Eye-tracking phenotypes reveal clinically meaningful heterogeneity of attention and executive control dysfunction after stroke

 How EXACTLY will this get survivors recovered? Oh, nothing, so fucking useless? You're all fired! 'Assessments' have NEVER GOTTEN SURVIVORS RECOVERED! You need EXACT REHAB PROTOCOLS for that! This has none, so fucking useless!

Eye-tracking phenotypes reveal clinically meaningful heterogeneity of attention and executive control dysfunction after stroke

• Xiao Fei,
• Ying Tang,
• Yue Shi &
• Yi Zhang 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Post-stroke impairments in attention and executive control are common and clinically relevant, whereas conventional neuropsychological tests mainly capture task outcomes and provide limited information about process-level task behavior. Eye tracking can quantify fixation behavior, saccadic activity, and visual sampling, but whether integrated eye-tracking features can reveal clinically interpretable heterogeneity after stroke remains insufficiently defined.

Objective

This study examined whether integrated multi-paradigm eye-tracking features could identify exploratory eye-movement phenotypes in individuals with stroke and whether these phenotypes were associated with behavioral, clinical, lesion-related, and functional characteristics.

Methods

In this single-center exploratory case-control study, 72 subacute stroke participants (14–90 days post-onset) and 36 matched healthy controls completed five tasks of attention and executive control and six eye-tracking paradigms. Group differences in behavioral and eye-tracking measures were examined with false discovery rate correction. Within the stroke group, K-means clustering was performed using four nonredundant integrated eye-tracking features: total fixation duration, first-fixation duration, number of fixations, and total saccade distance. Cluster stability and sensitivity analyses were conducted using bootstrap resampling, alternative feature sets, and combined clustering with healthy controls. Post-clustering comparisons and exploratory regression analyses were used to evaluate the clinical relevance of the identified phenotypes.

Results

Compared with healthy controls, participants with stroke showed lower performance across attention/executive-control tasks and altered eye-tracking metrics across paradigms. The most consistent eye-movement pattern was shorter total fixation duration and a higher number of fixations across the six paradigms, whereas total saccade distance differed most clearly during the antisaccade task. K-means clustering identified two exploratory eye-movement phenotypes: a High-Fixation/Low-Saccade phenotype and a Low-Fixation/High-Saccade phenotype. The two-cluster solution remained stable across bootstrap and sensitivity analyses. The Low-Fixation/High-Saccade phenotype showed poorer cognitive performance, greater neurological and functional impairment, higher emotional symptom burden, and more frequent frontal involvement and bilateral or multifocal involvement. In exploratory hierarchical regression, eye-movement phenotype explained additional variance in Barthel Index scores beyond demographic variables, post-stroke timing, neurological severity, and conventional attention/executive-control performance.

Conclusions

Integrated multi-paradigm eye-tracking features identified two exploratory eye-movement phenotypes in individuals with subacute stroke. The Low-Fixation/High-Saccade phenotype was associated with broader clinical burden. These findings suggest that eye tracking may provide process-level information complementary to conventional assessment of post-stroke attention and executive-control dysfunction. Given the single-center and cross-sectional design, these preliminary phenotypes require validation in longitudinal and multicenter studies.

Linking eye movements, pupil responses, and brain networks in early cognitive decline

 Will your competent? doctor put this into a testing protocol, so if problems are found, that EXACT DEMENTIA PREVENTION PROTOCOL WILL BE USED?

Do you prefer your doctor, hospital and board of director's incompetence NOT KNOWING? OR NOT DOING? Your choice; let them be incompetent or demand action!

OH NO! your doctor KNOWS NOTHING AND DOES NOTHING! 

Linking eye movements, pupil responses, and brain networks in early cognitive decline

Alzheimer's Research & Therapy

• Julius Opwonya, 
• Boncho Ku, 
• Frank van der Heide, 
• Kun Ho Lee, 
• Joong Il Kim & 
• Jaeuk U. Kim 

• 24 Accesses

• 7 Altmetric

• 1 Mention

• Explore all metrics 

 We are providing an unedited version of this manuscript to give early access to its findings. 

Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Early detection of Alzheimer’s disease (AD) requires biomarkers sensitive to pre-neurodegenerative dysfunction. Task-evoked ocular responses index arousal‑based gain and the stability of executive timing, but their relationship to brain structure, especially within AD‑signature cortex; regions that thin early in AD, remains poorly characterized. We tested whether ocular metrics map onto cortical thickness and subcortical volumes, and whether brain–ocular coupling differs between cognitively normal (CN) adults and those with mild cognitive impairment (MCI).

