Eye movement characteristics, particularly saccade accuracy, saccade latency, peak velocity, and slow-phase velocity, were independently associated with total MRI burden and cognitive impairment in cerebral small vessel disease patients.
Key Findings
Results
Decreased bilateral saccade accuracy and prolonged bilateral saccade latency were independently associated with increased total CSVD burden.
Decreased right saccade accuracy: OR = 0.923, 95% CI: 0.890–0.959, p < 0.001
Decreased left saccade accuracy: OR = 0.938, 95% CI: 0.908–0.968, p < 0.001
Prolonged right saccade latency: OR = 1.015, 95% CI: 1.008–1.023, p < 0.001
Prolonged left saccade latency: OR = 1.014, 95% CI: 1.007–1.022, p < 0.001
CSVD burden was scored on a 4-point MRI scale integrating white matter hyperintensities, lacunar infarcts, enlarged perivascular spaces, and cerebral microbleeds
Results
Multiple eye movement parameters were independently associated with cognitive impairment in CSVD patients.
Decreased right saccade accuracy: OR = 0.924, 95% CI: 0.876–0.973, p = 0.004
Decreased left saccade accuracy: OR = 0.944, 95% CI: 0.903–0.988, p = 0.012
Decreased right peak velocity: OR = 0.988, 95% CI: 0.978–0.998, p = 0.030
Decreased left peak velocity: OR = 0.986, 95% CI: 0.976–0.996, p = 0.007
Increased rightward slow-phase velocity: OR = 4.668, 95% CI: 1.669–13.066, p = 0.003
Methods
The study enrolled 120 CSVD patients stratified into mild, moderate, and severe groups based on MRI burden score.
Cross-sectional study conducted at Hebei General Hospital from January 2022 to October 2023
Total sample size was 120 patients with CSVD
Patients were stratified into mild (score 0), moderate (score 1–2), and severe (score 3–4) groups
Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA)
Eye movements were assessed using videonystagmography (VNG)
Results
Eye movement characteristics in CSVD patients were significantly correlated with both total MRI load and cognitive function.
Both saccade accuracy (bilateral) and saccade latency (bilateral) were linked to MRI burden
Cognitive impairment was associated with saccade accuracy, peak velocity, and slow-phase velocity abnormalities
The authors conclude these findings provide 'an important reference value for the early identification and assessment of CSVD severity'
Peak velocity abnormalities (bilateral) were specific to cognitive impairment associations but not reported as significant for MRI burden
What This Means
This research suggests that the way people move their eyes can reveal important information about the severity of a brain condition called cerebral small vessel disease (CSVD), which involves damage to small blood vessels in the brain and is a common cause of cognitive decline and dementia. The researchers studied 120 patients and used a specialized eye-tracking technology called videonystagmography (VNG) to measure how accurately and quickly patients' eyes moved in response to visual targets, along with standard brain MRI scans and cognitive testing.
The study found that patients with more severe CSVD brain damage (as seen on MRI) tended to have less accurate and slower eye movements (saccades) in both directions. Additionally, patients who showed cognitive impairment on testing had not only reduced saccade accuracy but also slower peak eye movement speed and abnormal slow-phase eye drift. These associations held up even after accounting for other factors, suggesting that eye movement problems are meaningfully linked to both brain damage burden and thinking difficulties in this condition.
This research suggests that measuring eye movements could serve as a practical, non-invasive tool to help doctors detect and monitor CSVD and its effects on cognition at an early stage. Since eye movement testing is relatively straightforward, it could potentially complement or supplement brain imaging in clinical assessments, offering a way to track disease severity and cognitive changes over time without requiring repeated MRI scans.
Wang F, Zhang X, Zhang X, Li L. (2026). Eye movement characteristics and their correlation with cognitive function in cerebral small vessel disease.. Frontiers in neurology. https://doi.org/10.3389/fneur.2026.1878897