Page 54 - JCBP-3-3

Journal of Clinical and
Basic Psychosomatics Integrative neurodegenerative care

the potential to facilitate early intervention, slow disease simpler focus-based exercises while monitoring ocular
progression, improve quality of life, and prolong patient activity. Identifying early signs of stress or cognitive fatigue
independence. enables the implementation of preventative strategies to
To illustrate how this framework translates into clinical mitigate further decline. By addressing the neurological,
practice, we present three hypothetical case applications: psychological, social, and physical dimensions of ADR,
this integrative framework promotes a more holistic and
(i) Case 1-Mild cognitive impairment with stress influence effective approach to patient care. 13
A 65-year-old male presents with a slight decline in
saccadic velocity (~10% below age-matched norms) 4. Clinical integration for
and a reaction time delay of ~120 ms, yet his SRSS neurodegenerative monitoring
stress levels are markedly elevated. This pattern suggests The integration of eye-tracking, reaction-retention testing,
that cognitive fatigue due to chronic stress may be and the SRSS presents a promising approach to ADR
exacerbating his cognitive performance deficits rather diagnostics and management (Figure 2). By combining
than indicating ADR pathology. The recommended these tools, clinicians gain a more comprehensive
approach for this case includes stress mitigation understanding of the relationship between cognitive
interventions such as structured relaxation protocols, function and emotional health, allowing for a more
behavioral therapy, and lifestyle modifications. personalized approach to patient care.
Reassessment in 3 – 6 months would determine whether
cognitive deficits persist independently of stress. 4.1. Eye-tracking

(ii) Case 2-Early ADR progression These non-invasive technologies monitor cognitive
A 72-year-old female demonstrates a more processes in real time by analyzing gaze patterns, saccadic
pronounced decline in saccadic velocity (~20%) movements, and pupil responses through pupillometry
and reaction time delays exceeding 250 ms, with and ocular activity. These objective metrics provide insight
moderate SRSS scores suggesting minimal impact into attention shifts and processing speed, both of which
from external stressors. These findings indicate early are often compromised in ADR. For instance, deviations
ADR progression, warranting further diagnostic in saccadic velocity or fixation duration may indicate
confirmation through neuroimaging (e.g., magnetic underlying executive function deficits, potentially enabling
resonance imaging or positron emission tomography earlier identification of ADR-related cognitive decline. 14,15
[PET] scan). Early intervention strategies such as
cognitive rehabilitation and tailored pharmacological 4.2. Reaction-retention
options may recommend. This tool complements pupillometry-based assessments

(iii) Case 3-Differential diagnosis of ADR versus by measuring a patient’s ability to respond to stimuli and
16
Parkinson’s disease retain information over short periods of time. Since
A 75-year-old male presents with a severe reduction reaction time and short-term memory are among the
earliest cognitive domains affected in ADR, their direct
in saccadic velocity (~35%) and significant reaction measurement offers important diagnostic value. Reaction
time delays (~500 ms), yet SRSS scores remain time assessments can reveal delays in cognitive processing
stable, and fixation stability is largely preserved. that traditional paper-based assessments may overlook.
This pattern suggests that motor control deficits When integrated with eye-tracking data, these tests create
characteristic of Parkinson’s disease rather than ADR a more holistic view of a patient’s cognitive function,
may be the underlying cause. Further evaluation with facilitating early intervention strategies and longitudinal
dopaminergic function testing and gait analysis may disease monitoring.
be recommended to refine the diagnosis.
By integrating multiple diagnostic metrics rather 4.3. SRSS
than relying on a single biomarker, this framework The SRSS assesses psychophysiological factors such as
enhances precision in tracking ADR progression and perceived stress and recovery, which significantly impact
distinguishing it from overlapping neurodegenerative cognitive and physical function. By correlating SRSS scores
conditions. Furthermore, these integrated tools allow with eye-tracking and reaction-retention data, clinicians
for flexible, patient-centered approaches. For example, can assess the effects of chronic stress and emotional strain
if a patient exhibits high stress or low mood on SRSS on cognitive performance. While SRSS results have been
assessments, clinicians can adjust tasks to accommodate linked to biomarkers such as cortisol and inflammatory
their current psychological state, such as starting with markers, 17,18 further validation is required to optimize

Volume 3 Issue 3 (2025) 48 doi: 10.36922/jcbp.8349