scholarly journals Vertical smooth pursuit as a diagnostic marker of traumatic brain injury

Concussion ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. CNC69 ◽  
Author(s):  
Melissa Hunfalvay ◽  
Claire-Marie Roberts ◽  
Nicholas P Murray ◽  
Ankur Tyagi ◽  
Kyle W Barclay ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Eye Tracking ◽  
Smooth Pursuit ◽  
Diagnostic Marker ◽  
Healthy Controls ◽  
Eye Tracker ◽  
Severe Tbi ◽  
Tracking Technology ◽  
Different Levels

Aim: Neural deficits were measured via the eye tracking of vertical smooth pursuit (VSP) as markers of traumatic brain injury (TBI). The present study evaluated the ability of the eye tracking tests to differentiate between different levels of TBI severity and healthy controls. Methodology: Ninety-two individuals divided into four groups (those with mild, moderate or severe TBI and healthy controls) participated in a computerized test of VSP eye movement using a remote eye tracker. Results: The VSP eye tracking test was able to distinguish between severe and moderate levels of TBI but unable to detect differences in the performance of participants with mild TBI and healthy controls. Conclusion: The eye-tracking technology used to measure VSP eye movements is able to provide a timely and objective method of differentiating between individuals with moderate and severe levels of TBI.

scholarly journals Horizontal and vertical self-paced saccades as a diagnostic marker of traumatic brain injury

Concussion ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. CNC60 ◽  
Author(s):  
Melissa Hunfalvay ◽  
Claire-Marie Roberts ◽  
Nick Murray ◽  
Ankur Tyagi ◽  
Hannah Kelly ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Eye Tracking ◽  
Diagnostic Marker ◽  
Vertical Saccades ◽  
Severe Tbi ◽  
Study Methodology ◽  
Performance Results ◽  
Tracking Technology

Aim: Eye tracking tests to measure horizontal and vertical saccades as a proxy for neural deficits associated with traumatic brain injury (TBI) were evaluated in the present study. Methodology: A total of 287 participants reporting either no TBI, mild, moderate or severe TBI participated in a suite of eye tracking tests to measure horizontal and vertical saccadic performance. Results: The horizontal saccades test offered a sensitivity of 0.77 and a specificity of 0.78, similarly the vertical saccades tests offered a sensitivity of 0.64 and a specificity of 0.65. Conclusion: The results indicated that using eye-tracking technology to measure these metrics offers an objective, reliable and quantifiable way of differentiating between individuals with different severities of TBI, and those without a TBI.

Eye-Tracking Technology for Estimation of Cognitive Load After Traumatic Brain Injury

2015 ◽  
pp. 136-143
Author(s):  
Ashley Safford ◽  
Jessica Kegel ◽  
Jamie Hershaw ◽  
Doug Girard ◽  
Mark Ettenhofer
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Eye Tracking ◽  
Cognitive Load ◽  
Tracking Technology

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.

Eye tracker outcomes in a randomized trial of 40 sessions of hyperbaric oxygen or sham in participants with persistent post concussive symptoms

2019 ◽  
pp. 299-311
Author(s):  
Paul A. Wetzel ◽  
◽  
Anne S. Lindblad ◽  
Caroline Mulatya ◽  
Mary A. Kannan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Eye Movements ◽  
Brain Injury ◽  
Hyperbaric Oxygen ◽  
Mild Traumatic Brain Injury ◽  
Smooth Pursuit ◽  
Tracking System ◽  
Eye Tracker ◽  
Normative Study

Purpose: Eye movements may offer a sensitive method to measure response to intervention in mild traumatic brain injury (mTBI). Methods: The Brain Injury and Mechanisms of Action of Hyperbaric Oxygen for Persistent Post-Concussive Symptoms after Mild Traumatic Brain Injury Study (BIMA) randomized 71 participants to 40 sessions of hyperbaric oxygen or sham. A companion normative study (Normal) enrolled 75 participants. An eye tracking system measured left and right eye movements for saccadic and smooth pursuit. At baseline two smooth pursuit tasks, circular and horizontal ramp, and four saccadic tasks, horizontal and vertical step, reading, and memory guided-on tasks differentiated BIMA from Normal participants. The change from baseline in these tasks were measured and compared between interventions and against Normal participants at 13 weeks and six-month follow-up using the two-sample t-test. The Holm-Bonferroni procedure was used to adjust for multiple testing. Results: Change from baseline in eyetracker measures for participants assigned to the hyperbaric oxygen arm did not significantly differ from those assigned to the sham arm at post-randomization time points 13 weeks and six months. Consistent shifts of BIMA participant values toward Normal values at 13 weeks and six months were observed for overall fixation duration, forward saccadic duration, and number of lines read for the reading task, number of misses on the memory guided-on task, and absolute intersaccadic interval velocity and absolute saccadic amplitude on the circular task. The distributions between Normal and BIMA participants were no longer statistically significantly different at 13 weeks and six months post enrollment for these measures. Conclusions: The baseline differences between BIMA and Normal suggest potential vulnerability of the smooth pursuit system and the saccadic system. During the sixmonth follow-up period, improvement toward Normal was seen on some measures in both the hyperbaric oxygen and sham intervention arms without difference between intervention groups. clinicaltrials.gov Identifiers NCT01611194 and NCT01925963

scholarly journals Slow wave activity moderates the association between new learning and traumatic brain injury severity

SLEEP ◽  
2020 ◽  
Author(s):  
Héjar El-Khatib ◽  
Erlan Sanchez ◽  
Caroline Arbour ◽  
Solenne Van Der Maren ◽  
Catherine Duclos ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sleep Quality ◽  
Eye Movement ◽  
Slow Wave ◽  
Memory Performance ◽  
Wave Activity ◽  
Healthy Controls ◽  
New Learning ◽  
Severe Tbi

