Saccadic eye movements in neurological disease: cognitive mechanisms and clinical applications

Saccadic eye movements are rapid, precisely coordinated shifts that centre the fovea on a visual target. Their control relies on the integration of cognitive processes spanning multiple brain regions. High-resolution video-oculography enables precise measurement of saccadic dynamics, offering a window into disruptions affecting these networks. This review examines the neuroanatomy and physiology of saccadic eye movements, emphasising the cognitive mechanisms underlying their control and the methodologies used for their assessment. We synthesise evidence from saccadic eye movement testing across a spectrum of neurological diseases, highlighting its potential as an early and sensitive biomarker for detecting subclinical disease impact. While current findings underscore its promise as a non-invasive, objective tool for tracking neuropsychological dysfunction in these various diseases, we also address existing limitations and critical directions for future research towards improving clinical utility.