Clinical testing of mild traumatic brain injury using computerised eye-tracking tests

2022 ◽  
pp. 1-7
Author(s):  
Alice Cade ◽  
Philip RK Turnbull
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Eye Tracking ◽  
Mild Traumatic Brain Injury ◽  
Clinical Testing

scholarly journals Saccade and Fixation Eye Movements During Walking in People With Mild Traumatic Brain Injury

2021 ◽  
Vol 9 ◽  
Author(s):  
Ellen Lirani-Silva ◽  
Samuel Stuart ◽  
Lucy Parrington ◽  
Kody Campbell ◽  
Laurie King
Keyword(s):  
Traumatic Brain Injury ◽  
Eye Movements ◽  
Brain Injury ◽  
Eye Tracking ◽  
Mild Traumatic Brain Injury ◽  
Peak Velocity ◽  
Lumbar Vertebrae ◽  
Gait Velocity ◽  
The Impact ◽  
Mobile Eye Tracking

Background: Clinical and laboratory assessment of people with mild traumatic brain injury (mTBI) indicate impairments in eye movements. These tests are typically done in a static, seated position. Recently, the use of mobile eye-tracking systems has been proposed to quantify subtle deficits in eye movements and visual sampling during different tasks. However, the impact of mTBI on eye movements during functional tasks such as walking remains unknown.Objective: Evaluate differences in eye-tracking measures collected during gait between healthy controls (HC) and patients in the sub-acute stages of mTBI recovery and to determine if there are associations between eye-tracking measures and gait speed.Methods: Thirty-seven HC participants and 67individuals with mTBI were instructed to walk back and forth over 10-m, at a comfortable self-selected speed. A single 1-min trial was performed. Eye-tracking measures were recorded using a mobile eye-tracking system (head-mounted infra-red Tobbii Pro Glasses 2, 100 Hz, Tobii Technology Inc. VA, United States). Eye-tracking measures included saccadic (frequency, mean and peak velocity, duration and distance) and fixation measurements (frequency and duration). Gait was assessed using six inertial sensors (both feet, sternum, right wrist, lumbar vertebrae and the forehead) and gait velocity was selected as the primary outcome. General linear model was used to compare the groups and association between gait and eye-tracking outcomes were explored using partial correlations.Results: Individuals with mTBI showed significantly reduced saccade frequency (p = 0.016), duration (p = 0.028) and peak velocity (p = 0.032) compared to the HC group. No significant differences between groups were observed for the saccade distance, fixation measures and gait velocity (p > 0.05). A positive correlation was observed between saccade duration and gait velocity only for participants with mTBI (p = 0.025).Conclusion: Findings suggest impaired saccadic eye movement, but not fixations, during walking in individuals with mTBI. These findings have implications in real-world function including return to sport for athletes and return to duty for military service members. Future research should investigate whether or not saccade outcomes are influenced by the time after the trauma and rehabilitation.

Oculomotor, vestibular, reaction time and cognitive eye-tracking mild traumatic brain injury assessment

Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S2.1-S2
Author(s):  
Alex Kiderman ◽  
Michael Hoffer ◽  
Mikhaylo Szczupak ◽  
Hillary Snapp ◽  
Sara Murphy ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Reaction Time ◽  
Eye Tracking ◽  
Regression Model ◽  
Mild Traumatic Brain Injury ◽  
Data Set ◽  
Retest Reliability ◽  
Test Retest Reliability ◽  
Tracking Technology

ObjectiveCan oculomotor, vestibular, reaction time and cognitive eye-tracking tests (OVRT-C) assess mild traumatic brain injury?BackgroundOVRT-C tests using eye tracking technology have been employed in our previous studies for assessing mild traumatic brain injury (mTBI). Here we present a composite Concussion Assessment algorithm that incorporates these findings.Design/MethodsConcussion Assessment algorithm was based on a data analysis from 406 males and females 18–45 years old. The subjects included 106 patients diagnosed with mTBI and 300 healthy controls. Diagnosis of mTBI was made using accepted medical practice. The participants were tested with a battery of OVRT-C tests delivered on the I-Portal Neuro Otologic Test Center (Dx NOTC) device (Neurolign Technology). A logistic regression model was used to derive the algorithm using a random sample of 70% of the data-set and validated on the remaining 30% of the data-set. Device test-retest reliability and inter-rater variability were assessed in a separate study in healthy control volunteers, ages 19–43 (n = 30). Subjects were tested with OVRT-C tests using the Dx100 which is equivalent to the NOTC. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC) and Cronbach's alpha; testers and devices influence were assessed using a random effect regression model.ResultsTest-retest reliability of OVRT-C tests using eye tracking technology was acceptable (ICC >0.6 for all variables). The Concussion assessment algorithm was based on six OVRT-C tests. In the validation data Concussion Assessment algorithm was able to separate concussed versus controls with a sensitivity of 78.6% and specificity of 72.3%.ConclusionsOVRT-C tests delivered on I-Portal devices are repeatable and reliable. The assessment can identify mTBI subjects within an acute time post-injury with high sensitivity and specificity. The results support the use of this eye tracking device as well as the assessment to aid in the diagnosis of mTBI for patients 18–45 year old.

