Supplementary Material for: Self-Recording of Eye Movements in Amyotrophic Lateral Sclerosis (ALS) Patients Using a Smartphone Eye-Tracking App (EyePhone)

Introduction: Amyotrophic Lateral Sclerosis (ALS) can affect various eye movements, making eye tracking a potential means for disease monitoring. In this study, we evaluated the feasibility of ALS patients self-recording their eye movements using the "EyePhone", a smartphone eye-tracking application. Methods: We prospectively enrolled ten participants and provided them with an iPhone equipped with the EyePhone app and a PowerPoint presentation with step-by-step recording instructions. The goal was for the participants to record their eye movements (saccades and smooth pursuit) without the help of the study team. Afterward, a trained physician administered the same tests using video-oculography (VOG) goggles and asked the participants to complete a questionnaire regarding their self-recording experience. Results: All participants successfully completed the self-recording process without assistance from the study team. Questionnaire data indicated that participants viewed self-recording with EyePhone favorably, considering it easy and comfortable. Moreover, 70% indicated that they prefer self-recording to being recorded by VOG goggles. Conclusion: With proper instruction, ALS patients can effectively use the EyePhone to record their eye movements, potentially even in a home environment. These results demonstrate the potential for smartphone eye-tracking technology as a viable and self-administered tool for monitoring disease progression in ALS, reducing the need for frequent clinic visits.

引言：肌萎缩侧索硬化症（Amyotrophic Lateral Sclerosis, ALS）可累及多种眼球运动，使得眼球追踪技术成为疾病监测的潜在手段。本研究旨在评估ALS患者使用智能手机眼球追踪应用"EyePhone"自行记录眼球运动的可行性。
方法：本研究前瞻性纳入10名受试者，为其配备安装了"EyePhone"应用的iPhone手机，以及一份包含分步录制指导的PowerPoint演示文稿。要求受试者在无研究团队协助的情况下完成眼球运动（扫视与平稳追随运动）的录制。随后，由经过培训的医师使用视频眼震电图（video-oculography, VOG）眼镜完成相同测试，并要求受试者填写关于其自行录制体验的调查问卷。
结果：所有受试者均在无研究团队协助的情况下顺利完成自行录制流程。调查问卷数据显示，受试者对使用"EyePhone"进行自行录制的体验评价良好，认为其操作简便且舒适。此外，70%的受试者表示相较于使用VOG眼镜录制，他们更倾向于自行录制。
结论：在获得恰当指导后，ALS患者可有效使用"EyePhone"完成眼球运动录制，甚至可在居家环境中进行。上述结果表明，智能手机眼球追踪技术有望成为一种可行且可自行操作的ALS疾病进展监测工具，从而减少患者频繁前往临床就诊的需求。