Gaze-control training in a sample of inattentive young adults: A Confidence-in-Concept study of neural mechanisms

Abstract Background Mounting evidence links attentional disorders to impairments in oculomotor control. Moreover, the brain’s oculomotor control network forms the backbone of neurocognitive systems typically impaired in neurodevelopmental conditions like Attention Deficit/Hyperactivity Disorder (ADHD). RECOGNeyes is an eye-tracker controlled computerised cognitive training game designed to improve oculomotor control. In this confidence-in-concept study, we investigated the effects of RECOGNeyes training on oculomotor control and its neurological correlates in an inattentive sample of young adults. Methods Thirty-five participants receiving support for ADHD, dyslexia or a related condition, were randomised to two, three, or four RECOGNeyes training sessions per week, at home, for two weeks. Total training time was recorded. Outcomes included measures of reading efficiency, and performance on an antisaccade task, during which brain oscillations were recorded magnetoencephalography. Electrophysiological measures included anticipatory alpha-band oscillatory amplitude in the frontal eyefields, and anticipatory beta-band amplitude in dorsolateral pre-frontal cortex. Oculomotor network connectivity at rest was measured using functional magnetic resonance imaging. Results Antisaccade task performance and oculomotor indices of reading efficiency improved after training, regardless of achieved training time. Greater total RECOGNeyes training time was associated with greater improvements in antisaccade performance; reduced fixation durations during reading; and greater anticipatory reductions in FEF alpha and DLPFC beta that were also associated with reduced antisaccade reaction time cost. Greater training time was also associated with reduced between-hemisphere resting-state connectivity, and increased within-hemisphere connectivity in the left hemisphere. Conclusions We found evidence that RECOGNeyes gaze-control training improves oculomotor control, with possible transfer to reading efficiency, as well as associated changes in electrophysiological correlates of anticipatory attention. Resting state connectivity changes suggest plastic changes within the oculomotor network in the direction of increased hemispheric independence. Next steps will be to establish whether the effects of RECOGNeyes transfer to real-world benefits in children with neurodevelopmental conditions like ADHD. Funding statement This project was funded MRC Confidence in Concept award (Grant ID CiC2017026); Wellcome Seed Award (202122/Z/16/Z); an MRC PhD studentship (AW); and a PhD studentship funded by Institute of Mental Health (PC). Competing Interest Statements PC and EL have a revenue-sharing agreement with the University of Nottingham regarding inventors’ share of any revenue accruing to the University arising from future commercialisation of the RECOGNeyes. Author Declarations I confirm all relevant ethical guidelines have been followed and all necessary ethics committee approvals have been obtained.