SCIENCE@home

Oculometric Assessment of Sensorimotor Impairment Associated with Liver Disease Is as Sensitive as Standard of Care Cognitive Tests

Dorion Liston,Katherine Wong,A. Yeoh,Shalonda R. Haywood,A. Goel,Paul Kwo,Quinn Kennedy,Philip N Okafor

Published 2025 in Geriatrics

ABSTRACT

Significance: Hepatic encephalopathy (HE) occurs in 20–80% of patients with liver cirrhosis, impacting attention, memory, processing speed, and visuospatial skills. HE standard-of-care psychometric assessments are time-consuming and require staff training. Oculometrics may provide a fast, non-invasive brain health assessment that can be self-administered in a medical environment. Purpose: We investigated whether an oculometric assessment could measure the severity of HE as accurately as standard-of-care psychometric methods. Methods: Forty-eight participants (19 with decompensated cirrhosis, 10 with compensated cirrhosis, 19 controls) completed a previously validated five-minute oculometric test and the standard-of-care psychometric hepatic encephalopathy (PHE) battery. The oculometric test consists of following a dot as it moves across a computer screen and generates 10 metrics including a summary score called nFit. The PHE battery entails five standard cognitive tests, generating seven metrics including a PHE composite score (PHES). Results: The oculometric summary score, nFit, correlated with the current diagnostic standard, the PHES (r = 0.51, p < 0.001), the presence or absence of HE as determined by PHES composite (r = −0.44, p < 0.001), as well as the severity of cirrhosis (r = −0.59, p < 0.001). Additionally, performance on both nFit and PHES distinguished compensated (ROC: nFit: 0.71, PHES: 0.68) and decompensated (ROC: nFit: 0.88, PHES: 0.85) patient groups from control participants comparably. Finally, compared to participants with decompensated cirrhosis, control participants had better scores for almost all oculometrics: acceleration, catch-up saccade amplitude, proportion smooth, direction noise, and speed noise. Conclusions: Patients with liver disease showed impairment on multiple aspects of visual processing compared to a control group. These functional visual processing impairments correlate with the presence or absence of HE, showing significant sensitivity in distinguishing people with HE from controls. Oculometric tests provide a quick, non-invasive functional assessment of brain health in patients with liver disease, with sensitivity indistinguishable from standard-of-case psychometric tests.

PUBLICATION RECORD

CITATION MAP

EXTRACTION MAP

CLAIMS

  • No claims are published for this paper.

CONCEPTS

  • No concepts are published for this paper.

REFERENCES

Showing 1-41 of 41 references · Page 1 of 1

CITED BY

  • No citing papers are available for this paper.

Showing 0-0 of 0 citing papers · Page 1 of 1