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Eye-tracking technology: a tool to enhance understanding of memory complaints in COVID-19 survivors

Published online by Cambridge University Press:  06 January 2025

Julián Benito-León*
Affiliation:
Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain
José Lapeña-Motilva
Affiliation:
Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain
Cecilia García-Cena
Affiliation:
ETSIDI-Center for Automation and Robotics UPM-CSIC, Universidad Politécnica de Madrid, Madrid, Spain
*
Corresponding author: Julián Benito-León; Email: jbenitol67@gmail.com
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Abstract

Type
Letter to the Editor
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press

Dear Editor,

We read with great interest the recent article by Cerioli et al.,Reference Cerioli, Giacovelli and Nostro 1 titled “Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints,” published in CNS Spectrums. This study offers valuable insights into the neuropsychiatric sequelae of COVID-19, particularly the intersection of cognitive complaints and psychiatric diagnoses. While the study effectively highlights the importance of psychiatric screening, we believe additional perspectives could enhance the understanding and management of post-COVID condition.

Our team has extensively explored the use of, eye-tracking technology to detect subtle cognitive impairments across diverse populations,Reference Guerrero-Molina, Rodriguez-López, Panadés-de Oliveira, Uriarte-Pérez de Urabayen, Garzo-Caldas, García-Cena, Saiz-Díaz, Benito-León and Gonzalez de la Aleja 2 Reference Benito-León 5 with a particular focus on individuals affected by post-COVID condition.Reference García Cena, Costa, Saltarén Pazmiño, Santos, Gómez-Andrés and Benito-León 4 , Reference Benito-León 5 In patients with post-COVID condition, we identified distinct oculomotor patterns, such as impaired saccadic control,Reference García Cena, Costa, Saltarén Pazmiño, Santos, Gómez-Andrés and Benito-León 4 , Reference Benito-León 5 which suggest frontal-subcortical dysfunction. These findings align closely with those of Cerioli et al.,Reference Cerioli, Giacovelli and Nostro 1 who emphasized the need for comprehensive neuropsychiatric assessments. Incorporating eye tracking into future research could provide objective biomarkers to differentiate primary cognitive impairments from deficits driven by psychiatric conditions.

We also concur with Cerioli et al.,Reference Cerioli, Giacovelli and Nostro 1 on the importance of multidisciplinary care, particularly in addressing the stigma associated with psychiatric evaluations. Integrating cognitive assessments with noninvasive technologies like eye tracking may enhance patient engagement and foster a more holistic approach to managing post-COVID cognitive and emotional sequelae.

Additionally, the findings by Cerioli et al.,Reference Cerioli, Giacovelli and Nostro 1 on the relationship between untreated psychiatric illness and poorer clinical outcomes resonate with our own clinical observations. Our research underscores the value of early identification and intervention, with objective tools like oculomotor metrics serving as critical complements to traditional psychometric scales. These measures enhance diagnostic precision and support the monitoring of treatment response and recovery.

We commend the authors for their comprehensive work and advocate for incorporating advanced methodologies, such as eye tracking and other neurocognitive tools, into future research. Such integration could significantly refine the diagnostic and therapeutic strategies for patients with post-COVID cognitive and psychiatric sequelae, ultimately improving outcomes for this population.

Author contribution

Conceptualization: C.G., J.L., J.B.; Data curation: C.G., J.L., J.B.; Funding acquisition: C.G., J.B.; Investigation: C.G., J.L., J.B.; Methodology: C.G., J.L., J.B.; Project administration: C.G., J.L., J.B.; Resources: C.G., J.L.; Software: C.G., J.L., J.B.; Supervision: C.G., J.L., J.B.; Validation: C.G., J.L., J.B.; Visualization: C.G., J.L., J.B.; Writing – review & editing: C.G., J.L., J.B.; Formal analysis: J.L.; Writing – original draft: J.B.

Financial support

No specific funding was received for this work.

Competing interest

The authors declare that there are no conflicts of interest relevant to this work.

Ethical standard

We confirm that we have read the journal’s position on issues involved in ethical publication and affirm that this work is consistent with those guidelines.

References

Cerioli, M, Giacovelli, L, Nostro, C, et al. Post-COVID condition: a focus on psychiatric symptoms and diagnoses in patients with cognitive complaints. CNS Spectrums. 2024. https://doi.org/10.1017/S1092852924000464.CrossRefGoogle ScholarPubMed
Guerrero-Molina, MP, Rodriguez-López, C, Panadés-de Oliveira, L, Uriarte-Pérez de Urabayen, D, Garzo-Caldas, N, García-Cena, CE, Saiz-Díaz, RA, Benito-León, J, Gonzalez de la Aleja, J. Antisaccades and memory-guided saccades in genetic generalized epilepsy and temporal lobe epilepsy. Epilepsy Behav. 2021 Oct;123:108236. https://doi.org/10.1016/j.yebeh.2021.108236.CrossRefGoogle ScholarPubMed
García Cena, CE, Gómez-Andrés, D, Pulido-Valdeolivas, I, Sánchez-Seco, VG, Domingo-Santos, A, Moreno-García, S, Benito-León, J. Toward an automatic assessment of cognitive dysfunction in relapsing-remitting multiple sclerosis patients using eye movement analysis. Sensors (Basel) 2022 Oct 27;22(21):8220. https://doi.org/10.3390/s22218220.CrossRefGoogle ScholarPubMed
García Cena, C, Costa, MC, Saltarén Pazmiño, R, Santos, CP, Gómez-Andrés, D, Benito-León, J. Eye movement alterations in post-COVID-19 condition: a proof-of-concept study. Sensors (Basel). 2022 Feb 14;22(4):1481. https://doi.org/10.3390/s22041481.CrossRefGoogle ScholarPubMed
Benito-León, J, et al. Exploring cognitive dysfunction in long COVID patients: eye movement abnormalities and frontal-subcortical circuits implications via eye-tracking and machine learning. Am J Med. 2024. https://doi.org/10.1016/j.amjmed.2024.04.004.CrossRefGoogle ScholarPubMed