Methods

Participants with MCI (n = 212) and CN controls (n = 516) completed an interleaved prosaccade–antisaccade task; binocular pupil diameter and eye movements were time‑locked to cue and target onsets to derive pupil amplitude/variability and saccade metrics. Region‑wise linear mixed‑effects models quantified brain–ocular coupling to cortical thickness and subcortical volumes and tested group (CN vs. MCI) differences in coupling slopes.

Results

Diagnosis‑independent analyses showed that saccade latency variability (Latency SD) and pupil amplitude/variability exhibited robust region‑dependent coupling across cortical and subcortical volumes, whereas mean saccadic latency and pupil timing measures displayed no reliable spatial pattern.

Diagnostic effects were modest and spatially selective but directionally opposite across modalities. For saccades, CN displayed positive thickness–variability slopes in frontal, cingulate, and insular cortices whereas MCI showed negative or near‑zero slopes. In the AD‑signature cortex, this inversionn CN(+)/MCI(−/0) was localized specifically to the supramarginal gyrus (Δβ≈–0.026). Subcortical volumes showed no significant diagnostic differences. For pupils, MCI showed more positive pupil–thickness coupling than CN within global cortex, most prominently in temporal, parietal, and insular regions, and within AD‑signature cortex this selective increase localized to medial temporal cortex (Δβ = 0.042) and to supramarginal gyrus (Δβ = 0.030); subcortical diagnostic differences were not significant after correction.

Conclusions

Task‑evoked ocular signals yield two complementary, region‑specific readouts of early Alzheimer‑relevant dysfunction. Pupil amplitude and variability reflect the strength of phasic, arousal‑linked responses arising from coordinated brainstem control hubs and show selective increases in MCI within medial temporal and temporoparietal regions that are vulnerable early in Alzheimer’s disease. Saccadic latency variability indexes loss of timing stability, revealing a thickness–stability inversion—positive in controls, absent or negative in MCI—that localizes to supramarginal gyrus within attention and executive‑control networks. Effects are modest and spatially circumscribed, positioning ocular measures as scalable, adjunct biomarkers of prodromal disease.

High-Speed Eye Tests Detect “Invisible” Brain Injuries

 How will your competent? doctor use this to objectively determine damage from your stroke? And then provide EXACT PROTOCOLS to fix such damage! 

Oh NO, your doctor HAS NOTHING!

High-Speed Eye Tests Detect “Invisible” Brain Injuries

Summary: Can a single concussion from your youth still affect your brain ten or twenty years later? A new study suggests the answer is yes.

Researchers used advanced eye-tracking technology to show that people who suffered concussions more than a decade ago still exhibit significant “neurological “lag” in how their eyes track moving objects. These subtle deficits, invisible to the naked eye or standard clinical exams, indicate that the brain’s “internal map” for movement and timing may never fully reset after a traumatic brain injury (TBI).

Key Facts

• The “Lag” Discovery: Participants with a history of concussions showed a delayed reaction in “pursuit eye movements”—the ability to smoothly follow a moving target.
• Decades of Impact: The neurological deficits were present in individuals whose last head injury occurred over 10 to 15 years ago, suggesting that some post-concussion changes are permanent.
• Beyond Standard Tests: These patients often passed traditional cognitive and physical exams, but the high-speed eye-tracking revealed “micro-stutters” in brain-to-eye communication.
• Brainstem & Cerebellum: The researchers believe the trauma affects long-term signaling in the brainstem and cerebellum, regions responsible for fine motor control and predictive timing.
• Predictive Tool: This study positions eye-tracking as a powerful, non-invasive biomarker for “hidden” brain trauma and could help identify those at higher risk for neurodegenerative diseases later in life.

Source: University of Colorado

A study from researchers at the CU Anschutz Marcus Institute for Brain Health suggests that veterans with concussions may continue to show subtle but measurable brain function differences more than a decade after their injury.

Researchers found these differences can be detected through specialized eye movement testing.

New research shows that eye-tracking technology can uncover subtle, persistent neurological deficits in individuals decades after a concussion. Credit: Neuroscience News

The findings were recently published in the Journal of Neuro-Ophthalmology.

Mild traumatic brain injuries are common among military service members and occur in athletes and civilians through sports impacts, car accidents and falls. While most individuals recover within weeks or months, the new research indicates that some may experience lingering changes in attention, processing speed and impulse control long after symptoms appear to resolve.

Eye Movements Reveal Subtle Brain Changes

“The eyes are directly connected to brain networks that control attention, information processing and decision-making,” said the study’s lead investigator Jeffrey Hebert, PhD, PT, associate professor at the CU Anschutz School of Medicine and director of research for the CU Anschutz Marcus Institute for Brain Health.

