BackgroundVarious functional impairments in eye movements have been observed in Alzheimer's disease (AD) and other neurodegenerative disorders. Detecting abnormal eye movements may help identify individuals at risk of memory diseases even when evident clinical symptoms are absent.ObjectiveTo investigate the earliest possible stage at which the risk of memory impairment can be detected using computer-based eye-tracking (ET) analysis of King-Devick (KD) test performance.MethodsWe recruited a total of 34 healthy controls and 33 participants with a Clinical Dementia Rating-Sum of Boxes (CDR-SOB) score of 0.5 or higher. They all underwent a neurological examination, the Consortium to Establish a Registry for Alzheimer's Disease neuropsychological test battery (CERAD-NB), and a CDR interview. The KD reading test was performed using computer-based ET. We analyzed fixation durations, saccade durations, and saccade amplitudes. For this study, test results were analyzed in relation to CDR-SOB.ResultsThe mean duration of saccades was significantly shorter in the CDR-SOB 0.5 group compared to healthy controls (p = 0.001), and this difference remained significant across groups with CDR-SOB >0.5. The mean amplitude of saccades was significantly lower in individuals with CDR-SOB scores ranging from 1 to 4, as well as those with scores exceeding 4.5, in comparison to healthy controls (p = 0.007).ConclusionsThese findings suggest that ET analysis of the KD test may help detect individuals with very early cognitive problems. Therefore, this method shows promise as a supportive or potentially indicative biomarker for future studies aimed at developing user-friendly tools to identify individuals at risk for AD or other memory diseases.

The frontal eye field (FEF), a region of frontal cortex, has long been associated with the cortical control of eye movements. Classically, saccades can be reliably evoked by delivering low-intensity electrical microstimulation to the FEF. Although this makes clear the importance of FEF in the descending control of eye movements, the way in which population activity in the FEF is integrated by downstream regions to generate a motor command remains a mystery. To probe these mechanisms, we used a 16-channel microelectrode array to deliver microstimulation to the FEF of two awake, behaving monkeys. First, we found that larger current intensities were required to evoke changes in saccade direction relative to saccade amplitude when single-site saccades were evoked by stimulating a single contact on the array. Second, when stimulating two contacts simultaneously to investigate how population activity in the FEF is read out, a new polar average model more accurately predicted the amplitude and direction of dual-site saccades than traditional vector sum and vector average models. Using preexisting data from the superior colliculus (SC), we found that although the polar average model was more accurate at predicting saccade amplitude in the SC, it was no more accurate than traditional models at predicting saccade direction. Finally, when stimulating two contacts in FEF simultaneously with unequal current intensities, model accuracy depended on the amplitude of the saccades evoked by stimulating each individual site alone, suggesting that the brain may flexibly combine amplitude and direction information from the FEF to generate saccadic plans.

Lindsay-Hemenway syndrome (LHS) is characterized by an acute unilateral vestibular loss followed by ipsilateral posterior semicircular canal (PSC) benign paroxysmal positional vertigo (BPPV). Despite its clinical relevance, comparative data between LHS, isolated acute unilateral vestibulopathy (AUVP), and idiopathic PSC BPPV are uncommon. This work aims to compare vestibular function and clinical outcomes in patients diagnosed with LHS, isolated AUVP, and idiopathic PSC BPPV. A multicenter longitudinal study was conducted between 2018 and 2025, enrolling 98 patients divided into three groups: LHS (n = 36), isolated AUVP (n = 30), and idiopathic PSC BPPV (n = 32). Vestibular evaluation was assessed through video head impulse test (vHIT), evaluation of spontaneous nystagmus, and Dix-Hallpike maneuver. Primary outcomes included vestibular gain at baseline and 6 months, presence and characteristics of corrective saccades, number of repositioning maneuvers required, and time to symptom resolution. Patients with LHS showed significantly greater initial vestibular impairment in both affected and contralateral ears compared to isolated AUVP (p < 0.05) and demonstrated slower functional recovery at 6 months. Saccade amplitude was notably larger in LHS patients (p < 0.05), while latency and clustering were similar across groups. Spontaneous nystagmus persisted more frequently in the LHS cohort (OR 3.67). All LHS patients developed ipsilateral PSC BPPV, which required more repositioning maneuvers (p < 0.043) and presented a longer clinical course than idiopathic PSC BPPV (p < 0.05). Lindsay-Hemenway syndrome involves more severe vestibular dysfunction, slower recovery, and more persistent BPPV than isolated AUVP or idiopathic PSC BPPV.

