Effect of Methylphenidate for Apathy on Visual Attention Scanning Behavior: a Pilot Study

Background The purpose of this pilot study was to explore the potential of eye-tracking technology in monitoring symptoms and predicting outcomes in apathetic Alzheimer’s disease (AD) patients treated with methylphenidate (MTP). Methods Neuropsychological tests and eye-tracking measurements were completed at baseline and following at least four weeks of treatment with MTP (5–10 mg BID). Eye-movements were measured while patients viewed novel and social stimuli. Cognition, behavior, and apathy were assessed using the Standardized Mini-Mental State Exam (sMMSE), Neuropsychiatric Inventory, and Apathy Evaluation Scale (AES), respectively. Results Nine patients were included in the analysis (age: median=75, interquartile range=8; sMMSE: median=22, interquartile range=14). Spearman correlations showed that improvement on the AES was associated with increased visual attention towards novel stimuli (ρ7=-0.809, p=.008). Additionally, lower baseline attention towards social images was associated with improvement on the AES (ρ7=0.905, p=.001). Conclusions Eye-tracking techniques can be developed as an objective and nonverbal method of monitoring symptoms and treatment outcomes in AD patients.