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 ◽  
...  
2012 ◽  
Vol 29 (17) ◽  
pp. 2606-2612 ◽  
Author(s):  
George Wolf ◽  
David Cifu ◽  
Laura Baugh ◽  
William Carne ◽  
Leonardo Profenna

Author(s):  
Ellen Lirani-Silva ◽  
Samuel Stuart ◽  
Lucy Parrington ◽  
Kody Campbell ◽  
Laurie King

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.


2019 ◽  
pp. 341-352
Author(s):  
Lindell K. Weaver ◽  
◽  
Susan Churchill ◽  
Stegffanie H. Wilson ◽  
Donald Hebert ◽  
...  

Introduction: Global outcomes can strengthen inferences from clinical trials. We evaluate global outcomes for persistent post-concussive symptoms (PCS) after mild traumatic brain injury (mTBI) in two clinical trials of hyperbaric oxygen (HBO2) in United States service members. Methods: During study design, outcomes of symptom, cognitive, and functional impairments planned for a trial of HBO2 for PCS (HOPPS) were weighted and grouped into different domains to formulate the composite outcome total score. The composite outcome was compared between the intervention groups in HOPPS and those in a subsequent HBO2 trial (BIMA) for validation. Additionally, two post hoc global outcome measures were explored, including one composed of components that demonstrated favorable characteristics in both studies and another via components used in another TBI randomized trial (COBRIT). Results: In total, 143 active-duty or veteran military personnel were randomized across the two studies. Composite total scores improved from baseline for HBO2 (mean±SD -2.9±9.0) and sham (-2.9±6.6) groups in HOPPS but did not differ significantly between groups (p=0.33). In BIMA, 13-week changes from baseline favored the HBO2 group (-3.6±6.4) versus sham (-0.3±5.2; p=0.02). No between-group differences were found when COBRIT composite scoring was applied to BIMA. Overall, HBO2 effects were maximized when the post hoc global measure derived from both studies was applied to the data. Conclusions: Composite total scores in HOPPS and BIMA were consistent with primary study results. The global measures considered may offer utility as endpoints to achieve maximal HBO2 effect in future trials of the mTBI population. clinicaltrials.gov Identifier: NCT01611194 (BIMA) and NCT01306968 (HOPPS)


Neurology ◽  
2020 ◽  
Vol 95 (20 Supplement 1) ◽  
pp. S2.1-S2
Author(s):  
Alex Kiderman ◽  
Michael Hoffer ◽  
Mikhaylo Szczupak ◽  
Hillary Snapp ◽  
Sara Murphy ◽  
...  

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.


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