“By studying how someone’s eyes move during a cognitively demanding task, we can detect subtle brain changes that might not appear on a standard bedside exam or brain scan.”

The study evaluated 78 military veterans, including 38 with a history of mild traumatic brain injury and 40 without. Participants completed a series of eye movement tasks and cognitive tests designed to measure executive function of attention, processing speed and self-control.

Researchers found that veterans with prior concussions were more likely to demonstrate slower and less accurate eye movements along with reduced performance on certain attention-based tasks. Some of these differences were still measurable more than 10 years after the original injury.

Hebert said eye movements rely on complex networks across multiple regions of the brain. Tasks that require individuals to quickly look away from a visual target and tasks that require rapid visual recognition and verbalization of a viewed object test not only visual function but also cognitive control.

This includes the ability to focus, suppress impulses and respond quickly and accurately. Because these processes depend on widespread neural connections, several mild injuries may leave lasting but difficult to detect effects.

“Even when someone feels recovered, their brain may still be working differently behind the scenes, especially during visually demanding tasks and in busy environments” Hebert said. “Objective eye movement testing gives us a measurable way to assess these often covert problems.”

Implications for Concussion Care

The findings could have important implications for long term concussion care.

“Standard imaging tools such as MRI scans often appear normal after mild brain injury, making persistent symptoms difficult to verify objectively,” Hebert said. “Cognitively challenging eye movement assessments may provide clinicians with an additional tool to better understand ongoing cognitive concerns and more precisely tailor rehabilitation strategies.

Although the study focused on military veterans, the results may apply more broadly to athletes, first responders and civilians who have experienced concussions.

The team emphasizes that most individuals recover well from mild traumatic brain injury. However, identifying those who continue to experience subtle effects could improve follow up care, long term monitoring and treatment planning optimizing healthier brain adaptation.

Future studies will explore whether incorporating cognitively challenging eye movement testing into routine concussion evaluations could help clinicians better identify traumatic brain injury, track recovery and guide treatment decisions.

Funding: The research was funded by the Congressionally Directed Medical Research Programs, U.S. Army Medical Research Acquisition Activity, Department of Defense, Vision Research Program Award.

Key Questions Answered:

Q: I had a concussion 10 years ago but I feel fine. Should I be worried?

A: Not necessarily. The “lag” found in this study is often imperceptible in daily life because the brain is incredibly good at compensating. However, it shows that the injury left a permanent “fingerprint” on your neural wiring. It’s a reminder to be extra protective of your head health as you age.

Q: Why use eye tests to check the brain?

A: Tracking a moving object is one of the most complex tasks the brain performs. it requires perfect synchronization between your vision, your balance (vestibular system), and your motor control. If there is a “hitch” in the brain’s wiring anywhere, an eye test will catch it before almost any other exam.

Q: Could this lead to a better way to diagnose concussions?

A: Absolutely. Current “sideline” tests are often subjective. High-speed eye-tracking provides objective, mathematical data. If we know your “baseline” eye speed, we can tell instantly if a new hit has caused a disruption in your neural pathways.

Editorial Notes:

• This article was edited by a Neuroscience News editor.
• Journal paper reviewed in full.
• Additional context added by our staff.

About this eye tracking and TBI research news

Author: Laura Kelley
Source: University of Colorado
Contact: Laura Kelley – University of Colorado
Image: The image is credited to Neuroscience News

Original Research: Closed access.
“Ocular Motor Control and Cognitive Function in Military Veterans With Chronic Mild Traumatic Brain Injury” by Hebert, Jeffrey R. PhD, PT; Wagner, Brandie D. PhD; Filley, Christopher M. MD; Crowder, Kayla L. PT, DPT, NCS; Rubinstein, David MD; McNamara, Stephen M. OD; Johnston-Brooks, Catharine H. PhD; Karki, Ramesh MS; McCann, Ashley V. PT, DPT, NCS; Subramanian, Prem S. MD, PhD. Journal of Neuro-Ophthalmology
DOI:10.1097/WNO.0000000000002435

Early detection of cognitive decline in Alzheimer’s disease using eye tracking

 Didn't your competent? doctor create an eye tracking protocol over a decade ago?NO? So, you DON'T have a functioning stroke doctor, do you? 

eye tracking (15 posts to June 2013)

Early detection of cognitive decline in Alzheimer’s disease using eye tracking

Shin-ichi Tokushige^1,2Hideyuki Matsumoto³Shun-ichi Matsuda⁴Satomi Inomata-Terada⁵Naoki Kotsuki²Masashi Hamada¹Shoji Tsuji^1,6Yoshikazu Ugawa⁷Yasuo Terao^1,5*

