BERN, Switzerland – A review paper published this year in Brain Communications highlights how fast, non-invasive, objective, standardized, and comparable functional brain measurements through the eyes are increasingly filling the gap in CNS clinical trials. Published by machineMD, a Swiss medical device innovator with a subsidiary in Boston, MA, and clinical collaborators in Switzerland and Germany, “Advances in ocular motor and pupil biomarkers for neurological disorders” discusses how these measures are being used and why they matter.
The review maps oculomotor and pupillary biomarkers to each of the three neurological diseases, making it easier for researchers to capture data with standardized medical devices rather than requiring years of specialist clinical examination experience.
“Researchers and trial managers need functional endpoints that reflect symptoms and quality of life,” said Mathias Abegg, MD, PhD, Medical Director and Co-Founder of machineMD. “What is new here is that neos provides a standardized way to measure these functional deficits — capturing changes that matter to how patients see and interact with the world.”
Vision problems affect up to three quarters of people living with Multiple Sclerosis and are often among the first symptoms they notice. Sudden vision loss in one eye is how MS first declares itself in one in three new diagnoses. Symptoms can also include double vision or blurred tracking caused by conditions such as internuclear ophthalmoplegia (INO), found in around one in four people with MS, which occurs when MS lesions disrupt the brainstem pathways that coordinate eye movement.
Around 70% of people with Parkinson's Disease (PD) experience convergence problems — difficulty focusing both eyes on a nearby object — which can cause double vision and trouble reading. Changes in how the pupil responds to light suggest that autonomic dysfunction in PD may begin up to 20 years before diagnosis.
People with Alzheimer's Disease often struggle with involuntary gaze shifts and difficulty holding attention on a target — changes measurable through eye tracking that reflect early disruption to brain regions controlling executive function. Even the pupil's response to light shows detectable changes tied to early cholinergic dysfunction, potentially before memory symptoms appear.
The broader significance is that these measures may add to CNS research a more standardized functional data layer that reflects neurological disfunction, especially when combined with other modalities such as MRI, OCT, EEG/VEP, and fluid biomarkers. Clinical adoption may still be further ahead but this review helps move the field in that direction by synthesizing the evidence and identifying relevant biomarkers by disease.
“Early detection of Parkinson’s is very important because, as with many neurodegenerative diseases, it starts much earlier than we notice clinically,” said Prof. Dr. med. Konrad Weber, Principal Investigator for this study at University Hospital Zurich and President of the European Neuro-Ophthalmology Society. “If we have biomarkers that indicate disease earlier, we can think about earlier intervention and, in the future, even neuroprotective therapy. That is why objective ocular biomarkers are so promising.”
about machineMD
machineMD is a medical device company, headquartered in Switzerland, with a subsidiary in Boston, USA, that is innovating at the intersection of neuroscience and ophthalmology. The company’s mission is to radically improve the measurement of brain function, with a vision for a world where people receive an accurate, fast, and early diagnosis of brain disorders.
about neos®
neos® is a CE-marked Class IIa (EU) and FDA-registered Class I (USA) medical device developed and manufactured by machineMD, intended to present visual stimuli and measure eye movements and pupillary responses to support the diagnosis and monitoring of neuro-ophthalmic conditions. It provides objective, quantitative data on the afferent and efferent visual system through standardized neuro-ophthalmic examinations.