Can Eye Tracking Predict Cognitive Function in Neglected Stroke Patients? A method Proposal
Authors:   Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil, Aching Nicole C. , Marques Lucas M. ,   Mental Health Department, Santa Casa of Sao Paulo Medical Science School, São Paulo, SP, Brazil, Cruz Sheila ,   Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil, Terranova Thais ,   Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil, Maki Eduardo ,   Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil, Fregni Felipe ,   Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA, Battisttella Linamara R. ,   Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil,   Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil, Simis Marcel ,   Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, SP, Brazil,   Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Published: May 2024

Stroke remains a significant public health challenge in Brazil, leading to permanent motor, functional, and cognitive problems that will impact the quality of life of patients and their families. The comprehensive evaluation of these deficits poses a substantial challenge in rehabilitation, particularly when assessing the interplay between cognitive impairments and motor function. While validated clinical tests exist for individual motor and cognitive assessments, a defined methodology for assessing both domains while performing tasks, such as gaming, with the upper limb affected by stroke, is lacking. This methodology article aims to demonstrate the feasibility of using the eye-tracking system to map the eye movement of stroke patients during training with an exoskeleton associated with virtual reality gaming. Additionally, it will introduce new technology for cognitive assessment of stroke patients by integrating both systems. The present methodology will include five stroke patients diagnosed at the brain injury outpatient clinic of the Institute of Physical Medicine and Rehabilitation, Clinical Hospital, School of Medicine, University of Sao Paulo (IMREA-HCFMUSP), according to the following criteria: age over 18 years, both genders, clinical and radiological diagnosis (Magnetic Resonance Imaging and/or Computed Tomography) of stroke, right or left hemiparesis. A control group of five healthy subjects will be collected for comparative analysis. This method will evaluate the feasibility of combining eye-tracking and virtual reality gaming through an exoskeleton to predict cognition in stroke patients. The innovative integration of these technologies offers a promising avenue for advancing our understanding of the complex interactions between motor and cognitive functions in the rehabilitation of stroke survivors.