• ¹Department of Neurology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
• ²Department of Neurology, Kyorin University, Tokyo, Japan
• ³Department of Neurology, Mitsui Memorial Hospital, Tokyo, Japan
• ⁴Department of Neurology, NTT Medical Center Tokyo, Tokyo, Japan
• ⁵Department of Medical Physiology, Kyorin University, Tokyo, Japan
• ⁶Institute of Medical Genomics, International University of Health and Welfare, Chiba, Japan
• ⁷Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan

Background: Patients with Alzheimer’s disease (AD) are known to exhibit visuospatial processing impairment, as reflected in eye movements from the early stages of the disease. We investigated whether the pattern of gaze exploration during visual tasks could be useful for detecting cognitive decline at the earliest stage.

Methods: Sixteen AD patients (age: 79.1 ± 7.9 years, Mini Mental State Examination [MMSE] score: 17.7 ± 5.3, mean ± standard deviation) and 16 control subjects (age: 79.4 ± 4.6, MMSE score: 26.9 ± 2.4) participated. In the visual memory task, subjects memorized presented line drawings for later recall. In the visual search tasks, they searched for a target Landolt ring of specific orientation (serial search task) or color (pop-out task) embedded among arrays of distractors. Using video-oculography, saccade parameters, patterns of gaze exploration, and pupil size change during task performance were recorded and compared between AD and control subjects.

Results: In the visual memory task, the number of informative regions of interest (ROIs) fixated was significantly reduced in AD patients compared to control subjects. In the visual search task, AD patients took a significantly longer time and more saccades to detect the target in the serial but not in pop-out search. In both tasks, there was no significant difference in the saccade frequency and amplitude between groups. On-task pupil modulation during the serial search task was decreased in AD. The number of ROIs fixated in the visual memory task and search time and saccade numbers in the serial search task differentiated both groups of subjects with high sensitivity, whereas saccade parameters of pupil size modulation were effective in confirming normal cognition from cognitive decline with high specificity.

Discussion: Reduced fixation on informative ROIs reflected impaired attentional allocation. Increased search time and saccade numbers in the visual search task indicated inefficient visual processing. Decreased on-task pupil size during visual search suggested decreased pupil modulation with cognitive load in AD patients, reflecting impaired function of the locus coeruleus. When patients perform the combination of these tasks to visualize multiple aspects of visuospatial processing, cognitive decline can be detected at an early stage with high sensitivity and specificity and its progression be evaluated.

Simple, Noninvasive Eye Tracking May Flag, Rule Out, Cognitive Decline

 Do you really think your competent? doctor has enough functioning brain cells to implement this and create EXACT PROTOCOLS to prevent cognitive decline post stroke? I don't.

Simple, Noninvasive Eye Tracking May Flag, Rule Out, Cognitive Decline

Naturalistic gaze patterns appear to be a simple, noninvasive, and reliable indicator of cognitive decline, new research suggested.

Investigators found that gaze patterns during image viewing mirrored memory performance and distinguished healthy adults from those at risk for, or with, cognitive impairment.

“We are still in the early stages of establishing eye tracking as a marker of memory and cognitive status,” lead investigator Jordana S. Wynn, PhD, assistant professor of psychology at the University of Victoria, British Columbia, Canada, told Medscape Medical News.

Although larger, more diverse, and longitudinal research validation is warranted, “this work lays important groundwork by demonstrating that naturalistic eye movement patterns are meaningfully related to memory function,” she added.

The study was published online on August 11 in the Proceedings of the National Academy of Sciences.

Novel Research

Because the fovea — a small, cone-dense region at the center of the retina — captures high-resolution detail only in the center of the visual field, the eyes must constantly move to sample the full environment.

These movements provide a precise, noninvasive measure of how visual information is encoded and retrieved from memory. While prior research has linked certain gaze metrics to memory decline, it remains unclear how multivariate gaze patterns — considering multiple eye movement features together — relate to memory function.

For the study, which researchers note is the first work to analyze how eye movements differ across a range of brain health and memory function levels, Wynn and colleagues assessed 106 individuals across five groups — young adults, healthy older adults, individuals at risk for significant cognitive decline, those with mild cognitive impairment (MCI), and those with amnesia.

They hypothesized that changes in gaze patterns would correspond in a linear fashion to cognitive function from the healthiest participants to those with amnesia.

The study included two experiments. In the first, participants viewed a series of 120 distinct images, each for 5 seconds, to assess “idiosyncratic gaze similarity,” or the uniqueness of their viewing patterns. As expected, memory function declined across groups — from young adults to healthy older adults, then to the at-risk group, followed by individuals with MCI and those with amnesia, showing a “meaningful linear relationship.”

