[Correlation between eye movement and white matter hyperintensity characteristics in patients with cerebral small vessel disease].

objectivesThe mechanism of abnormal eye movements in patients with cerebral small vessel disease (CSVD) remains unclear. This study aims to explore the potential link between eye movement in CSVD patients and the severity and distribution of white matter hyperintensities (WMH), and to evaluate the possibility of using eye movement assessment as a tool for specific diagnosis.

methodsThis retrospective cross-sectional study was conducted at Xiangya Hospital, Central South University between September 7th, 2022 and October 27th, 2023, enrolling a total of 161 patients with CSVD. Demographic characteristics, past medical history, medication history, and imaging data were collected. The Montreal Cognitive Assessment (MoCA) was used to evaluate patients' cognitive function, and the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were used to assess patients' anxiety and depressive symptoms. All participants completed the EyeKnow Intelligent Eye Movement Analysis System within one week of enrollment, with data recorded on the following eye movement paradigms: saccade, smooth pursuit, fixation, and antisaccade. WMH were scored using both the Age-Related White Matter Change (ARWMC) scale and the Fazekas grading system. Based on the scores, patients were categorized into three severity groups (mild, moderate, severe). The Kruskal-Wallis rank sum test was used to analyze intergroup differences, while Spearman correlation analysis and multiple linear regression were used to explore the relationship between eye movement characteristics and WMH. Receiver Operating Characteristic (ROC) curve analysis was performed to evaluate the ability of eye movement characteristics to discriminate between patients with and without WMH in the five brain regions: frontal lobe, temporal lobe, parietal-occipital lobe, infratentorial region, and basal ganglia region. A weighted random forest model was developed to assess the performance of eye movement characteristics in predicting WMH severity at different locations.

resultsThis study enrolled a total of 161 patients with CSVD. Baseline data were collected for all participants. According to the total ARWMC scores, patients were divided into a mild (0 to 10 points), a moderate (11 to 20 points), and a severe (21 to 30 points) WMH groups. The mild WMH group included 100 patients [66 males and 34 females, age (61.40±9.45) years]. The moderate WMH group included 46 patients [32 males and 14 females, age (63.72±8.77) years]. And the severe WMH group included 15 patients [12 males and 3 females, age (63.47±10.40) years]. Significant differences were observed among the 3 groups in MoCA scores (

conclusionsThe eye movement performance of CSVD patients worsens with the increasing severity of WMH, especially in the frontal lobe and infratentorial region. Cognitive function exerts an influence on eye movement that appears largely independent of imaging changes.