Augmenting dementia cognitive assessment with instruction-less eye-tracking tests

Mengoudi, Kyriaki, Ravi, Daniele, Yong, Keir X.X., Primativo, Silvia, Pavisic, Ivanna M., Brotherhood, Emilie, Lu, Kirsty, Schott, Jonathan M., Crutch, Sebastian J. and Alexander, Daniel C. (2020) Augmenting dementia cognitive assessment with instruction-less eye-tracking tests. IEEE Journal of Biomedical and Health Informatics, 24 (11): 9124654. pp. 3066-3075. ISSN 2168-2194
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Eye-tracking technology is an innovative tool that holds promise for enhancing dementia screening. In this work, we introduce a novel way of extracting salient features directly from the raw eye-tracking data of a mixed sample of dementia patients during a novel instruction-less cognitive test. Our approach is based on self-supervised representation learning where, by training initially a deep neural network to solve a pretext task using well-defined available labels (e.g. recognising distinct cognitive activities in healthy individuals), the network encodes high-level semantic information which is useful for solving other problems of interest (e.g. dementia classification). Inspired by previous work in explainable AI, we use the Layer-wise Relevance Propagation (LRP) technique to describe our network's decisions in differentiating between the distinct cognitive activities. The extent to which eye-tracking features of dementia patients deviate from healthy behaviour is then explored, followed by a comparison between self-supervised and handcrafted representations on discriminating between participants with and without dementia. Our findings not only reveal novel self-supervised learning features that are more sensitive than handcrafted features in detecting performance differences between participants with and without dementia across a variety of tasks, but also validate that instruction-less eye-tracking tests can detect oculomotor biomarkers of dementia-related cognitive dysfunction. This work highlights the contribution of self-supervised representation learning techniques in biomedical applications where the small number of patients, the non-homogenous presentations of the disease and the complexity of the setting can be a challenge using state-of-the-art feature extraction methods.


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