In the second experiment, investigators used the same set of images, presenting 60 images once and another 60 three times for 5 seconds each to measure “repetitive gaze similarity.” This approach revealed whether participants consistently encoded the same image features each time on repeat viewings or if they updated their memory with different features, indicating stronger or more flexible memory encoding.

The researchers found that the healthy young adult group encoded unique image features with each image presentation. In contrast, participants with decreased memory and/or hippocampal/medial temporal function tended to focus on the same features each time they saw the same image.

These results confirm that memory decline is associated with reduced visual exploration, less effective updating of encoded representations over repeated exposures, and lower differentiation of the images.

Exciting, but Not Surprising

Wynn said she was not particularly surprised by the study findings. “Our previous work in healthy populations provided evidence that the brain and cognitive systems supporting eye movements and memory are closely linked. In past experimental work, we found that certain gaze patterns were predictive of memory performance,” she said.

Therefore, Wynn and colleagues postulated that memory decline from aging, disease, or injury would yield similar changes in eye movements.

“That our prediction was confirmed was certainly exciting, but not surprising,” she added.

The investigators concluded that the results provide “compelling evidence that naturalistic gaze patterns can serve as a sensitive marker of cognitive decline.”

This research lays a foundation for future work using multivariate gaze metrics to diagnose and track memory and/or hippocampal/medial temporal lobe function, they added.

It’s too early to determine whether naturalistic eye movements could become a first-line screening tool for cognitive decline, Wynn said.

“The value of eye tracking compared to standard neuropsychological tests is that it is noninvasive, cost-effective, and perhaps most importantly, universal,” she noted. Nearly anyone — regardless of age, ability, or language — can view pictures on a screen, so creating a screening tool that doesn’t rely on written or verbal responses would be particularly practical, Wynn said.

It is still too early to know whether naturalistic eye movements could serve as a first-line screening tool for cognitive decline. Wynn noted that eye tracking is noninvasive, cost-effective, and broadly accessible — anyone, regardless of age, ability, or language, can view images on a screen. With further refinement, she said, these measures could provide a high-resolution way to monitor memory and brain function in clinical settings.

Novel Insights

Commenting on the research for Medscape Medical News, Mariam Aly, PhD, acting associate professor of psychology at the University of California, Berkeley, said the study “yields novel insights into how the way people move their eyes can contribute to, and reflect, memory impairments.”

“This elegant study uses sophisticated analyses to provide a comprehensive picture of how eye movement patterns differ across groups that span a continuum of memory abilities.”

Importantly, these differences in eye movements were apparent even though participants had no explicit task, added Aly, who was not affiliated with the research.

“This means that assessment of eye movements during natural viewing of images has the potential to be developed into an important tool for detecting memory decline in clinical settings,” she said.

The study was independently supported. Wynn and Aly reported having no relevant financial relationships.

Eye tracking as a tool to identify mood in aphasia: A feasibility study.

Why work on this secondary problem? Mood problems in aphasia wouldn't exist if you had EXACT PROTOCOLS WITH EXACT REPETITION NUMBERS.   Yeah, that might be hard to solve but leaders solve problems, they don't work on minor shit. Solve the damn primary problem, getting to 100% recovery.

Eye tracking as a tool to identify mood in aphasia: A feasibility study.

Neurorehabilitation and Neural Repair (NNR) , Volume 34(5) , Pgs. 463-471.

NARIC Accession Number: J83845.  What's this?
ISSN: 1545-9683.
Author(s): Ashaie, Sameer A. ; Cherney, Leora R..
Publication Year: 2020.
Number of Pages: 9.

Abstract: 

Study examined the feasibility of using eye tracking to measure mood in people with post-stroke aphasia. Twenty-two subjects with chronic aphasia and 12 healthy controls completed 2 self-report measures of mood. They also viewed faces that showed happy, sad, and neutral facial expressions during eye tracking. Two eye-tracking indices were analyzed: (1) initial gaze orientation and (2) gaze maintenance to happy, sad, and neutral faces. For initial gaze orientation, participants with aphasia fixated faster on emotional faces compared with healthy controls but directed their gaze less often to happy faces compared with healthy controls. For gaze maintenance components, the duration of first fixation and total fixation duration were shorter on sad faces for participants with aphasia compared with healthy controls. Findings indicate that use of eye tracking with faces representing different mood states is feasible in people with aphasia. Although there were some similarities, participants with aphasia had different gaze patterns to emotional faces compared with healthy controls. Further research is needed to establish whether this is a valid and reliable method of mood assessment.
Descriptor Terms: APHASIA, DEPRESSION, EMOTIONS, EVALUATION TECHNIQUES, FEASIBILITY STUDIES, VISION.


