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Concussion and Eye Tracking

Nicholas G Murray, Nathan R D'Amico, Douglas Powell, Megan E Mormile, Katelyn E Grimes, Barry A Munkasy, Russell K Gore, Rebecca J Reed-Jones
BACKGROUND: Approximately 90% of athletes with concussion experience a certain degree of visual system dysfunction immediately post-concussion. Of these abnormalities, gaze stability deficits are denoted as among the most common. Little research quantitatively explores these variables post-concussion. As such, the purpose of this study was to investigate and compare gaze stability between a control group of healthy non-injured athletes and a group of athletes with concussions 24-48hours post-injury...
March 6, 2017: Clinical Biomechanics
Jun Maruta, Eugene Jaw, Peter Modera, Umesh Rajashekar, Lisa A Spielman, Jamshid Ghajar
Human visual tracking performance is known to be reduced with an increase of the target's speed and oscillation frequency, but changes in brain states following a concussion may alter these frequency responses. The goal of this study was to characterize and compare frequency-dependent smooth pursuit velocity degradation in normal subjects and patients who had chronic postconcussion symptoms, and also examine cases of acutely concussed patients. Eye movements were recorded while subjects tracked a target that moved along a circular trajectory of 10° radius at 0...
March 2017: Military Medicine
Joshua D Fischer, Dawie J van den Heever
Concussion is currently a serious health problem and can lead to severe brain dysfunction. There is a definite need for sensitive and reliable tests to detect and evaluate the subtle changes in brain function caused by concussion. This study details the development of a low cost portable eye tracking device that can aid in the detection of concussions. The device evaluates ocular motor function and can be used on the sidelines of sporting events to give a quick indication of the severity of head trauma. It can further be used to evaluate and monitor mild Traumatic Brain Injuries and aid in the return to play decision making process...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Joshua D Fischer, Dawie J van den Heever, Joshua D Fischer, Dawie J van den Heever, Dawie J Van den Heever, Joshua D Fischer
Concussion is currently a serious health problem and can lead to severe brain dysfunction. There is a definite need for sensitive and reliable tests to detect and evaluate the subtle changes in brain function caused by concussion. This study details the development of a low cost portable eye tracking device that can aid in the detection of concussions. The device evaluates ocular motor function and can be used on the sidelines of sporting events to give a quick indication of the severity of head trauma. It can further be used to evaluate and monitor mild Traumatic Brain Injuries and aid in the return to play decision making process...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Christina Lin Master, Abdullah Bin Zahid, Julia Lockyer, Eileen Houseknecht, Vikalpa Dammavalam, Matthew Grady, Michael Nance, Uzma Samadani
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
John-Ross Rizzo, Todd E Hudson, Weiwei Dai, Ninad Desai, Arash Yousefi, Dhaval Palsana, Ivan Selesnick, Laura J Balcer, Steven L Galetta, Janet C Rucker
OBJECTIVE: Concussion is a major public health problem and considerable efforts are focused on sideline-based diagnostic testing to guide return-to-play decision-making and clinical care. The King-Devick (K-D) test, a sensitive sideline performance measure for concussion detection, reveals slowed reading times in acutely concussed subjects, as compared to healthy controls; however, the normal behavior of eye movements during the task and deficits underlying the slowing have not been defined...
March 15, 2016: Journal of the Neurological Sciences
Inae C Gadotti, Leonard Elbaum, YoungJin Jung, Victor Garbalosa, Stephen Kornbluth, Bruno Da Costa, Kinsuk Maitra, Denis Brunt
This study tested the feasibility of a method to synchronise and to evaluate eye, head and trunk movement patterns during target tracking tasks performed by 10 subjects. A projected central target was randomly repositioned at 40° and 70° of rotation to the left and right. Subjects were instructed to change gaze as quickly as possible. Head and trunk motion was measured using a motion analysis system, and eye movement was measured using an eye-tracker; all data were synchronised. For healthy subjects, the eye moved faster than the head, there was no trunk movement and the head moved more than the eye to reach further displaced targets...
November 2016: Ergonomics
Christopher A DiCesare, Adam W Kiefer, Patrick Nalepka, Gregory D Myer
Assessment of deficits in oculomotor function may be useful to detect visuomotor impairments due to a closed head injury. Systematic analysis schemes are needed to reliably quantify oculomotor deficits associated with oculomotor impairment via brain trauma. We propose a systematic, automated analysis scheme using various eye-tracking tasks to assess oculomotor function in a cohort of adolescents with acute concussion symptoms and aged-matched healthy controls. From these data we have evidence that these methods reliably detect oculomotor deficits in the concussed group, including reduced spatial accuracy and diminished tracking performance during visually guided prosaccade and self-paced saccade tasks...