scholarly journals Effects of hyperbaric oxygen on eye tracking abnormalities in males after mild traumatic brain injury

2014 ◽  
Vol 51 (7) ◽  
pp. 1047-1056 ◽  
Author(s):  
David X. Cifu ◽  
Kathy W. Hoke ◽  
Paul A. Wetzel ◽  
Joanna R. Wares ◽  
George Gitchel ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Eye Tracking ◽  
Hyperbaric Oxygen ◽  
Mild Traumatic Brain Injury

The Speech-Language Pathologists' Role in Mild Traumatic Brain Injury for Middle and High School–Age Children: Viewpoints on Guidelines From the Centers for Disease Control and Prevention

2019 ◽  
Vol 28 (3) ◽  
pp. 1363-1370 ◽  
Author(s):  
Jessica Brown ◽  
Katy O'Brien ◽  
Kelly Knollman-Porter ◽  
Tracey Wallace
Keyword(s):  
High School ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Disease Control ◽  
Mild Traumatic Brain Injury ◽  
School Age Children ◽  
School Age ◽  
Speech Language Pathologists ◽  
Control And Prevention ◽  
Centers For Disease Control

Purpose The Centers for Disease Control and Prevention (CDC) recently released guidelines for rehabilitation professionals regarding the care of children with mild traumatic brain injury (mTBI). Given that mTBI impacts millions of children each year and can be particularly detrimental to children in middle and high school age groups, access to universal recommendations for management of postinjury symptoms is ideal. Method This viewpoint article examines the CDC guidelines and applies these recommendations directly to speech-language pathology practices. In particular, education, assessment, treatment, team management, and ongoing monitoring are discussed. In addition, suggested timelines regarding implementation of services by speech-language pathologists (SLPs) are provided. Specific focus is placed on adolescents (i.e., middle and high school–age children). Results SLPs are critical members of the rehabilitation team working with children with mTBI and should be involved in education, symptom monitoring, and assessment early in the recovery process. SLPs can also provide unique insight into the cognitive and linguistic challenges of these students and can serve to bridge the gap among rehabilitation and school-based professionals, the adolescent with brain injury, and their parents. Conclusion The guidelines provided by the CDC, along with evidence from the field of speech pathology, can guide SLPs to advocate for involvement in the care of adolescents with mTBI. More research is needed to enhance the evidence base for direct assessment and treatment with this population; however, SLPs can use their extensive knowledge and experience working with individuals with traumatic brain injury as a starting point for post-mTBI care.

Assessment of Cognitive-Communicative Disorders of Mild Traumatic Brain Injury Sustained in Combat

2009 ◽  
Vol 19 (2) ◽  
pp. 47-57 ◽  
Author(s):  
Christine Parrish ◽  
Carole Roth ◽  
Brooke Roberts ◽  
Gail Davie
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Psychological Health ◽  
Communication Disorders ◽  
Service Members ◽  
Patient Questionnaire ◽  
Speech Language Pathologists ◽  
Test Protocol ◽  
Communication Deficits

Abstract Background: Mild traumatic brain injury (mTBI) is recognized as the signature injury of the current conflicts in Iraq and Afghanistan, yet there remains limited understanding of the persisting cognitive deficits of mTBI sustained in combat. Speech-language pathologists (SLPs) have traditionally been responsible for evaluating and treating the cognitive-communication disorders following severe brain injuries. The evaluation instruments historically used are insensitive to the subtle deficits found in individuals with mTBI. Objectives: Based on the limited literature and clinical evidence describing traditional and current tests for measuring cognitive-communication deficits (CCD) of TBI, the strengths and weaknesses of the instruments are discussed relative to their use with mTBI. It is necessary to understand the nature and severity of CCD associated with mTBI for treatment planning and goal setting. Yet, the complexity of mTBI sustained in combat, which often co-occurs with PTSD and other psychological health and physiological issues, creates a clinical challenge for speech-language pathologists worldwide. The purpose of the paper is to explore methods for substantiating the nature and severity of CCD described by service members returning from combat. Methods: To better understand the nature of the functional cognitive-communication deficits described by service members returning from combat, a patient questionnaire and a test protocol were designed and administered to over 200 patients. Preliminary impressions are described addressing the nature of the deficits and the challenges faced in differentiating the etiologies of the CCD. Conclusions: Speech-language pathologists are challenged with evaluating, diagnosing, and treating the cognitive-communication deficits of mTBI resulting from combat-related injuries. Assessments that are sensitive to the functional deficits of mTBI are recommended. An interdisciplinary rehabilitation model is essential for differentially diagnosing the consequences of mTBI, PTSD, and other psychological and physical health concerns.

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