Objective: To assess the feasibility of eye-tracking metrics in a Visual Paired Comparison (VPC) task as biomarkers for impulsivity in Parkinson’s disease (PD) and to examine the interplay between personality traits, medication use, and disease progression.

Background: PD involves motor and non-motor symptoms, including cognitive decline and novelty-seeking changes. Reduced novelty preference has been linked to executive dysfunction and dopaminergic alterations (Paulk & Neilson, 2024). The VPC task assesses visual attention and memory, relying on the tendency to fixate longer on novel stimuli. In PD, disrupted scanning behavior may reflect cognitive changes, making eye-tracking a valuable assessment tool (Lagun et al., 2011). However, factors like posture and dyskinesias may affect accuracy (Jiang et al., 2025).

Method: Four PD participants completed a VPC task in two rounds (VPC1 and VPC2), recording fixation patterns and gaze duration. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA), FAS verbal fluency, Frontal Assessment Battery (FAB), and D-KEFS Color-Word Interference Test (CWIT). Impulsivity traits were evaluated with the Questionnaire for Impulsive-Compulsive Disorders in Parkinson’s Disease (QUIP-RS). Data on medication use (donepezil, amantadine), dyskinesias, and levodopa equivalent daily dose (LEDD) were collected. One participant (NSPD001) was excluded due to severe anterocollis, affecting eye-tracking alignment. Descriptive statistics summarized demographic and clinical characteristics.

Results: The three analyzed participants had a mean MoCA score of 25.25. Executive function performance varied. QUIP-RS scores showed heterogeneity, with minimal gambling but higher hobbyism and eating-related impulsivity. VPC results suggested individual differences in novelty preference.

Conclusion: This study supports the feasibility of integrating eye-tracking with cognitive assessments in PD. Visual scanning and novelty preference may be influenced by medication and disease progression. Postural abnormalities, such as anterocollis, can hinder accuracy, necessitating stabilization equipment. These findings support eye-tracking as a potential biomarker for cognitive and behavioral phenotypes in PD, laying the groundwork for further research on personality traits, medication effects, and disease progression.

References: Paulk, K., & Neilson, L. E. (2024). Novelty Seeking in Parkinson’s Disease: A Candidate Biomarker for Cognitive Changes. International Journal of Translational Medicine, 4(4), 608–617.
Jiang, M., Liu, Y., Cao, Y., Xia, S., Teng, F., Zhao, W., Lin, Y., & Liu, W. (2025). Diagnosis of Parkinson’s Disease by Eliciting Trait-Specific Eye Movements in Multi-Visual Tasks. Journal of Translational Medicine, 23(1), 65.
Lagun, D., Manzanares, C., Zola, S. M., Buffalo, E. A., & Agichtein, E. (2011). Detecting Cognitive Impairment by Eye Movement Analysis Using Automatic Classification Algorithms. Journal of Neuroscience Methods, 201(1), 196–203.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/exploring-visual-scanning-behavior-and-novelty-seeking-in-parkinsons-disease-a-pilot-study/