February 2017: Behavior Research Methods
Tara D Fischer, Stuart D Red, Alice Z Chuang, Elizabeth B Jones, James J McCarthy, Saumil S Patel, Anne B Sereno
This study examined the potential for novel tablet-based tasks, modeled after eye tracking techniques, to detect subtle sensorimotor and cognitive deficits after mild traumatic brain injury (mTBI). Specifically, we examined whether performance on these tablet-based tasks (Pro-point and Anti-point) was able to correctly categorize concussed versus non-concussed participants, compared with performance on other standardized tests for concussion. Patients admitted to the emergency department with mTBI were tested on the Pro-point and Anti-point tasks, a current standard cognitive screening test (i...
July 1, 2016: Journal of Neurotrauma
Tao Pan, Ke Liao, Kristen Roenigk, Janis J Daly, Mark F Walker
Persistent post-concussive symptoms are reported by 10-15% of individuals who suffer mild traumatic brain injury (mTBI), but their basis is often uncertain. One such symptom is disequilibrium, a sensation of impaired balance during standing and walking. The hypothesis for this study was that this subjective symptom is associated with objective and measurable deficits in static and dynamic postural stability. An infrared motion tracking system was used to record body motion during quiet standing and in response to waist perturbations in fourteen veterans (age 22-40 years, 13 male) of the Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF), who had a history of mTBI that occurred 7 months to 7 years prior to testing...
October 2015: Gait & Posture
Mithun Diwakar, Deborah L Harrington, Jun Maruta, Jamshid Ghajar, Fady El-Gabalawy, Laura Muzzatti, Maurizio Corbetta, Ming-Xiong Huang, Roland R Lee
A barrier in the diagnosis of mild traumatic brain injury (mTBI) stems from the lack of measures that are adequately sensitive in detecting mild head injuries. MRI and CT are typically negative in mTBI patients with persistent symptoms of post-concussive syndrome (PCS), and characteristic difficulties in sustaining attention often go undetected on neuropsychological testing, which can be insensitive to momentary lapses in concentration. Conversely, visual tracking strongly depends on sustained attention over time and is impaired in chronic mTBI patients, especially when tracking an occluded target...
2015: NeuroImage: Clinical
Jun Maruta
This correspondence points out a need for clarification concerning the methodology utilized in the study "Eye tracking detects disconjugate eye movements associated with structural traumatic brain injury and concussion", recently published in Journal of Neurotrauma. The authors of the paper state that binocular eye movements were recorded using a single-camera video-oculography technique and that binocular disconjugate characteristics were analyzed without calibration of eye orientation. It is claimed that a variance-based disconjugacy metric was found to be sensitive to the severity of a concussive brain injury and to the status of recovery after the original injury...
2015: F1000Research
Serguei V Astafiev, Gordon L Shulman, Nicholas V Metcalf, Jennifer Rengachary, Christine L MacDonald, Deborah L Harrington, Jun Maruta, Joshua S Shimony, Jamshid Ghajar, Mithun Diwakar, Ming-Xiong Huang, Roland R Lee, Maurizio Corbetta
Concussion, or mild traumatic brain injury (mTBI), can cause persistent behavioral symptoms and cognitive impairment, but it is unclear if this condition is associated with detectable structural or functional brain changes. At two sites, chronic mTBI human subjects with persistent post-concussive symptoms (three months to five years after injury) and age- and education-matched healthy human control subjects underwent extensive neuropsychological and visual tracking eye movement tests. At one site, patients and controls also performed the visual tracking tasks while blood-oxygen-level-dependent (BOLD) signals were measured with functional magnetic resonance imaging...
August 15, 2015: Journal of Neurotrauma
Rachel E Ventura, Jeffrey M Jancuska, Laura J Balcer, Steven L Galetta
BACKGROUND: Concussion, particularly in relation to sports and combat activities, is increasingly recognized as a potential cause of both short- and long-term neurologic sequelae. This review will focus on the neuro-ophthalmologic findings associated with concussion, the current tests for concussion, and the potential for visual performance measures to improve our detection and assessment of concussions. EVIDENCE ACQUISITION: A PubMed search using the specific key words "concussion," "mild traumatic brain injury," "neuro-ophthalmological findings," and "diagnostic and management tests" was performed...
