Wang Raymond Kong, Kwong Kenneth, Liu Kevin, Kong Xue-Jun
Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Department of Mathematics and Statistics, University of Massachusetts Lowell, Lowell, MA, United States.
Front Psychiatry. 2024 Dec 11;15:1518180. doi: 10.3389/fpsyt.2024.1518180. eCollection 2024.
Eye tracking (ET) is emerging as a promising early and objective screening method for autism spectrum disorders (ASD), but it requires more reliable metrics with enhanced sensitivity and specificity for clinical use.
This study introduces a suite of novel ET metrics: Area of Interest (AOI) Switch Counts (ASC), Favorable AOI Shifts (FAS) along self-determined pathways, and AOI Vacancy Counts (AVC), applied to toddlers and preschoolers diagnosed with ASD. The correlation between these new ET metrics and Autism Diagnostic Observation Schedule, Second Edition (ADOS-2) scores via linear regression and sensitivity and specificity of the cut-off scores were assessed to predict diagnosis.
Our findings indicate significantly lower FAS and ASC and higher AVC (P<0.05) in children with ASD compared to their non-ASD counterparts within this high-risk cohort; the significance was not seen in total fixation time neither pupil size (p > 0.05). Furthermore, FAS was negatively correlated with ADOS-2 total scores and social affect (SA) subscale (p < 0.05). Among these new ET metrics, AVC yielded the best sensitivity 88-100% and specificity 80-88% with cut off score 0.305-0.306, followed by FAS and ASC to separate ASD from non-ASD for diagnosis.
This study confirms the utility of innovative ET metrics-FAS, AVC, and ASC-which exhibit markedly improved sensitivity and specificity, enhancing ASD screening and diagnostic processes.
眼动追踪（ET）正在成为一种有前景的用于自闭症谱系障碍（ASD）的早期客观筛查方法，但它需要更可靠的指标，以提高临床应用中的敏感性和特异性。
本研究引入了一套新颖的眼动追踪指标：感兴趣区域（AOI）切换计数（ASC）、沿自主确定路径的有利AOI转移（FAS）和AOI空缺计数（AVC），并将其应用于被诊断为ASD的幼儿和学龄前儿童。通过线性回归评估这些新的眼动追踪指标与《自闭症诊断观察量表第二版》（ADOS-2）得分之间的相关性，并评估截止分数的敏感性和特异性以预测诊断。
我们的研究结果表明，在这个高危队列中，与非ASD儿童相比，ASD儿童的FAS和ASC显著更低，AVC更高（P<0.05）；在总注视时间和瞳孔大小方面均未发现显著差异（p>0.05）。此外，FAS与ADOS-2总分和社会情感（SA）子量表呈负相关（p<0.05）。在这些新的眼动追踪指标中，AVC在截止分数为0.305 - 0.306时，产生了最佳的敏感性88 - 100%和特异性80 - 88%，其次是FAS和ASC，可用于区分ASD和非ASD以进行诊断。
本研究证实了创新的眼动追踪指标——FAS、AVC和ASC的实用性，这些指标表现出显著提高的敏感性和特异性，增强了ASD的筛查和诊断过程。