Can this document be ordered through NARIC's document delivery service*?: Y.
Get this Document: https://journals.sagepub.com/doi/10.1177/1545968320916160.

Citation: Ashaie, Sameer A. , Cherney, Leora R.. (2020). Eye tracking as a tool to identify mood in aphasia: A feasibility study.  Neurorehabilitation and Neural Repair (NNR) , 34(5), Pgs. 463-471. Retrieved 7/18/2020, from REHABDATA database.

Eye Tracking as a Tool to Identify Mood in Aphasia: A Feasibility Study

Why the fuck are you wasting time on this? Do the research that creates protocols for 100% aphasia recovery. And your mentors and senior researchers were ok with this crapola? Useless.

Eye Tracking as a Tool to Identify Mood in Aphasia: A Feasibility Study 

Sameer A. Ashaie PhD, Leora R. Cherney, PhD

First Published April 28, 2020 Research Article Find in PubMed

Abstract

Background.
Persons with aphasia often present with low mood/depression, which can negatively affect their quality of life.(Precisely because you have NO PROTOCOLS FOR RECOVERY. SOLVE THE CORRECT PROBLEM, APHASIA, not depression.)The validity and reliability of existing depression measures for aphasia have been called into question. Eye tracking in nonstroke populations is reliable in identifying low mood/depression. Depressed persons are biased to negative emotions compared with nondepressed persons and have an absence of bias to positive emotions. However, nondepressed persons may be biased to positive emotions.  
Objective.
To examine the feasibility of using eye tracking to measure mood in persons with aphasia.  
Methods.
We recruited 22 persons with chronic aphasia and 12 healthy controls. Participants completed 2 self-report measures of mood. They also viewed faces that showed happy, sad, and neutral facial expressions during eye tracking. We analyzed 2 eye tracking indices: initial gaze orientation and gaze maintenance to happy, sad, and neutral faces.  
Results. For initial gaze orientation, participants with aphasia fixated faster on emotional faces compared with healthy controls but directed their gaze less often to happy faces compared with healthy controls. For gaze maintenance components, the duration of first fixation and total fixation duration were shorter on sad faces for participants with aphasia compared with healthy controls.  
Conclusion.
Use of eye tracking with faces representing different mood states is feasible in persons with aphasia. Although there were some similarities, participants with aphasia had different gaze patterns to emotional faces compared with healthy controls. Further research is needed to establish whether this is a valid and reliable method of mood assessment.

Eye-Tracking Provides a Sensitive Measure of Exploration Deficits After Acute Right MCA Stroke

What is more essential is protocols that correct spatial neglect.
https://www.frontiersin.org/articles/10.3389/fneur.2018.00359/full?

Margarete Delazer*, Martin Sojer, Philipp Ellmerer, Christian Boehme and Thomas Benke

• Department of Neurology, Medical University Innsbruck, Innsbruck, Austria

The eye-tracking study aimed at assessing spatial biases in visual exploration in patients after acute right MCA (middle cerebral artery) stroke. Patients affected by unilateral neglect show less functional recovery and experience severe difficulties in everyday life. Thus, accurate diagnosis is essential, and specific treatment is required(Where is the protocol located that corrects this?). Early assessment is of high importance as rehabilitative interventions(What are they?) are more effective when applied soon after stroke. Previous research has shown that deficits may be overlooked when classical paper-and-pencil tasks are used for diagnosis. Conversely, eye-tracking allows direct monitoring of visual exploration patterns. We hypothesized that the analysis of eye-tracking provides more sensitive measures for spatial exploration deficits after right middle cerebral artery stroke. Twenty-two patients with right MCA stroke (median 5 days after stroke) and 28 healthy controls were included. Lesions were confirmed by MRI/CCT. Groups performed comparably in the Mini–Mental State Examination (patients and controls median 29) and in a screening of executive functions. Eleven patients scored at ceiling in neglect screening tasks, 11 showed minimal to severe signs of unilateral visual neglect. An overlap plot based on MRI and CCT imaging showed lesions in the temporo–parieto–frontal cortex, basal ganglia, and adjacent white matter tracts. Visual exploration was evaluated in two eye-tracking tasks, one assessing free visual exploration of photographs, the other visual search using symbols and letters. An index of fixation asymmetries proved to be a sensitive measure of spatial exploration deficits. Both patient groups showed a marked exploration bias to the right when looking at complex photographs. A single case analysis confirmed that also most of those patients who showed no neglect in screening tasks performed outside the range of controls in free exploration. The analysis of patients’ scoring at ceiling in neglect screening tasks is of special interest, as possible deficits may be overlooked and thus remain untreated. Our findings are in line with other studies suggesting considerable limitations of laboratory screening procedures to fully appreciate the occurrence of neglect symptoms. Future investigations are needed to explore the predictive value of the eye-tracking index and its validity in everyday situations.

