Use of eye tracking improves the detection of evoked responses to complex visual stimuli during EEG in infants

Objective: To improve the reliability of detecting EEG responses evoked by complex visual stimuli to the level required for clinical use by integrating an eye tracker to the EEG setup and optimizing the analysis protocol. Methods: Infants were presented with continuous orientation reversal (OR), global form (GF), and global motion (GM) stimuli. Eye tracking was used to control stimulus presentation and exclude epochs with disoriented gaze. The spectral responses were estimated from 13 postcentral EEG channels using a circular variant of Hotelling's T² test statistic. Results: Among 39 healthy infants, statistically significant (p < 0.01) responses to OR/GF/GM stimuli were found from 92%/100%/95% recordings, respectively. The specificity test of the detection algorithm, using non-stimulated baseline EEG, did not yield any false-positive findings. Taken together, this yields 15% improvement on average in the detection performance compared to that in the current literature. Conclusions: Changes to the test protocol and incorporation of the eye tracking information improves the detection of responses to complex visual stimuli in infants. Significance: This work presents a test protocol suitable for use in a clinical environment at a level of reliability that allows individual diagnostics.