The ability to quickly and precisely follow another person's gaze reflects critical evolutionary mechanisms underlying social interactions, such as attention modulation and the prediction of others’ future actions. Recent studies show that observers use another person's gaze direction and peripheral scene information to make anticipatory saccades toward the gaze goal. However, it remains unclear how these eye movements are influenced by complex features of natural scenes, such as a foveal gazer, multiple peripheral gaze goals, and the relative distance between gazer and goal. We presented dynamic stimuli (videos) of real-world scenes with or without a gazer shifting their head to gaze at other individuals (gaze goals). Participants were instructed to search for a specific target individual in the videos while their eye movements were recorded. We measured the accuracy of the first saccade in locating the gaze goal. First, we found that the absence of a foveal gazer significantly increased saccade error, but only when the goal was at least approximately 9 degrees of visual angle from the initial fixation. First saccade amplitude and onset latency were higher in the gazer-present condition. Second, when there were multiple potential gaze goals in the periphery, the first saccade was directed to the individual closer to the initial fixation (gazer) location. Finally, the presence of multiple peripheral gaze goals shortened saccade latencies and increased the frequency of anticipatory saccades made before the gazer completed their head movement. These findings extend our understanding of gaze following in complex, naturalistic scenes and inform theories of attention and real-world decision-making.

When visual input is uncertain, visual perception is biased toward the stimulation from the recent past. We can attend to stimuli either endogenously based on an internal decision or exogenously, triggered by an external event. Here, we wondered whether serial dependencies are selective for the attentional mode which we draw to stimuli. We studied overt attention shifts: saccades and recorded either motor error correction or visual orientation judgments. In Experiment 1, we assessed sensorimotor serial dependencies, focusing on how the postsaccadic error influences subsequent saccade amplitudes. In Experiment 2, we evaluated visual serial dependencies by measuring orientation judgments, contingent on the type of saccade performed. In separate sessions, participants performed either only voluntary saccades or only delayed saccades, or both saccade types alternated within a session. Our results revealed that sensorimotor serial dependencies were selective for the saccade type performed. When voluntary saccades had been performed in the preceding trial, serial dependencies were much stronger in the current trial if voluntary instead of delayed saccades were executed. In contrast, visual serial dependencies were not influenced by the type of saccade performed. Our findings reveal that shifts in exogenous and endogenous attention differentially impact sensorimotor serial dependencies, but visual serial dependencies remain unaffected.

IntroductionSpinocerebellar ataxias (SCA) form a group of dominantly inherited neurodegenerative diseases represented by progressive cerebellar ataxia and various other neurological deficits. SCA3 is the most prevalent type globally and represents 28% of the autosomal dominant cerebellar ataxias in The Netherlands. The associated oculomotor disorders, with distance esotropia as its hallmark, cause diplopia and often present early. To gain further insight into this, we examined eye movements made during a continuous visual stimulus tracking task (SONDA; Standardized Oculomotor and Neuro-Ophthalmic Disorder Assessment).MethodsThirteen genetically confirmed SCA3 cases underwent SONDA, both monocularly and binocularly. As a reference, we used previously collected data from 36 monocularly and 13 binocularly measured healthy subjects.ResultsSCA3 cases were well capable of tracking the moving stimulus, but they performed the task differently. More specifically, their eyes were not synchronized in their movements, and they made multiple small saccades in response to a large stimulus jump instead of a larger saccade followed by a small corrective saccade. The saccadic amplitude distribution shape was related to the severity of the oculomotor disorder, suggesting that the saccadic amplitude distribution could be used as a biomarker of disease severity.ConclusionOverall, this study highlights that eye-tracking during a standardized task can give valuable insights into how eye movements are affected in SCA3 and provides suggestions for potential biomarkers for severity and the associated treatment options. Longitudinal research is needed to elaborate on these findings and validate the proposed biomarkers.

