New research published in Psychiatric Research: Neuroimaging We found that adolescents with major depressive disorder exhibit abnormal eye movement patterns associated with cognitive problems such as memory and attention deficiencies. Using visual techniques, the researchers compared the visual behavior of adolescents, with or without depression during different visual tasks. They found that certain eye movement characteristics differed significantly in adolescents with depression and were associated with poor performance on cognitive testing.
Major depressive disorders often begin in adolescence. This is a period of intense emotional, social and cognitive development. Not only does depression in teenagers become more common, they tend to recur and interfere in many areas of life, including school, family relationships, and social functioning. In many cases, cognitive difficulties such as memory, attention, and understanding social cues can persist, even if mood symptoms improve with treatment. These issues can make it difficult for adolescents to return to normal daily activities, and can contribute to lower outcomes of treatment and higher recurrence rates.
In recent years, researchers have been interested in using vision techniques as a non-invasive method for studying how the brain processes information. Eye movements are known to reflect underlying cognitive processes, such as how often you can see a particular part of an image or how often you can follow a moving object. For example, smooth, tuned eye movements require attentional control, whereas frequent or unstable eye movements may indicate difficulties in focus and information processing. As brain regions involved in eye control also play a role in cognitive function, researchers wanted to investigate whether eye movement patterns could serve as indicators of cognitive problems in adolescents with a decline.
This study was conducted by researchers at the second Xiangya Hospital at Central South University in China. They recruited a total of 113 participants, ages 12-17. Of these, 71 had been diagnosed with major depressive disorder, while the remaining 42 were healthy adolescents without mental illness. All participants had normal or corrected vision, with visual acuity excluded with other medical or neurological problems. Researchers collected demographic information, assessed depression severity using a standardized questionnaire, and used a series of neuropsychological tests to assess cognitive performance.
Cognitive tests included measures of memory, attention, language, and social reasoning. For example, we assessed mood symptoms using the Inventory of Child Depression and Hamilton’s Depression Scale, whereas reproducible batteries for assessment of neuropsychological states (RBANS) measured various areas of cognitive function. Social cognition was assessed using a test designed to measure the ability to detect social branders known as the fake PAS test.
Eye movement data were collected using a high-precision eye tracker that monitors the dominant eyes while participants completed two tasks. The first was a Freeview task, where participants were presented with a series of neutral images, including landscapes and geometric shapes, for 8 seconds each. The second was a smooth tracking task, involving tracking dot movements with complex sine wave patterns on the screen. The researchers measured various aspects of eye movement, including how many times participants saw different parts of the image (fixed counts), how long the eyes still remained (fixed period), and how quickly the eyes moved (saccade measurements).
Comparing the groups, researchers found several differences in both cognitive function and eye movement patterns. Depressed adolescents scored significantly lower overall cognitive performance, particularly in areas related to immediate memory, attention, and delayed memory. They also suggest that fake PAS tests are exacerbated and difficult to understand social situations.
On the free viewing task, the depressed group had a smaller average saccade amplitude. In other words, eye movements when scanning images cover a shorter distance. This may indicate a more restrictive or careful visual exploration pattern. In the smooth tracking task that tested their ability to follow a moving target, the depressed group showed more frequent fixation and saccades. These patterns suggest that moving objects were difficult to track smoothly and had to compensate with more frequent adjustments.
The most interesting part of this study came from the correlation between eye movement variables and cognitive test scores. In the depressed group, several specific eye movement characteristics were linked to better or worse cognitive performance. For example, more frequent fixation was associated with better direct memories, while longer fixed periods were linked to lower memories. Faster eye movements and longer saccade durations were associated with better attention and memory. The number of saccades in complex background tracking tasks was also positively associated with improved performance in Faux PAS tests, suggesting how visual scenes can be scanned to see how visual scenes can understand social situations.
These associations were not observed in healthy groups, indicating that the eye movement patterns seen in the depression group may reflect the underlying difficulties inherent in compensation strategies or conditions. For example, adolescents with depression may rely on faster or more frequent eye movements to compensate for cognitive limitations, particularly in tasks that require persistent attention and memory encoding.
This study adds to the growing evidence that gaze tracing may serve as a useful tool for understanding how depression affects the brain and behavior. It also highlights the possibility of using ocular movement data as part of clinical evaluations, particularly the possibility of detecting subtle cognitive impairments that are not apparent in traditional interviews and questionnaires.
However, this study has some limitations. It is unclear how the medication affected cognitive or eye movements, as all participants with depression were already undergoing treatment. The distribution of age and gender in groups also differs and may affect outcomes. Furthermore, the tasks used were relatively simple and neutral images involved, which may not fully capture how adolescents with depression respond to more emotionally recharged or socially complex situations. Cross-sectional design also limits the ability to determine whether eye movement abnormalities cause cognitive problems, are attributed to them, or develop side by side.
Researchers suggest that future research should explore these relationships using more diverse tasks, longitudinal design, and possibly untreated patients. They also highlight the need to improve eye movement tests to better capture the unique features of adolescent cognitive development.
the study, “Relationship between eye movement characteristics and cognitive function in adolescents with major depressive disorders.was written by Yuanyuan Lu, Lintong Song, Chunxiang Huang, Tianqing Fan, Jinqiao Huang, Leyin Zhang, Xuerong Luo, Yanhua Li, and Yanmei Shen.