Eye tracking is being used by physicians and scientists to measure cognitive performance and monitor cognition in people at risk for cognitive decline.

You can hope that your doctor and hospital use this testing to baseline your cognitive abilities to see if you need immediate cognitive protocols. But that won't occur in your incompetent stroke hospitals. You can call the stroke hospital president but s/he will just blow you off because you are stroke addled.  You absolutely need this testing. Because:

1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.

https://www.neurotrack.com/science/?

Neurotrack combines validated science with cutting-edge technology to help you manage the health of your memory.

Discover the 30 years of research behind our assessment and recommended lifestyle interventions.

The foundation

Eye tracking overview

The measurement of eye movements offers unique insights into the brain and critical aspects of cognition. Assessments of speed, direction and larger patterns of eye movements serve as markers of memory performance. For this reason, eye tracking is being used by physicians and scientists to measure cognitive performance and monitor cognition in people at risk for cognitive decline.

Risk of Cognitive Decline in Emory Study Participants.

Percentage of those developing MCI or Alzheimer’s Disease in 3 years after initial testing

0% risk High Scoring  Initial scores of 67+

20% risk Average Scoring Initial scores of 50-67

90% risk Low Scoring Initial scores below 50

More at link.

This 5-minute test could detect if you are at risk for Alzheimer's disease

I could find no research in Google Scholar so I have no clue what proof this has that it works.
But this is on their website;
Our Imprint Check-Up is based on a landmark research study by Dr. Stuart Zola at Emory University. Dr. Zola found that participants’ performance on a longer 30-minute assessment was highly predictive of their cognitive decline. He tracked each person's level of cognitive decline and then correlated it with his or her assessment result over 3 years.
The president discussing it here; 2:13 video;
https://www.youtube.com/watch?v=YOn2TzvZS1U
The basic website for the marketing push here:
https://www.neurotrack.com/

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Your doctor should be following this up so you have a baseline measurement before you get dementia/Alzheimers.
1. A documented 33% dementia chance post-stroke from an Australian study?   May 2012.
2. Then this study came out and seems to have a range from 17-66%. December 2013.
3. A 20% chance in this research.   July 2013.
If you have anything close to a decent doctor a protocol will already be in place to prevent this from occurring.  

Scientists Discover Concussion Biomarker

But is it better than all the eye-tracking tests out there?
http://www.biosciencetechnology.com/news/2016/12/scientists-discover-concussion-biomarker?

The secret to reliably diagnosing concussions lies in the brain's ability to process sound, according to a new study by researchers from Northwestern University's Auditory Neuroscience Laboratory.
Widely considered a crisis in professional sports and youth athletic programs, sports-related concussions have had devastating neurological, physical, social and emotional consequences for millions of athletes. Still, no single test has been developed to reliably and objectively diagnose concussions.
The groundbreaking research, to be published Dec. 22 in the journal Nature, Scientific Reports, has found a biological marker in the auditory system that could take the ambiguity and controversy out of diagnosing concussions and tracking recovery.
"This biomarker could take the guesswork out of concussion diagnosis and management," said lead author Nina Kraus, the Hugh Knowles Professor in the School of Communication and director of the Auditory Neuroscience Laboratory. "Our hope is this discovery will enable clinicians, parents and coaches to better manage athlete health, because playing sports is one of the best things you can do."
By observing research subjects' brain activity as they were exposed to auditory stimuli, Kraus and her team discovered a distinct pattern in the auditory response of children who suffered concussions compared to children who had not.
Kraus and colleagues placed three simple sensors on children's heads to measure the frequency following response, which is the brain's automatic electric reaction to sound. With this measure they successfully identified 90 percent of children with concussions and 95 percent of children in the control group who did not have concussions.
Children who sustained concussions had on average a 35 percent smaller neural response to pitch, allowing the scientists to devise a reliable signature neural profile. As the children recovered from their head injuries, their ability to process pitch returned to normal.
"Making sense of sound requires the brain to perform some of the most computationally complex jobs it is capable of, which is why it is not surprising that a blow to the head would disrupt this delicate machinery," Kraus said.
What was surprising, Kraus said, was the specificity of the findings.
"This isn't a global disruption to sound processing," she said. "It's more like turning down a single knob on a mixing board."
Kraus is a biologist who studies the auditory system, which is at the nexus of our cognitive, sensory and limbic systems. She described the research findings -- based on a small study of 40 children being treated for concussion and a control group -- as a major first step.
Dr. Cynthia LaBella, the director of the Institute of Sports Medicine at the Ann and Robert H. Lurie Children's Hospital of Chicago and professor of pediatrics at Northwestern University Feinberg School of Medicine, is Kraus' partner in the research.
"Our ambition is to produce a reliable, objective, portable, user-friendly, readily available and affordable platform to diagnose concussion," Kraus said.
Concussions, a type of mild traumatic brain injury, are the result of a direct or indirect blow to the head that causes the brain to be jostled within the skull. But there is little relation between the force of an impact and the potential for injury -- two athletes can suffer similar hits but experience vastly different outcomes.
"With this new biomarker, we are measuring the brain's default state for processing sound and how that has changed as a result of a head injury," Kraus said. "This is something patients cannot misreport, you cannot fake it or will your brain to perform better or worse."