BackgroundEye movement degradation occurs early in Alzheimer's disease (AD). Visual search paradigms demonstrate that AD patients show slower reaction times, greater time to first fixation, and longer fixation durations than controls. Such paradigms may be especially important for evaluating impairment in patients unable to complete traditional pen‐and‐paper neuropsychological assessments. We sought to evaluate the relationship between eye movement metrics and performance on traditional tests of visuospatial function, and investigate whether these relationships differed depending on stimulus category (affective face or neutral scene).MethodWe collected in‐scanner eye‐tracking data (area of interest (AOI) dwell time, fixation duration, and saccade amplitude) while participants freely viewed images of neutral scenes and affective faces, and out‐of‐scanner measures of spatial function and general cognition (WAIS‐III Blocks Design, Judgement of Line Orientation (JLO), Hooper Visual Organization Test (HVOT), and MMSE) in individuals with clinically heterogeneous AD (5 amnestic AD, 10 non‐amnestic AD) and age‐matched healthy controls (n = 19). We compared groups using one‐way ANOVA, Kruskal‐Wallis tests, and post‐hoc pairwise t‐tests as appropriate. Linear regression was used to compute the relationship between eye movement metrics and cognitive performance.ResultAs expected, amnestic AD participants underperformed on nearly all neuropsychological metrics compared to HC. Non‐amnestic AD participants performed significantly worse than amnestic AD and HC participants across tests of visuospatial function. We found no group differences in any eye‐tracking metric, regardless of stimulus, or in the overall relationship between eye‐tracking metrics and cognitive testing results. In non‐amnestic AD participants, fixation duration was negatively correlated with JLO and Block Design scores in face trials, but was positively correlated in scene trials.ConclusionNon‐amnestic AD participants showed different relationships between fixation duration and visuospatial function scores for face vs. scene trials, suggesting that more frequent sampling of regions of an affective face may improve visuospatial task performance in non‐amnestic AD participants. While preliminary, these findings suggest eye movement metrics may add meaningful information to our interpretation of neuropsychological test performance, and highlight the importance of considering eye movement performance in a clinical context.

BackgroundCognitive impairment (CI) presents significant challenges in neurodegenerative conditions and aging populations. Traditional cognitive assessment tools often face limitations such as high costs, accessibility barriers, and lengthy administration times. ViewMind Atlas™, a digital biomarker combining eye‐tracking technology and artificial intelligence, provides a novel, efficient approach to cognitive evaluation. This study aimed to evaluate the capacity of ViewMind Atlas™ to detect CI, correlate its results with the Montreal Cognitive Assessment (MoCA) and other neuropsychological tests, and assess its clinical validity.MethodThis cross‐sectional, single‐centre study included 154 participants aged 45–95 years with and without cognitive complaints. Cognitive assessments were performed using ViewMind Atlas™, which incorporates a head‐mounted display (HMD) with integrated eye‐tracking sensors. The system measured saccade amplitude, fixation duration, refixation rates, and response times during five validated visual tasks (Moving Dot, Go/No‐Go, New Colors, Color Combinations, and n‐back). Participants also completed the MoCA and a neuropsychological battery, including the Word Accentuation Test‐Buenos Aires (WAT‐BA), BEM‐144 Logical Memory and Serial Learning, Rey Complex Figure Test, Digit Span and Matrix Reasoning (WAIS‐III), Trail Making Tests A and B, Boston Naming Test, Phonological and Semantic Verbal Fluency Tests, and Clock Drawing Test. Statistical analyses included sensitivity, specificity, accuracy, and receiver operating characteristic (ROC) curves, as well as correlations between ViewMind metrics and cognitive test scores.ResultViewMind Atlas™ demonstrated a sensitivity of 78%, specificity of 70%, and balanced accuracy of 74% for CI detection. Significant correlations were observed between ViewMind metrics and MoCA scores and other neuropsychological test results (p <0.05), validating its ability to identify CI.ConclusionViewMind Atlas™, leveraging HMD‐based eye‐tracking technology, is a valid, efficient tool for detecting cognitive impairment. Its strong alignment with traditional cognitive assessments supports its potential for clinical and research applications.

Background: Eye-tracking technology enables the objective quantification of oculomotor behavior, providing key insights into visuocognitive performance. This study presents a comparative analysis of visual attention patterns between rhythmic gymnasts and school-aged students using an optical eye-tracking system combined with machine learning algorithms. Methods: Eye movement data were recorded during controlled visual tasks using the DIVE system (sampling rate: 120 Hz). Spatiotemporal metrics—including fixation duration, saccadic amplitude, and gaze entropy—were extracted and used as input features for supervised models: Support Vector Machine (SVM), k-Nearest Neighbors (k-NN), Decision Tree (CART), Random Forest, XGBoost, and a one-dimensional Convolutional Neural Network (1D-CNN). Data were divided according to a hold-out scheme (70/30) and evaluated using accuracy, F1-macro score, and Receiver Operating Characteristic (ROC) curves. Results: XGBoost achieved the best performance (accuracy = 94.6%; F1-macro = 0.945), followed by Random Forest (accuracy = 94.0%; F1-macro = 0.937). The neural network showed intermediate performance (accuracy = 89.3%; F1-macro = 0.888), whereas SVM and k-NN exhibited lower values. Gymnasts demonstrated more stable and goal-directed gaze patterns than students, reflecting greater efficiency in visuomotor control. Conclusions: Integrating eye-tracking with artificial intelligence provides a robust framework for the quantitative assessment of visuocognitive performance. Ensemble algorithms demonstrated high discriminative power, while neural networks require further optimization. This approach shows promising applications in sports science, cognitive diagnostics, and the development of adaptive human–machine interfaces.

