Krebs Christine, Falkner Michael, Niklaus Joel, Persello Luca, Klöppel Stefan, Nef Tobias, Urwyler Prabitha
University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
Gerontechnology & Rehabilitation group, University of Bern, Bern, Switzerland.
JMIR Serious Games. 2021 Mar 22;9(1):e24151. doi: 10.2196/24151.
Recent studies suggest that computerized puzzle games are enjoyable, easy to play, and engage attentional, visuospatial, and executive functions. They may help mediate impairments seen in cognitive decline in addition to being an assessment tool. Eye tracking provides a quantitative and qualitative analysis of gaze, which is highly useful in understanding visual search behavior.
The goal of the research was to test the feasibility of eye tracking during a puzzle game and develop adjunct markers for cognitive performance using eye-tracking metrics.
A desktop version of the Match-3 puzzle game with 15 difficulty levels was developed using Unity 3D (Unity Technologies). The goal of the Match-3 puzzle was to find configurations (target patterns) that could be turned into a row of 3 identical game objects (tiles) by swapping 2 adjacent tiles. Difficulty levels were created by manipulating the puzzle board size (all combinations of width and height from 4 to 8) and the number of unique tiles on the puzzle board (from 4 to 8). Each level consisted of 4 boards (ie, target patterns to match) with one target pattern each. In this study, the desktop version was presented on a laptop computer setup with eye tracking. Healthy older subjects were recruited to play a full set of 15 puzzle levels. A paper-pencil-based assessment battery was administered prior to the Match-3 game. The gaze behavior of all participants was recorded during the game. Correlation analyses were performed on eye-tracking data correcting for age to examine if gaze behavior pertains to target patterns and distractor patterns and changes with puzzle board size (set size). Additionally, correlations between cognitive performance and eye movement metrics were calculated.
A total of 13 healthy older subjects (mean age 70.67 [SD 4.75] years; range 63 to 80 years) participated in this study. In total, 3 training and 12 test levels were played by the participants. Eye tracking recorded 672 fixations in total, 525 fixations on distractor patterns and 99 fixations on target patterns. Significant correlations were found between executive functions (Trail Making Test B) and number of fixations on distractor patterns (P=.01) and average fixations (P=.005).
Overall, this study shows that eye tracking in puzzle games can act as a supplemental source of data for cognitive performance. The relationship between a paper-pencil test for executive functions and fixations confirms that both are related to the same cognitive processes. Therefore, eye movement metrics might be used as an adjunct marker for cognitive abilities like executive functions. However, further research is needed to evaluate the potential of the various eye movement metrics in combination with puzzle games as visual search and attentional marker.
近期研究表明，电脑益智游戏趣味性强、易于操作，且能调动注意力、视觉空间能力和执行功能。除了作为一种评估工具外，它们可能有助于缓解认知衰退中出现的损伤。眼动追踪可对注视进行定量和定性分析，这对于理解视觉搜索行为非常有用。
本研究的目的是测试在益智游戏中进行眼动追踪的可行性，并使用眼动追踪指标开发认知表现的辅助标志物。
使用Unity 3D（Unity Technologies）开发了一款具有15个难度级别的桌面版三消益智游戏。三消益智游戏的目标是通过交换两个相邻的游戏元素，找到可以变成一排3个相同游戏元素（方块）的组合（目标图案）。通过操纵游戏板大小（宽度和高度从4到8的所有组合）和游戏板上独特方块的数量（从4到8）来创建难度级别。每个级别由4个游戏板（即要匹配的目标图案）组成，每个游戏板有一个目标图案。在本研究中，桌面版游戏在配备眼动追踪设备的笔记本电脑上呈现。招募健康的老年受试者来玩全套15个益智游戏级别。在玩三消游戏之前，进行了纸笔评估测试。在游戏过程中记录所有参与者的注视行为。对眼动追踪数据进行年龄校正后的相关分析，以检查注视行为是否与目标图案和干扰图案相关，以及是否随游戏板大小（集合大小）而变化。此外，还计算了认知表现与眼动指标之间的相关性。
共有13名健康老年受试者（平均年龄70.67[标准差4.75]岁；年龄范围63至80岁）参与了本研究。参与者总共玩了3个训练级别和12个测试级别。眼动追踪总共记录了672次注视，其中525次注视在干扰图案上，99次注视在目标图案上。发现执行功能（连线测验B）与干扰图案上的注视次数（P = 0.01）和平均注视次数（P = 0.005）之间存在显著相关性。
总体而言，本研究表明，益智游戏中的眼动追踪可以作为认知表现数据的补充来源。执行功能的纸笔测试与注视之间的关系证实，两者都与相同的认知过程相关。因此，眼动指标可能用作执行功能等认知能力的辅助标志物。然而，需要进一步研究来评估各种眼动指标与益智游戏结合作为视觉搜索和注意力标志物的潜力。
