Eye-Tracking Technology: A Promising Tool for Assessing Cognitive Functions in DOC Patients. Results from a Multicenter Clinical Trial

Background. The proper assessment of cognitive functioning is the subject of numerous scientific studies. Current behavioral methods essentially preclude this assessment in patients with disorders of consciousness (DOC). However, the development of eye-tracking technology and the establishment of contact via this channel have created an opportunity to diagnose the cognitive function (CF) of DOC patients. The purpose of this study was to assess the level of CF of DOC patients for whom vision is the only channel of communication, conducted using eye tracking technology. Methods. The clinical multicenter study involved 31 DOC patients, whose attention, language functions, visual-spatial functions, personal orientation, memory, and abstract thinking were assessed three times (T1-T3) using the Cognitive Functions Assessment (CFA) scale, installed on the C-EYE X system. The data obtained were compared with the CF assessment results obtained with the CRS-R, and then statistically analyzed. Results. There were no statistically significant differences between different time points. Patients scoring higher on the CRS-R receive progressively lower values on the CFA. Statistically significant and moderate correlations were found between the CFA and CRS-R. Conclusions. The results of the study indicate that the diagnosis of CF made with the use of the CFA takes greater account of the diversity of CFs as well as makes their assessment independent of the experience of the examiner and the cooperation of the patient. The use of eye tracking technology, without reducing the quality of the examination, reduces the cost of working with patients by reducing the workload of qualified personnel. The study was registered on the ClinicalTrials.gov clinical trials platform ID NCT05536921.