ArticleJournal of neurology2026
What if it is the eyes? The effect of eye movement disorders on cognitive testing in MS.
Article in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Training effects in oculography in multiple sclerosis patients: a one-year longitudinal study.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026Article
- Visual impairment in multiple sclerosis involving post-geniculate gray and white matter: above and beyond.Frontiers in neurology · 2026Review
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
backgroundVisual cognitive tests that rely on saccades may be affected by internuclear ophthalmoplegia (INO), irrespective of cognitive ability. INO and cognitive decline are common in people with multiple sclerosis (PwMS). We assessed the impact of INO on visual versus non-visual cognitive tests in PwMS.
methodsPwMS (n=197) completed auditory and visual neuropsychological tests, and demographically corrected Z-scores were obtained. INO was quantified using the DEMoNS infrared oculography protocol, applying the versional dysconjugacy index (VDI) of area under the saccadic trajectory (AUC) and peak velocity amplitude ratio (pV/Am). A subset (n=102) was reassessed after 6 years. Regression models were adjusted for disease duration, disability, cortical grey matter, and thalamic volume.
resultsThe presence of (mild) INO alone (n=66, 34%) was not associated with visual cognitive test performance after adjusting for disease characteristics. However, more severe right-sided INO on leftward gaze was associated with poorer performance on the Symbol Digit Modalities Test (SDMT) and Concept Shifting Test (CST): 0.1 increase in leftward VDI-pV/Am corresponded to SDMT and CST Z-score reductions of -0.08 (95% CI -0.13 to -0.03) and -0.14 (95% CI -0.22 to -0.07), respectively. This effect was not observed for the Paced Auditory Serial Addition Test (PASAT). Longitudinally, new right-sided INO (n=2) corresponded with CST performance decline (Z-score -3.96, 95% CI -5.88 to -2.05), but not after adjustment for disease characteristics.
conclusionsSevere right-sided INO impairs performance on cognitive tests requiring rapid eye movements (e.g. SDMT, CST), independent of cognitive ability. These tests should be interpreted with caution in people with severe INO.
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