patients with mood disorders, 28 patients with neurotic disorders and 250 normal controls). The patients were recruited from eight university hospitals and three affiliated hospitals. For this study with a large sample, we developed a new digital computerized version of the EEM test, which automatically handled large amounts of data. We measured four parameters: number of eye fixations (NEF), total eye scanning length (TESL), mean eye scanning length (MESL) and responsive search score (RSS). These parameters of schizophrenics differed significantly from those of the other three groups. The stepwise regression analysis selected the TESL and the RSS as the valid parameters for discriminating between schizophrenics and non-schizophrenics. In the discriminant analysis using the RSS and TESL as prediction parameters, 184 of the 251 clinically diagnosed schizophrenics were discriminated as having schizophrenia (sensitivity 73.3%); and 308 of the 389 clinically diagnosed non-schizophrenic subjects were discriminated as non-schizophrenics (specificity 79.2%). Based on our findings we believe that the EEM measures may be useful for the clinical diagnosis of schizophrenia.

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    • "Further, more errors in antisaccade tasks were found (Fukushima et al., 1988; Petrovsky et al., 2009; Dyckman et al., 2011; Cutsuridis et al., 2014). Exploratory eye movements have been used as discriminator from controls, from other neurotic disorders, or from mood disorders in largesample studies (Kojima et al., 2001; Suzuki et al., 2009; Benson et al., 2012). Impaired eye movements were also found in highrisk groups (Nieman et al., 2007; van Tricht et al., 2010), and fist-degree relatives (Holzman et al., 1974; Thaker et al., 2000; Radant et al., 2010; Kang et al., 2011; Aichert et al., 2013; Roberts et al., 2013), and people with schizotypal personality (O'Driscoll et al., 1998; Ettinger et al., 2005; Mitropoulou et al., 2011). "
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    ABSTRACT: Impaired eye movements have a long history in schizophrenia research and meet the criteria of a reliable biomarker. However, the effects of cognitive load and task difficulty on saccadic latencies (SL) are less understood. Recent studies showed that SL are strongly task dependent: SL are decreased in tasks with higher cognitive demand, and increased in tasks with lower cognitive demand. The present study investigates SL modulation in patients with schizophrenia and their first-degree relatives. A group of 13 patients suffering from ICD-10 schizophrenia, 10 first-degree relatives, and 24 control subjects performed two different types of visual tasks: a color task and a Landolt ring orientation task. We used video-based oculography to measure SL. We found that patients exhibited a similar unspe-cific SL pattern in the two different tasks, whereas controls and relatives exhibited 20–26% shorter average latencies in the orientation task (higher cognitive demand) compared to the color task (lower cognitive demand). Also, classification performance using support vector machines suggests that relatives should be assigned to the healthy controls and not to the patient group. Therefore, visual processing of different content does not modulate SL in patients with schizophrenia, but modulates SL in the relatives and healthy controls. The results reflect a specific oculomotor attentional dysfunction in patients with schizophrenia that is a potential state marker, possibly caused by impaired top-down disinhibition of the superior colliculus by frontal/prefrontal areas such as the frontal eye fields.
    Full-text · Article · Feb 2015 · Frontiers in Behavioral Neuroscience
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    • "Discriminant analysis revealed that individuals with schizophrenia could be differentiated from those without, with a sensitivity and specificity of 76.7% and 81.4%, respectively [68]. This methodology has since been replicated across global World Health Organization collaborative research sites [69], most recently with the aid of a digital computerized system to handle extensive data loads [70]. Other researchers have also used a variety of diagrams, including the Wechsler Adult Intelligence Scale picture completion task [71], Rey-Osterrieth Complex Figure [46], " smiley " faces and scene drawings [72], Rorschach inkblots [58] [73], Benton Visual Retention Test [74], natural landscapes and fractal patterns [51] [75], as well as static linear segments [76]. "
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    ABSTRACT: The human visual system is comprised of an array of complex organs, which jointly decode information from visible light to construct a meaningful representation of the surrounding environment. The study of visual scanpaths transpired in a bid to enhance our understanding of the role of eye movements underpinning adaptive functioning as well as psychopathology and was further aided by the advent of modern eye-tracking techniques. This review provides a background to the nature of visual scanpaths, followed by an overview and critique of eye movement studies in specific clinical populations involving the psychotic, anxiety, and mood disorders, and concludes with suggested directions for future research. We performed a Medline and PsycInfo literature search, based on variations of the terms "visual scanpath," "eye-tracking," and "eye movements," in relation to articles published from 1986 to the present. Eye-tracking studies in schizophrenia mostly concurred with the existence of a "restricted" scanning strategy, characterized by fewer number of fixations of increased durations, with shorter scanpath lengths, and a marked avoidance of salient features, especially in relation to facial emotion perception. This has been interpreted as likely reflecting dual impairments in configural processing as well as gestalt perception. Findings from the anxiety and mood disorders have conversely failed to yield coherent results, with further research warranted to provide corroborating evidence and overcome identified methodological limitations. Future studies should also look toward applying similar techniques to related disorders as well as conducting parallel neuroimaging investigations to elucidate potential neurobiological correlates.
    Full-text · Article · Feb 2011 · Comprehensive psychiatry
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    ABSTRACT: Schizophrenia (SZ) is a complex, heterogeneous, and disabling psychiatric disorder that impairs multiple aspects of human cognitive, perceptual, emotional, and behavioral functioning. SZ is relatively frequent (prevalence around 1%), with onset usually during adolescence or early adulthood, and has a deteriorating course. The rapidly growing area of neuroimaging research has has found clear evidence of many cortical and subcortical abnormalities in individuals with SZ. In this article the most recent findings from multiple studies on neurological disorders in SZ are reviewed, and the authors make a strong argument for a neurological basis of the schizophrenic process.
    No preview · Article · Dec 2009 · The Psychiatric clinics of North America
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