Differential Eye Movements in Mild Traumatic Brain Injury Versus Normal Controls

Aim: Despite its high frequency of occurrence, mild traumatic brain injury (mTBI), or concussion, is difficult to recognize and diagnose, particularly in pediatric populations. Conventional methods to diagnose mTBI primarily rely on clinical questionnaires and sometimes include neuroimaging or pencil and paper neuropsychological testing. However, these methods are time consuming, require administration/interpretation from health professionals, and lack adequate test sensitivity and specificity. This study explores the use of BrainCheck Sport, a computerized neurocognitive test that is available on iPad, iPhone, or computer desktop, for mTBI assessment. The BrainCheck Sport Battery consists of 6 gamified traditional neurocognitive tests that assess areas of cognition vulnerable to mTBI such as attention, processing speed, executing functioning, and coordination. Methods: We administered BrainCheck Sport to 10 participants diagnosed with mTBI at the emergency department of Children’s hospital or local high school within 96 hours of injury, and 115 normal controls at a local high school. Statistical analysis included Mann-Whitney U test, chi-square tests, and Hochberg tests to examine differences between the mTBI group and control group on each assessment in the battery. Significant metrics from these assessments were used to build a logistic regression model that distinguishes mTBI from control participants. Results: BrainCheck Sport was able to detect significant differences in Coordination, Stroop, Immediate/Delayed Recognition between normal controls and mTBI patients. Receiver operating characteristic (ROC) analysis of our logistic regression model found a sensitivity of 84% and specificity of 81%, with an area under the curve of 0.884. Conclusions: BrainCheck Sport has potential in distinguishing mTBI from control participants, by providing a shorter, gamified test battery to assess cognitive function after brain injury, while also providing a method for tracking recovery with the opportunity to do so remotely from a patient’s home.

Download Full-text

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

Frontiers in Bioengineering and Biotechnology ◽

10.3389/fbioe.2021.701712 ◽

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.

Download Full-text

Antisaccadic Eye Movements Are Correlated with Corpus Callosum White Matter Mean Diffusivity, Stroop Performance, and Symptom Burden in Mild Traumatic Brain Injury and Concussion

Frontiers in Neurology ◽

10.3389/fneur.2015.00271 ◽

2016 ◽

Vol 6 ◽

Cited By ~ 13

Author(s):

Windsor Kwan-Chun Ting ◽

Tom A. Schweizer ◽

Jane Topolovec-Vranic ◽

Michael D. Cusimano

Keyword(s):

Traumatic Brain Injury ◽

Eye Movements ◽

Brain Injury ◽

White Matter ◽

Corpus Callosum ◽

Mild Traumatic Brain Injury ◽

Mean Diffusivity ◽

Symptom Burden

Download Full-text

Tract-Based Bayesian Multivariate Analysis of Mild Traumatic Brain Injury

Computational and Mathematical Methods in Medicine ◽

10.1155/2014/120182 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Yongkang Liu ◽

Tianyao Wang ◽

Xiao Chen ◽

Jianhua Zhang ◽

Guoxing Zhou ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Multivariate Analysis ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Graphical Model ◽

Diffusion Tensor ◽

Brain Regions ◽

Neuroimaging Biomarkers ◽

Normal Controls ◽

Local Research

Purpose. Detecting brain regions characterizing mild traumatic brain injury (mTBI) by combining Tract-Based Spatial Statistics (TBSS) and Graphical-model-based Multivariate Analysis (GAMMA).Materials and Methods. This study included 39 mTBI patients and 28 normal controls. Local research ethics committee approved this prospective study. Diffusion-tensor imaging was performed in mTBI patients within 7 days of injury. Skeletonized fractional anisotropy (FA) maps were generated by using TBSS. Brain regions characterizing mTBI were detected by GAMMA.Results. Two clusters of lower frontal white matter FA were present in mTBI patients. We constructed classifiers based on FA values in these two clusters to differentiate mTBI and controls. The mean accuracy, sensitivity, and specificity, across five different classifiers, were 0.80, 0.94, and 0.61, respectively.Conclusions. Combining TBSS and GAMMA can detect neuroimaging biomarkers characterizing mTBI.