Recent investigations have shown that the tympanic membranes exhibit synchronous oscillations with each saccadic eye movement (Gruters et al., 2018), a phenomenon known as eye movement-related eardrum oscillations (EMREOs). However, the dependence of these saccade-associated EMREOs on ongoing visual activity remains to be elucidated. Given the direct projections from motor areas to primary auditory and visual cortices and the observation that EMREOs' onset occurs concurrently with, or even precedes, saccades, we hypothesized that EMREOs would persist in the absence of visual stimulation. This report presents a study wherein sixteen healthy, male and female participants, executed horizontal saccades under three distinct conditions: i) in a well-lit environment, ii) in a darkened environment with eyes open, and iii) in a darkened environment with eyes closed. Ocular movements were quantified via electrooculography, and tympanic membrane oscillations were registered using in-ear microphones. The results demonstrated the presence of EMREOs concurrent with both visually guided and memory-guided saccades, although a late minor reduction in amplitude was observed in the 'dark with open eyes' condition. Significant attenuation of EMREOs was evident when participants performed saccades with their eyelids closed, despite maintaining the same saccade amplitude and initial velocity. This amplitude reduction may reflect modulations in cortical states associated with predictive coding.Significant Statement Eye movement-related eardrum oscillations (EMREOs) occur synchronously with saccadic eye movements and persist even in the absence of visual input, indicating that visual stimuli do not solely drive these oscillations. However, the amplitude of EMREOs decreases slightly when saccades are made in darkness and strongly decreases with eyes closed, despite consistent saccade metrics. This attenuation suggests that EMREOs are modulated by cortical states associated with predictive coding rather than just motor commands or sensory feedback. These findings highlight a complex interaction between motor activity, sensory processing, and cortical predictive mechanisms.

Background/Objectives: Children with dyslexia report poor motor control; several studies have shown poor eye movements control during reading and important body instability in these children. The present study aimed to test in children whether reading and postural abilities in children with dyslexia could benefit from a short combined reading and postural training program. Methods: Thirty-two children with dyslexia were randomly assigned to training group (G1) or control group (G2). All participants completed eye movements recording during reading and postural recording under an unstable support before and after the intervention. G1 underwent a 10 min combined reading and postural training while G2 had a 10 min rest. During reading, the reading time, the duration of fixations, as well as the occurrence, amplitude, and number of forward saccades (saccades from the left to the right) and backward saccades (saccades from the right to the left) were measured. The PII (postural instability index) was measured under unstable support. G1 exhibited a significant decrease after training in reading time, fixation duration, and the number of forward saccades. Furthermore, we observed a significant reduction in postural instability. In contrast, G2 failed to show any significant changes in eye movements and postural recordings. Conclusions: We suggest such a combined reading and postural training approach could help dyslexic children to improve motor abilities. Adaptive mechanisms through improved cerebellar activity could be responsible for such motor enhancement.

