Study Rationale:
Over the past 14 years, we have utilized sophisticated commercial eye movement monitoring equipment to collect data from over 3300 participants. Our work aims to identify abnormal eye movement features in people with Parkinson’s disease (PD) that are not present in those with other movement disorders or in healthy individuals. Our preliminary studies in those with REM behavior sleep disorder (RBD), who are at a high risk for developing PD, suggest that eye movement testing may be used to rapidly, non-invasively and accurately detect PD at least 10 years before it is currently diagnosed.
Hypothesis:
We hypothesize that eye tracking can be used to accurately diagnose PD in those presenting symptoms, such as slowing of gait or tremor, as well as in those who are at risk but not yet showing clinical signs of PD.
Study Design:
This study will include multi-center teams of movement and sleep disorders clinicians, biomedical engineers and a statistician. In the first part of the study, 3 groups of participants who either have PD or a wide variety of other movement disorders, as well as healthy controls, will be evaluated with the aim of validating eye movement testing as a reliable means to confirm a diagnosis of PD. In the second part of the study, a larger group of participants who have RBD and normal neurological exams will be followed yearly with the aim of establishing eye movement testing as a reliable means to determine those will develop clinical PD.
Impact on Diagnosis/Treatment of Parkinson’s Disease:
Eye tracing technology is expected to overcome the current challenge of inaccurate and missed diagnoses of PD. Further, this technology is anticipated to permit screening among the general population for candidates for disease-modifying therapy trials well before the onset of motor symptoms, when such therapies should have their greatest impact.
Next Steps for Development:
With the completion of the proposed studies, we hope to establish collaborations with investigators and sponsors of novel disease-modifying therapies. Affordability, regulatory approval and reimbursement will be addressed prior to potential dissemination of this technology among generalists, optometrists/ophthalmologists, neurologists and other physicians.