Download Full-text

Saccadic Eye Movements in Mild Traumatic Brain Injury: A Pilot Study OPEN ACCESS

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100016279 ◽

2014 ◽

Vol 41 (1) ◽

pp. 58-65 ◽

Cited By ~ 15

Author(s):

Sarah J. Mullen ◽

Yeni H. Yücel ◽

Michael Cusimano ◽

Tom A. Schweizer ◽

Anton Oentoro ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Eye Movements ◽

Brain Injury ◽

Pilot Study ◽

Mild Traumatic Brain Injury ◽

Neuropsychological Testing ◽

Saccadic Eye Movements ◽

Post Injury ◽

Persistent Symptoms

Objective:To investigate whether repeat saccadic reaction time (SRT) measurements using a portable saccadometer is useful to monitor patients with mild traumatic brain injury (mTBI).Methods:Seven patients with newly-diagnosed mTBI and five agematched controls were prospectively recruited from an emergency Department. Saccadic eye movements, symptom self-reporting and neuropsychological tests were performed within one week of injury and again at follow-up three weeks post-injury. Control patients underwent saccade recordings at similar intervals.Results:Median saccade reaction times were significantly prolonged within one week post-injury in mTBI compared to controls. At follow-up assessment there was no significant between-groups difference. Changes in median SRT between the two assessments were not statistically significant. Four of the seven mTBI patients showed significantly increased SRT at follow-up; three of the mTBI patients and all controls showed no significant change. Among the three mTBI patients with persistent decreased SRT, two experienced loss of consciousness and reported the greatest symptoms, while the third was the only subject with significant decrease in neuropsychological testing scores at both assessments.Conclusion:In three of seven mTBI patients, saccadic eye movements remained delayed within three weeks post-injury. These three patients also showed persistent symptoms or no improvement on neuropsychological testing. This pilot study using a portable saccadometer suggests that comparing SRT from three weeks post-injury to that within one week of injury may be useful for early detection of a subpopulation at risk of persistent disability from mTBI. This finding suggests that further investigation in a large study population is warranted.

Download Full-text

Eye Movements, Dizziness, and Mild Traumatic Brain Injury (mTBI)

Journal of Neurologic Physical Therapy ◽

10.1097/npt.0000000000000272 ◽

2019 ◽

Vol 43 ◽

pp. S31-S36 ◽

Cited By ~ 4

Author(s):

Susan L. Whitney ◽

Patrick J. Sparto

Keyword(s):

Traumatic Brain Injury ◽

Eye Movements ◽

Brain Injury ◽

Mild Traumatic Brain Injury

Download Full-text

Machine Learning Classification of Mild Traumatic Brain Injury Using Whole-Brain Functional Activity: A Radiomics Analysis

Disease Markers ◽

10.1155/2021/3015238 ◽

2021 ◽

Vol 2021 ◽

pp. 1-7

Author(s):

Xiaoping Luo ◽

Dezhao Lin ◽

Shengwei Xia ◽

Dongyu Wang ◽

Xinmang Weng ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Short Range ◽

Low Frequency ◽

Brain Regions ◽

Classification Performance ◽

Imaging Parameters ◽

The Brain ◽

Normal Controls

Objectives. To investigate the classification performance of support vector machine in mild traumatic brain injury (mTBI) from normal controls. Methods. Twenty-four mTBI patients (15 males and 9 females; mean age, 38.88 ± 13.33 years) and 24 age and sex-matched normal controls (13 males and 11 females; mean age, 40.46 ± 11.4 years) underwent resting-state functional MRI examination. Seven imaging parameters, including amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), degree centrality (DC), voxel-mirrored homotopic connectivity (VMHC), long-range functional connectivity density (FCD), and short-range FCD, were entered into the classification model to distinguish the mTBI from normal controls. Results. The ability for any single imaging parameters to distinguish the two groups is lower than multiparameter combinations. The combination of ALFF, fALFF, DC, VMHC, and short-range FCD showed the best classification performance for distinguishing the two groups with optimal AUC value of 0.778, accuracy rate of 81.11%, sensitivity of 88%, and specificity of 75%. The brain regions with the highest contributions to this classification mainly include bilateral cerebellum, left orbitofrontal cortex, left cuneus, left temporal pole, right inferior occipital cortex, bilateral parietal lobe, and left supplementary motor area. Conclusions. Multiparameter combinations could improve the classification performance of mTBI from normal controls by using the brain regions associated with emotion and cognition.

Download Full-text