Are eye movements miscalibrated when the distance to be crossed is misperceived? The two-visual-stream hypothesis posits that while perception is influenced by visual context and thus prone to illusions, actions rely on context-independent metrics and are thus unaffected by such distortions. In contrast, empirical evidence consistently shows that saccadic eye movements are influenced by the Müller-Lyer illusion. However, this finding could be explained by saccades being attracted toward the figure's center of gravity, while perceptual distortion would result from distinct mechanisms. To disentangle these effects, we conducted four experiments (N = 114) between 2022 and 2025, measuring the amplitude of saccades performed along horizontal lines embedded in Müller-Lyer figures carefully designed to control for center-of-gravity biases. Results showed that both saccade amplitude and length judgment were systematically modulated by the illusion beyond what could be attributed to changes in the actual center of gravity, its saliency, or computation time. Additionally, the illusion's influence on saccade amplitude diminished after a longer previewing time (2,000 ms) compared to a shorter one (50 ms). These findings support the hypothesis that perception and oculomotor behavior rely on a shared visual representation that is influenced by contextual information but becomes more precise with increased processing time. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Reactive saccades are rapid eye movements performed toward salient stimuli. Saccadic adaptation maintains the accuracy of visual reactive saccades throughout life and is thought to occur at the motor level of the saccade circuitry. Recently, we revealed that saccadic adaptation also emerges with non-visual, namely tactile targets (Batikh et al. J Neurophysiol 132: 1183-1197, 2024). In addition, such adaptation of tactile saccades transferred partially to nonadapted visual reactive saccades of similar amplitude, compared with a complete visual-to-tactile transfer, suggesting the adaptation occurred upstream of the motor level common to all saccade modalities. Here, we test whether and how saccadic adaptation and transfer occur for auditory saccades. Experiment 1 tested the visual-to-auditory transfer of both backward and forward adaptation whereas experiment 2 investigated the possibility of adapting auditory saccades and the extent to which such adaptation transfers to visual saccades. Experiment 1 revealed a strong visual-to-auditory transfer of both forward and backward adaptations. In experiment 2, stepping the auditory target to another location while the saccade was in flight induced backward adaptation, but could not elicit any significant forward adaptation. Furthermore, we found a partial auditory-to-visual transfer of backward adaptation, in agreement with our previous findings regarding tactile saccades adaptation. This work brings additional insights into our understanding of saccadic adaptation, highlighting the adaptive functional levels of the different saccade modalities.NEW & NOTEWORTHY In this study, we showed that both backward and forward adaptations of visual reactive saccades transfer to nonadapted auditory saccades. Furthermore, we were able to induce a decrease in auditory saccades amplitude when stepping the target sound backward while the saccade was inflight. This indicates that auditory saccades can be subject to adaptive amplitude changes, which, however, are transferred only partially to visual saccades, pointing to the presence of modality-specific adaptation sites.

Understanding the neurocognitive underpinnings of driving behavior in adolescents is critical to improving road safety. To address this, we established a novel paradigm linking magnetoencephalography (MEG)-recorded frequency-specific brain activity to simulated driving performance, identifying periods of increased cognitive control. However, this initial paradigm did not incorporate eye-tracking – a potentially scalable proxy for cognitive control that could be leveraged by in-vehicle driver monitoring systems. This proof-of-concept study expands our paradigm by integrating eye-tracking to identify scanning behavior metrics associated with periods of increased cognitive control validated by MEG. Typically developing adolescents (n = 11; mean age = 15.1 ± 1.5 yrs) completed three driving tasks of varying cognitive demand, and MEG frequency specific analysis confirmed periods of high (Hi) and low (Lo) cognitive control via the established biomarker of frontal midline theta (FMT). Fixation count, fixation duration, horizontal/vertical mean gaze position, saccade amplitude, and horizontal/vertical spread of search were compared between Hi vs. Lo periods of cognitive control. Task-specific differences in fixation count (p < 0.05), mean gaze position (p < 0.01), saccade amplitude (p < 0.05), and spread of search (p < 0.01) were observed between Hi compared to Lo cognitive control periods. These differences corresponded to expected task-specific changes in scanning behavior that would accompany cognitive control over behavior, suggesting a signal that eye-tracking may serve as a proxy for underlying neurocognitive processes. This integrated approach demonstrates methodological rigor and offers a promising framework for further research and informing development of in-vehicle driver monitoring systems for detecting cognitive deficits in real time, with implications for enhancing teen driver safety.

Supplemental Material for The Time-Dependent Modulation of Saccade Amplitude by Illusory Length Reflects a Shared Representation Between Perception and Action

Two-month antipsychotic exposure induces domain-specific eye movement alterations in clinical high-risk individuals.

