Clinical highlights – February 2025
This month’s newsletter is eye-opening.
As you may know, neuroClues® has officially received its CE-marking as a Class IIa medical device! And as if that wasn’t exciting enough, we’ve also reached a major milestone—50 patients recorded in the ICEBERG cohort. We’ll take a moment to explain what that means for us… and you!
As always, we’re committed to bringing you the latest insights on the power of eye tracking. This time, we’re presenting a fascinating review by Leng et al. (2024), which demonstrates how eye movement analysis is proving to be a promising tool for detecting cognitive impairment.
In the coming months, we’ll explore how neuroClues® can elevate your practice by focusing on the biomarkers it extracts and how proven research demonstrates their diagnostic value. Stay tuned!
Enjoy the reading!
1. ICEBERG COHORT
The ICEBERG study, officially titled “Cohort Study to Identify Predictor Factors of Onset and Progression of Parkinson’s Disease,” is a comprehensive, ongoing longitudinal study focused on understanding Parkinson’s Disease (PD).With an aim to enroll 360 patients, this four-year natural history study aims to identify clinical, imaging, and biological markers of PD onset and progression for use in clinical trials of disease-modifying therapies.
Launched in November 2014 at Hôpital Pitié-Salpêtrière in Paris, ICEBERG is expected to reach its primary completion in November 2029. With neuroClues® now part of the study, 50 patients have already been successfully recorded!
The Parkinson’s Iceberg
Parkinson’s Disease (PD) has been compared to an iceberg, where the visible symptoms—such as tremors, rigidity, and slow movements—are just the tip. Beneath the surface lie a host of hidden, non-motor symptoms from sleep disturbance to cognitive impairment.
The clinical symptoms of Parkinson’s Disease are just the visible result of a much larger process that has been developing beneath the surface for some time—underlying lesions and changes in the brain.
The ICEBERG cohort focuses on uncovering these hidden aspects through biomarkers, aiming to reveal the more subtle, fine details of PD progression. By identifying these early indicators, we can better understand the disease’s evolution, predict which cases will evolve faster, and ultimately detect Parkinson’s at its earliest stages.
Eye movements, in particular, have emerged as a promising biomarker, offering new possibilities for earlier detection and more precise tracking of the disease’s development.
Just like an iceberg, the biggest part of Parkinson’s remains hidden. This research aims to bring these unseen elements to light.
neuroClues’ Role in the Iceberg study
neuroClues® has been part of the ICEBERG study since April 2023, achieving the milestone of the first 50 patient recordings of oculomotor biomarkers.
2. Eye Movements to Detect Cognitive Impairement
As the global population ages, the prevalence of cognitive impairment is expected to rise, making early identification and intervention crucial. A recent reveiw by Leng et. al (2024) highlights the potential of advanced eye movement examinations as a valuable tool in the early detection and understanding of cognitive impairment.
Advanced Eye Movements
Unlike low-level reflexive eye movements, advanced eye movements are voluntary and controlled by cortical and subcortical pathways, reflecting cognitive levels and functions. These include various types of saccades, such as shown here :
Clinical Features in Various Cognitive Disorders
Leng et al. (2024) presented a comprehensive table illustrating how neurological disorders associated with cognitive impairment show unique eye movement abnormalities, reinforcing the potential of this approach for identifying and distinguishing specific diseases.
Example : Parkinson’s Disease (PD) and Parkinson’s Disease Dementia (PDD)
- Early PD is marked by prolonged anti-saccade latency and increased error rate.
- PDD patients exhibit worse performance compared to PD patients in tasks such as anti-saccades, predictive saccades and pro-saccades.
Clinical Implications
Advanced eye movement examination offers a non-invasive, objective, and reproducible method, with potential as a biomarker for early screening and diagnosis of cognitive impairment. This approach may even outperform traditional neuropsychological scales in terms of screening efficacy and differentiation.
When integrated with neuropsychological assessments and other diagnostic tools, eye movement analysis holds promise for improving early detection and intervention, ultimately helping to delay disease progression.
So, where does this fit in the clinical journey of a patient?
What is the clinical question?
The physician’s concern is whether the patient is showing signs of cognitive impairment that could point toward the onset of dementia
Where is this question asked?
This question is typically posed during the initial consultation, where symptoms are first assessed, but it becomes especially important in follow-up appointments as the disease progresses.
Who asks the question?
It is the physician who raises this critical question, prompted by observed symptoms and cognitive changes.
At what point in the patient’s journey does this question arise?
- During screening for at-risk populations—such as individuals with Parkinson’s disease after several years of disease progression.
- When there’s clinical suspicion—either from the physician’s observations or from the family.
What is the impact on management?
If cognitive decline is detected, management can focus on:
- Earlier detection, allowing for more timely and effective care, enabling tailored interventions based on the patient’s specific needs.
- Objective measures, providing a way to monitor disease progression and assess the response to treatment, ensuring that therapies are as effective as possible.
3. Sneak Peak of Upcoming Newsletters
Over the coming months, we’ll be providing insights on how neuroClues® can elevate your consultations, supported by compelling studies and research.
Here’s a preview of the upcoming newsletters:
- March — Reflexive vs. Voluntary Saccades and their Neural Pathways
- April — Exploring Anti-Saccades and Frontal Lobe Function
- May — The Science Behind our Biomarker Computation
We’re going to be at these upcoming events, let’s meet!
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