Identification of Early Markers of Alzheimer's Disease by Using Eye Tracking in Reading. (ADAL)

Identification of Early Semantic Markers of Alzheimer's Disease by Using Eye Tracking in Reading Neutral and Predictable Sentences

The objective of this study is to identify early and accurate semantics markers of Alzheimer's disease (AD) by using two types of methods. First, the investigator will evaluate semantic processing of patients with AD or related disorders which will be compared to age matched controls by taking neuropsychological tests. Then, the investigator will analyze the effect of contextual word predictability on eye movements in reading sentences with the help of the same participants by using an eye tracker. Both of these methods will be used twice with a time interval of 6 months.

Study Overview

• Status: Completed
• Conditions: Alzheimer's Disease
• Intervention / Treatment: Behavioral: An eye tracking experiment; Behavioral: A neuropsychological evaluation

Detailed Description

Scientific background:

Identifying Alzheimer's disease (AD) as early as possible should enable to propose a re-education platform that would fit the early stage of neuronal loss in this pathology. Neuropsychological evaluations are currently one of the main tools for the early screening of AD. Among the tests proposed during those evaluations, the investigator find the Isaacs Set Test which evaluates the early degradation of semantic memory. Whereas eyes movement behavior during reading is sensitive to semantics factors and allows collecting accurate measurements (as precisely as one millisecond), no study has yet used this technique to precisely identify the precocious semantics troubles of AD.

Goal:

The objective of this study is to identify early and accurate markers of AD by associating semantic neuropsychological assessments and eye tracking during sentences reading.

Method:

The study will include 24 patients with AD or related disorders (Mini Mental State Examination between 20 and 27 ) and 24 age matched controls participants. The experiment will be divided in two steps. First, patients will take a standard neuropsychological evaluation. A specific semantic analysis will be performed on each participant using, for example, the Isaacs Set Test or the Weschler Similarities. The second step will ask the participants to read sentences while an eye tracker (the Eye Link 1000 remote) will record their eyes movements. In order to manipulate semantics factors, each sentence will contain a target word, either predictable or not. The experiment will last one hour and a half. Neuropsychological assessments and eye tracking will be done twice with a time interval of 6 months. The two times will be called T1 and T2 and are required to estimate whether eye tracking is a better predictor of AD than neuropsychological tests or not.

Evaluation criteria:

The eye tracking technique enables to record different sorts of measures. More specifically, the investigator will evaluate gaze duration on the target word. Moreover, neuropsychological tests scores will be collected. It will be, for example, the number of good answers.

Hypothesis and expected results:

First, the investigator expect that the predictability effect on eye movements would be less pronounced for patients with AD or related disorders than for the control group. This effect would be even more diminished at T2. It could be explained by a progressive degradation of the semantic memory of patients. Then, and for the same reasons, the investigator expect that the scores collected from the neuropsychological tests would be pathological for patient suffering from AD or related disorders. The test scores would be even more in deficit at T2. Finally, the investigator predict a correlation between neuropsychological tests data and eye movements data. With an extrapolation, and because eye movements recording allow us to obtain more accurate information about the quality of semantic processes, the investigator formulate the hypothesis that this technique will help to predict earlier AD.

• Study Type: Interventional
• Enrollment (Actual): 14
• Phase: Not Applicable

Contacts and Locations

Study Locations

• France
  • Nice, France, 06000
    • Institut Claude Pompidou

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 60 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

Pour le bras A :

Inclusion criteria

• Mother tongue french participants
• Participants with a level of education = or > to Junior Secondary School Diploma
• Participants with a normal or corrected vision
• Participants with good score at the neuro visual assessments (> or = to 15 at the "detection test" ; > or = to 16 at the "degraded letters" test
• Participants suffering from Alzheimer's or related disorders disease (ICD-10 criteria)
• Participants with an MMSE's score between 20 and 27
• Participants must sign the informed consent
• Participants must be affiliated to the social insurance. Non-inclusion criteria
• Impossibility to realize the experiment because of a blurred vision
• History of neurological or psychiatric disease, of alcoholism and of brain injury
• Participants under trusteeship, guardianship or placed under judicial protection
• Persons deprived of their liberty

Pour le bras B :

Inclusion criteria

• Mother tongue french participants
• Participants with a level of education = or > to Junior Secondary School Diploma
• Participants with a normal or corrected vision
• Participants with no global cognitive impairment with a MMSE's score > or = to 28 and with no difficulty to repeat and recall the 3 words
• Participants with good score at the neuro visual assessments (> or = to 15 at the "detection test" ; > or = to 16 at the "degraded letters" test
• Participants must sign the informed consent
• Participants must be affiliated to the social insurance. Non-inclusion criteria
• Impossibility to realize the experiment because of a blurred vision
• Prescription of psychotropic medication during the week preceding the experiment
• History of neurological or psychiatric disease, of alcoholism and of brain injury
• Evidence of cognitive decline
• Decline in the day-to-day operations
• Participants under trusteeship, guardianship or placed under judicial protection
• Persons deprived of their liberty

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Alzheimer's disease group; 24 patients with an Alzheimer's disease or related disorders	Behavioral: An eye tracking experiment; Neuropsychological assessments and eye tracking during reading will be practice twice with an interval of 6 months; Behavioral: A neuropsychological evaluation; Neuropsychological assessments and eye tracking during reading will be practice twice with an interval of 6 months
Active Comparator: control group; 24 age matched controls participants	Behavioral: An eye tracking experiment; Neuropsychological assessments and eye tracking during reading will be practice twice with an interval of 6 months; Behavioral: A neuropsychological evaluation; Neuropsychological assessments and eye tracking during reading will be practice twice with an interval of 6 months

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Eye tracking	Eye tracking (More specifically, the investigator will evaluate gaze duration on target words included in sentences while participant's eye movements will be recorded with the Eye link 1000 remote. Gaze duration is the sum of all fixations on a word prior to moving to another word)	at six months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The probability that the eyes skip the target word	The Visual Object and Space Perception Battery ( for the "degraded letters" test scores range from 0 to 20 and a score below 16 is considered as pathological; for the "test of detection" scores range from 0 to 20 and a score below 15 is considered as pathological). This test assesses neurovisual capacity	at six months
the initial landing position of the eye in the target word (in letters)	An eye tracking experiment while participants read sentences on a computer screen	at six months
the percentage of refixation done on the target word		at six months
the first fixation duration in the target word	(i.e. the duration of the first fixation on the target word, provided that the word wasn't skipped	at six months
the single fixation duration	the fixation of the target word when only one fixation is made on that word	at six months
the percentage of regressive saccade on the target word and the total viewing time		at six months
Neuropsychological tests scores		at six months

Collaborators and Investigators

• Sponsor: Centre Hospitalier Universitaire de Nice

Study record dates

Study Major Dates

• Study Start (Actual): November 10, 2015
• Primary Completion (Actual): July 5, 2018
• Study Completion (Actual): July 5, 2018

Study Registration Dates

• First Submitted: September 10, 2015
• First Submitted That Met QC Criteria: September 22, 2015
• First Posted (Estimated): September 23, 2015

Study Record Updates

• Last Update Posted (Estimated): November 14, 2023
• Last Update Submitted That Met QC Criteria: November 13, 2023
• Last Verified: November 1, 2023

More Information

Terms related to this study

• Keywords: eye movements; reading; semantic memory
• Additional Relevant MeSH Terms: Mental Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Neurodegenerative Diseases; Dementia; Tauopathies; Alzheimer Disease
• Other Study ID Numbers: 15-AOI-04