Abstract Study Objectives Sleep–wake complaints and difficulties in making new learning are among the most persistent and challenging long-term sequelea following moderate to severe traumatic brain injury (TBI). Yet, it is unclear whether, and to what extent, sleep characteristics during the chronic stage of TBI contribute to sleep–wake and cognitive complaints. We aimed to characterize sleep architecture in chronic moderate to severe TBI adults and assess whether non-rapid eye movement slow wave activity (SWA) is associated to next day performance in episodic memory tasks according to TBI severity. Methods Forty-two moderate to severe TBI participants, 12–47 months post-injury, and 38 healthy controls were tested with one night of in-laboratory polysomnography, followed the next morning by questionnaires (sleep quality, fatigue, and sleepiness) and neuropsychological assessment. We used multiple regression analyses to assess the moderator effect of SWA power on TBI severity and next-day memory performance. Results We found that TBI participants reported worse sleep quality and fatigue, and had worse cognitive performance than controls. No between group differences were found on macro- and micro-architecture of sleep. However, SWA significantly interacted with TBI severity to explain next-day memory performance: higher SWA was more strongly associated to better memory performance in more severe TBI compared to milder TBI. Conclusions This study provides evidence that the injured brain is able to produce macro- and micro-architecture of sleep comparable to what is seen in healthy controls. However, with increasing TBI severity, lower non-rapid eye movement SWA power is associated with reduced ability to learn and memorise new information the following day.

Challenges and Opportunities for Neuroimaging in Young Patients with Traumatic Brain Injury: a Coordinated Effort towards Advancing Discovery from the ENIGMA Pediatric Moderate/Severe TBI Group

2019 ◽  
Author(s):  
Emily L. Dennis ◽  
Karen Caeyenberghs ◽  
Robert F. Asarnow ◽  
Talin Babikian ◽  
Brenda Bartnik-Olson ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Meta Analysis ◽  
Young Patients ◽  
Future Research ◽  
Childhood And Adolescence ◽  
Developmental Issues ◽  
Challenges And Opportunities ◽  
Severe Tbi ◽  
Advance Research

Traumatic brain injury (TBI) is a major cause of death and disability in children in both developed and developing nations. Children and adolescents suffer from TBI at a higher rate than the general population; however, research in this population lags behind research in adults. This may be due, in part, to the smaller number of investigators engaged in research with this population and may also be related to changes in safety laws and clinical practice that have altered length of hospital stays, treatment, and access to this population. Specific developmental issues also warrant attention in studies of children, and the ever-changing context of childhood and adolescence may require larger sample sizes than are commonly available to adequately address remaining questions related to TBI. The ENIGMA (Enhancing NeuroImaging Genetics through Meta-Analysis) Pediatric Moderate-Severe TBI (msTBI) group aims to advance research in this area through global collaborative meta-analysis. In this paper we discuss important challenges in pediatric TBI research and opportunities that we believe the ENIGMA Pediatric msTBI group can provide to address them. We conclude with recommendations for future research in this field of study.

scholarly journals Modulated Neuroprotection in Unresponsive Wakefulness Syndrome after Severe Traumatic Brain Injury

2021 ◽  
Vol 11 (8) ◽  
pp. 1044
Author(s):  
Cristina Daia ◽  
Cristian Scheau ◽  
Aura Spinu ◽  
Ioana Andone ◽  
Cristina Popescu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Severe Traumatic Brain Injury ◽  
Functional Independence ◽  
Unresponsive Wakefulness Syndrome ◽  
Coma Scale ◽  
Severe Tbi ◽  
Neuroprotective Treatment ◽  
Gcs Score

Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.

Exploring persistent complaints of imbalance after mTBI: Oculomotor, peripheral vestibular and central sensory integration function

2021 ◽  
pp. 1-12
Author(s):  
Kody R. Campbell ◽  
Lucy Parrington ◽  
Robert J. Peterka ◽  
Douglas N. Martini ◽  
Timothy E. Hullar ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Sensory Integration ◽  
Balance Control ◽  
Vestibular Function ◽  
Healthy Controls ◽  
Subjective Symptoms ◽  
Central Function ◽  
Validated Questionnaires ◽  
Sensory Integration Dysfunction

BACKGROUND: Little is known on the peripheral and central sensory contributions to persistent dizziness and imbalance following mild traumatic brain injury (mTBI). OBJECTIVE: To identify peripheral vestibular, central integrative, and oculomotor causes for chronic symptoms following mTBI. METHODS: Individuals with chronic mTBI symptoms and healthy controls (HC) completed a battery of oculomotor, peripheral vestibular and instrumented posturography evaluations and rated subjective symptoms on validated questionnaires. We defined abnormal oculomotor, peripheral vestibular, and central sensory integration for balance measures among mTBI participants as falling outside a 10-percentile cutoff determined from HC data. A X-squared test associated the proportion of normal and abnormal responses in each group. Partial Spearman’s rank correlations evaluated the relationships between chronic symptoms and measures of oculomotor, peripheral vestibular, and central function for balance control. RESULTS: The mTBI group (n = 58) had more abnormal measures of central sensory integration for balance than the HC (n = 61) group (mTBI: 41% –61%; HC: 10%, p’s <  0.001), but no differences on oculomotor and peripheral vestibular function (p >  0.113). Symptom severities were negatively correlated with central sensory integration for balance scores (p’s <  0.048). CONCLUSIONS: Ongoing balance complaints in people with chronic mTBI are explained more by central sensory integration dysfunction rather than peripheral vestibular or oculomotor dysfunction.

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