Sport-related concussion (SRC) is a public health crisis that results in growing diagnoses each year. Recent evidence suggests that there are oculomotor deficits present in patients with SRC. It is unclear if this oculomotor deficit is linked to other clinical outcomes or lingers beyond clinical symptom resolution. The purpose of this study is to investigate the progression of oculomotor and clinical deficits following SRC at the acute stage of injury and again when they are clinically considered fully symptom-free for at least 24 h. 13 NCAA athletes completed a multifaceted concussion battery that included postural (tandem gait), symptom provocation (Vestibular/Ocular Motor Screening), and oculomotor assessments (eye-tracking) once within 48 h of diagnosis of SRC (AC) and again once free of symptoms (SF). Significant group differences were observed in several oculomotor metrics. Both AC and SF groups exhibited elevated peak saccadic velocity and acceleration compared to controls (p < 0.01), with no significant difference between AC and SF. Saccadic amplitude was significantly reduced in both AC and SF groups relative to controls (p < 0.001). The number of masked saccades during SP was lower in the AC group than in controls (p = 0.05), but this difference was not observed in the SF group. No significant group differences were found for saccade duration or SP velocity. There are still oculomotor deficits that persist when SRC student-athlete patients’ injuries are deemed clinically resolved. Lingering issues are not uncommon; however, these functional eye movement deficits are concerning and warrant additional research.

ObjectiveColor and spatial location are key cues influencing visual selection in binocular color rivalry, jointly modulating attentional resource allocation and prefrontal cortex (PFC) activity. However, how these cues—individually and in combination—regulate ocular behavior and PFC activation remains insufficiently understood and lacks systematic empirical investigation.MethodsThis study integrates eye tracking, functional near-infrared spectroscopy (fNIRS), and reaction time measurements to systematically investigate the cortical and oculomotor response characteristics under a binocular rivalry paradigm, focusing on color rivalry (Color stimuli), spatial location (Location stimuli), and their combined (Color & Location stimuli).ResultsThe results revealed that Color stimuli elicited rapid saccades, significant pupil dilation, and a decrease in prefrontal HbO concentration. Location stimuli induced stable saccadic patterns and a typical biphasic HbR response in BA46. The combined Color & Location stimuli triggered significant changes in oculomotor behavior during the later processing stage, accompanied by a marked increase in HbO activation in BA10, suggesting its dominant role in multisensory integration and cognitive resource reallocation. Further coupling analyses showed a significant positive correlation between prefrontal HbO concentration and reaction time (r = 0.555, p < 0.01), and a significant negative correlation between HbO concentration and saccade amplitude (r = –0.376, p < 0.05), consistent with the theoretical predictions of the “neural efficiency–cognitive load trade-off” model. Task-dependent coupling relationship were also observed among oculomotor parameters and between eye movement and cerebral hemodynamic signals.ConclusionColor stimuli induce rapid saccadic behavior and impose higher prefrontal load, Location stimuli engage a more efficient dorsal pathway, while Color & Location stimuli intensify resource rivalry and induce a processing bottleneck, manifested as prolonged reaction times co-occurring with heightened cortical activation.

Industry 5.0 represents the next frontier in advancing human-machine interfaces through human-centric approaches. This paper outlines industrial regulations emphasizing operators’ cognitive and physiological capabilities in HMI design for control systems. Through process control cases, we demonstrate how eye-tracking captures operators’ engagement with interfaces and perception of design elements. Fixation, scan path, and saccadic measures effectively evaluate attention allocation and search efficiency. Pupil size, blink rate, and saccade amplitude support in assessing mental workload under changing HMI configurations. Findings remain preliminary; involving experienced operators and diverse scenarios could improve generalizability and promote practitioner engagement to develop human-centered HMIs for industrial applications.

Functional neurological disorders (FND) can include various sensory, motor or cognitive symptoms. Eye movement recordings, measured through video-oculography, could serve as biomarkers for characterizing these dysfunctions in FND. To identify oculomotor patterns that may help to support a positive diagnosis of FND. We conducted a retrospective analysis of video-oculography recordings performed between 2011 and 2023 in 149 patients with FND, focusing on horizontal and vertical prosaccades, smooth pursuit, and antisaccades. These data were compared with those obtained from 132 age and gender-matched healthy volunteers and 43 patients diagnosed with multiple sclerosis (MS). FND patients exhibited significantly increased mean saccade latencies in both horizontal and vertical prosaccade tasks compared to controls (t-test, P < 0.0001). Additionally, variability in horizontal and upward saccade latency was substantially greater in the FND group than in the control and MS groups (P < 0.0001). Vertical saccades in FND patients were hypometric (P < 0.0001) with increased variability of upward saccade amplitude (P < 0.0001). Both MS and FND patients had higher antisaccade error rates than controls (P < 0.0001). These findings suggest that video oculography may be useful in understanding the pathophysiology of FND and highlight its potential as a complementary tool to support diagnostic reasoning in complex clinical presentations.