Brain Scans Could Help Detect Concussions

But better than eye tracking software? Available on the sideline of football games? Faster than 60 seconds?

SyncThink gets FDA approval for eye-tracking device to test for concussions in 60 seconds April 2016

New Technology Advances Eye Tracking As Biomarker for Brain Function and Recovery from Brain Injury Dec. 2014 

Oculogica’s eye-tracking machine could tell you if you’ve had a concussion  July 2014 

http://www.rdmag.com/article/2016/12/brain-scans-could-help-detect-concussions?

There may be a new method in helping to detect concussions that conventional scans might miss.
Researchers from Simon Fraser University in Burnaby, Canada have found that high-resolution brain scans along with computational analysis could help play a role in detecting concussions.
The recent study shows how magnetoencephalography (MEG), which maps interactions between regions of the brain, could detect greater levels of neural changes than typical clinical imaging tools such as MRI or CAT scans.
Concussions are typically diagnosed using the existing diagnostic tools along with other self-reporting measures, such as headaches and fatigues.
"Changes in communication between brain areas, as detected by MEG, allowed us to detect concussion from individual scans, in situations where MRI or CT failed," Vasily Vakorin, Ph.D., a scientist with the Behavioral and Cognitive Neuroscience Institute based at SFU and SFU's ImageTech Lab, a new facility at Surrey Memorial Hospital and co-lead author of the study, said in a statement.
This breakthrough can be especially vital in the world of sports, where concussion detection and treatment has come under fire in the last decade.
Using the new techniques could lead to better diagnosis of mild traumatic brain injuries, which are common among football players and cannot be detected on conventional scans.
 The researchers conducted the study by taking MEG scans of 41 men between 20 and 44 years of age where half had been diagnosed with concussions within the past three months.
The study shows that the concussions were associated with alterations in the interactions between different brain areas, meaning there were observable changes in how areas of the brain communicate with one another.
The new diagnostic methods were proven to provide important measurements of changes in the brain during concussion recovery. MEG was described by Vakorin and fellow study co-author Sam Doesburg as an “unprecedented combination of ‘excellent temporal and spatial relationship’ for reading brain activity to better diagnose concussion where other methods fail.”
The researchers now hope to refine their understanding of specific neural changes associated with concussions to further improve detection, treatment and recovery processes.
The study, which appeared in PLOS Computational Biology, can be viewed here.
About 300,000 sports-related concussions occur each year nationwide among all ages. In high school athletics, they occur at a rate of almost three per 10,000 games or practices.
Concussion detection has become especially important in recent years.
According to University of Arkansas concussion researcher R.J. Elbin, the lead author of a different study, evidence suggests up to 50 percent of concussions in teen sports aren't reported. Athletes are sometimes not aware they've experienced a concussion, or they suspect a head injury but continue playing because "they don't want to let their teammates down."
Many youth football and other sports leagues have become particularly cognizant of concussions by requiring coaches to take preseason classes and mandating an athletic trainer present at every game and practice.
In New Jersey high school athletics there is a five-to-six-day protocol that must be completed by concussed athletes where they slowly progress through different tests before they can return to the playing field.
Another study estimated that in 2013 more than 2 million concussions from sports or play activities occur in the U.S. with many not receiving treatment.
The concussion problem also occurs on the professional level.
The NFL has received criticism and has been subject to lawsuits in recent years filed by ex-players for hiding the risks of football on the brain.
Dr. Bennet Omalu, who was recently portrayed by Will Smith in the 2015 film “Concussion,” has discovered that several deceased football players were diagnosed with degenerative brain diseases chronic traumatic encephalopathy (CTE).
For more information on Omalu and some other concussion-related data, visit  R&D Magazine’s previous article.