JMIR Publications

ABSTRACT

Apathy is one of the most prevalent and disabling neuropsychiatric symptoms in dementia, characterized by reduced motivation and diminished goal-directed activity, with strong impacts for both the person living with dementia and their caregivers. Despite its prevalence, its assessment remains challenging, as it relies largely on subjective self-reports and scales. In response, objective and quantifiable biomarkers derived from digital health technologies have emerged as a promising approach. The ECOCAPTURE program at the Paris Brain Institute (ICM) has developed ecological paradigms to identify behavioral and physiological markers of apathy, highlighting a core “exploration deficit” associated with this symptom. The present paper describes ECOCAPTURE@HOME(EYE), the eye-tracking and neuroimaging component of the broader ECOCAPTURE@HOME-V2 protocol. This study integrates eye-tracking across laboratory-based tasks and an ecological at-home setting to characterize oculomotor dynamics and visual exploration patterns in behavioral variant frontotemporal dementia (bvFTD), Alzheimer’s disease (AD), and healthy controls. These measures will be combined with clinical assessments of apathy and structural and functional MRI to investigate the behavioral and neural mechanisms underlying this symptom. This protocol aims to identify objective, ecologically valid, and clinically meaningful ocular markers of apathy, and to refine its digital phenotype within a multimodal framework. More broadly, it seeks to support the development of improved assessment tools and contribute to data-driven, individualized approaches in dementia care.