244. Comparison of visuomotor coordination in patients with obsessive–compulsive disorder between active and remitted states using eye-tracking analysis

Abstract

Abstract Background Visuospatial dysfunction has been reported across diverse tasks in obsessive–compulsive disorder (OCD), suggesting involvement of supramodal cognitive mechanisms such as intolerance of uncertainty and reduced cognitive flexibility. These abnormalities are thought to arise from both state-dependent changes linked to symptom severity and trait-related vulnerabilities. Eye-tracking has recently gained attention as a highly sensitive approach to capture such supramodal processes with high temporal resolution, providing dynamic indices beyond conventional behavioral measures. Aims & Objectives We hypothesized that eye-tracking analysis during visuospatial tasks would enable sensitive detection of both state- and trait-related visuomotor abnormalities in OCD by comparing patients with active symptoms, patients in remission, and healthy controls. Method A total of 45 adults who met DSM-5 diagnostic criteria for OCD were enrolled and assigned to either a remitted group (R group: Y-BOCS ≤ 12, n = 18) or an active-symptom group (A group: Y-BOCS ≥ 16, n = 16). Twenty age- and sex-matched healthy adults were included as the control group (CTR). All participants completed a visuospatial cognitive battery including the Rapid Automatized Naming (RAN) object task, MNREAD-J, Picture Completion, and the Rey–Osterrieth Complex Figure Test. Eye movements were recorded during task performance, and fixation counts, fixation regressions, and Kullback–Leibler divergence (KLD) values (selected according to task characteristics) were analyzed. The study was approved by the institutional ethics board, and all participants provided informed consent. Results No significant group differences were observed in behavioral performance across visuospatial tasks. Eye-tracking analysis showed that fixation regressions in the RAN object task were greater in the A group (4.0 ± 3.3) than in the R group (2.5 ± 1.9) (ANOVA: p = 0.034; post-hoc A vs R: p = 0.040; A vs CTR: n.s.; R vs CTR: n.s.; CTR: 2.7 ± 2.1). No other gaze indices showed significant group differences. Discussion & Conclusions This is the first eye-tracking study directly comparing OCD patients with active symptoms and those in the remitted status. While Visuomotor abnormalities , such as frequent reversals shown by fixation regressions during visual object recognition under cognitively loaded conditions may reflect functional impairments associated to the intolerance to uncertainty in the pathology of active OCD, whereas trait-related visuomotor markers were not identified, contrary to our hypothesis. These findings suggest that dynamic eye-movement parameters may be more sensitive indicators of OCD-related pathology than visuospatial task performance itself. The limitation of this study is that the relatively small sample size and cross-sectional design may have limited the detection of subtle trait-related impairments. Additionally, the range of visuospatial paradigms was restricted. Future longitudinal studies incorporating a broader variety of tasks and eye-movement metrics are warranted to clarify state–trait distinctions.