March 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Uzma Samadani, Robert Ritlop, Marleen Reyes, Elena Nehrbass, Meng Li, Elizabeth Lamm, Julia Schneider, David Shimunov, Maria Sava, Radek Kolecki, Paige Burris, Lindsey Altomare, Talha Mehmood, Theodore Smith, Jason H Huang, Christopher McStay, S Rob Todd, Meng Qian, Douglas Kondziolka, Stephen Wall, Paul Huang
Disconjugate eye movements have been associated with traumatic brain injury since ancient times. Ocular motility dysfunction may be present in up to 90% of patients with concussion or blast injury. We developed an algorithm for eye tracking in which the Cartesian coordinates of the right and left pupils are tracked over 200 sec and compared to each other as a subject watches a short film clip moving inside an aperture on a computer screen. We prospectively eye tracked 64 normal healthy noninjured control subjects and compared findings to 75 trauma subjects with either a positive head computed tomography (CT) scan (n=13), negative head CT (n=39), or nonhead injury (n=23) to determine whether eye tracking would reveal the disconjugate gaze associated with both structural brain injury and concussion...
April 15, 2015: Journal of Neurotrauma
David X Cifu, Kathy W Hoke, Paul A Wetzel, Joanna R Wares, George Gitchel, William Carne
The effects of hyperbaric oxygen (HBO2) on eye movement abnormalities in 60 military servicemembers with at least one mild traumatic brain injury (TBI) from combat were examined in a single-center, randomized, double-blind, sham-controlled, prospective study at the Naval Medicine Operational Training Center. During the 10 wk of the study, each subject was delivered a series of 40, once a day, hyperbaric chamber compressions at a pressure of 2.0 atmospheres absolute (ATA). At each session, subjects breathed one of three preassigned oxygen fractions (10...
2014: Journal of Rehabilitation Research and Development
M V Vartiainen, A Holm, K Peltonen, T M Luoto, G L Iverson, L Hokkanen
The King-Devick (K-D) test, a measure of processing speed, visual tracking, and saccadic eye movements, has shown promise as a supplemental screening test following concussion. However, limited normative data for this test have been published.The K-D test was administered to 185 professional ice hockey players as a preseason baseline test in seasons 2012-2013 and 2013-2014. Their average age was 23.8 years (median = 22.0 years, range = 16-40 years). The average K-D score was 40.0 s (SD = 6.1 s, range = 24...
June 2015: Scandinavian Journal of Medicine & Science in Sports
Jun Maruta, Jamshid Ghajar
An attention-based biomarker may be useful for concussion screening. A key role of attention is to generate time-based expectancies of specific sensory information, and it is postulated that postconcussion cognitive impairments and symptoms may stem from a primary deficit in this predictive timing mechanism. There is a close relationship between gaze and attention, but in addressing predictive timing, there is a need for an appropriate testing paradigm and methods to quantify oculomotor anomalies. We have utilized a continuous predictive visual tracking paradigm because human visual tracking requires predicting the temporal course of a stimulus and dynamically synchronizing the required action with the stimulus...
2014: Progress in Neurological Surgery
David X Cifu, Joanna R Wares, Kathy W Hoke, Paul A Wetzel, George Gitchel, William Carne
OBJECTIVES: Objective measures to diagnose and to monitor improvement of symptoms following mild traumatic brain injury (mTBI) are lacking. Computerized eye tracking has been advocated as a rapid, user friendly, and field-ready technique to meet this need. DESIGN: Eye-tracking data collected via a head-mounted, video-based binocular eye tracker was used to examine saccades, fixations, and smooth pursuit movement in military Service Members with postconcussive syndrome (PCS) and asymptomatic control subjects in an effort to determine if eye movement differences could be found and quantified...
January 2015: Journal of Head Trauma Rehabilitation
Nicholas G Murray, V N Pradeep Ambati, Monica M Contreras, Anthony P Salvatore, Rebecca J Reed-Jones
PRIMARY OBJECTIVE: Balance disturbances occur in ∼30% of concussion injuries, with vestibular dysfunction reported as the main contributor. However, few have studied oculomotor control post-concussion to assess vestibular dysfunction. RESEARCH DESIGN: The current research measured the differences in oculomotor control between athletes post-concussion (PC) and athletes without concussion (NC) during an active balance control task. METHODS: Nine PC and nine NC athletes wore a monocular eye tracking device, while balance tests were performed using the Nintendo WiiFit® soccer heading game...
2014: Brain Injury: [BI]
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