Eye Tracking Detects Disconjugate Eye Movements Associated with Structural Traumatic Brain Injury and Concussion

Samadani, Uzma; Ritlop, Robert; Reyes, Marleen; Nehrbass, Elena; Li, Meng; Lamm, Elizabeth; Schneider, Julia; Shimunov, David; Sava, Maria; Kolecki, Radek; Burris, Paige; Altomare, Lindsey; Mehmood, Talha; Rjh, Smith; Huang, Jason H.; McStay, Christopher; Todd, S. Rob; Qian, Meng; Kondziolka, Douglas; Wall, Stephen P.; Huang, Paul P.

doi:10.1089/neu.2014.3687

Cited by 122 publications

(90 citation statements)

References 22 publications

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“…79 Modern ocular tracking techniques draw inspiration from methods that have been used in patients with TBI since the time of ancient Egypt. 127 More recently, however, algorithms for assessing eye tracking have enabled rapid and accurate assessment of the severity of ocular motor disruption associated with structural brain damage. 127 In cases where MRI and CT scans are inconclusive in the setting of mTBI, ocular evaluations can be a useful adjuvant for diagnosis.…”

Section: 116mentioning

confidence: 99%

Sports-related brain injuries: connecting pathology to diagnosis

Pan¹,

Connolly²,

Dangelmajer³

et al. 2016

FOC

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Neurosurg Focus 40 (4):E14, 2016M any sports-related brain injuries involve mild traumatic brain injuries (mTBIs), which result from physical blows to the head sustained over a period of time. Sports associated with an increased risk of head injury include American football, ice hockey, soccer, rugby, the martial arts, boxing, and bicycling. 21,90 These injuries are often unrecognized, undiagnosed, or underreported, which reflects the fact that this is a growing medical concern, often labeled a "silent epidemic." 8,66 Chronic exposure to mild brain injuries can result in long-term neurological consequences and represents a spectrum of disorders. The most remarkable outcome of mTBI is termed chronic traumatic encephalopathy (CTE), a clinical syndrome that is associated with neurodegeneration and behavioral, cognitive, and/or motor deficits. Although this disease has distinct pathological features, CTE is considered a diagnosis of exclusion because only postmortem biopsies can confirm the diagnosis. Therefore, new diagnostic methods need to be developed to: 1) inform patients of a definitive diagnosis, 2) better understand the epidemiology and risk factors of the disease, and 3) implement intervention programs to prevent any potential long-term complications. This review examines how understanding the pathology and molecular changes associated with repeated head trauma can lead to the discovery of novel imaging techniques and biomarkers. Mild Traumatic Brain Injury and CTEChronic traumatic encephalopathy has evolved from the so-called punch-drunk syndrome, which was used to describe a distinct neuropsychiatric condition that seemed to affect boxers, eventually becoming known as dementia pugilistica during the 1920s and 1930s. Symptoms such ABBrEvIATIoNs AD = Alzheimer's disease; APOE = apolipoprotein E; ASL = arterial spin labeling; BBB = blood-brain barrier; BOLD = blood oxygen level-dependent; CA = cornu ammonis; CTE = chronic traumatic encephalopathy; DTI = diffusion tensor imaging; FA = fractional anisotropy; fMRI = functional MRI; GFAP = glial fibrillary acidic protein; GRE = gradient recall echo; miRNA = microRNA; MRS = MR spectroscopy; mTBI = mild traumatic brain injury; NFL = National Football League; NFT = neurofibrillary tangle; NINDS = National Institute of Neurological Disorders and Stroke; NSE = neuron-specific enolase; p-tau = phosphorylated tau; SWI = susceptibility-weighted imaging; TDP-43 = TAR DNA-binding protein 43;18 F-FDDNP = 2-(1-{6- [(2-[fluorine-18] Brain injuries are becoming increasingly common in athletes and represent an important diagnostic challenge. Early detection and management of brain injuries in sports are of utmost importance in preventing chronic neurological and psychiatric decline. These types of injuries incurred during sports are referred to as mild traumatic brain injuries, which represent a heterogeneous spectrum of disease. The most dramatic manifestation of chronic mild traumatic brain injuries is termed chronic traumatic encephalopathy, which is associated with profo...

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Section: 116mentioning

confidence: 99%

Sports-related brain injuries: connecting pathology to diagnosis

Pan¹,

Connolly²,

Dangelmajer³

et al. 2016

FOC

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“…Therefore, the hypothesis is that wearing customized eyeglasses can create measurable changes in EEG tracings. 19,20 QEEG testing is highly reliable. Without interventions, results will remain consistent.…”

Section: Discussionmentioning

confidence: 99%

Quantitative electroencephalograms and neuro-optometry: a case study that explores changes in electrophysiology while wearing therapeutic eyeglasses

Zelinsky¹,

Feinberg

2017

Neurophoton

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Abstract. The brain is equipped with a complex system for processing sensory information, including retinal circuitry comprising part of the central nervous system. Retinal stimulation can influence brain function via customized eyeglasses at both subcortical and cortical levels. We investigated cortical effects from wearing therapeutic eyeglasses, hypothesizing that they can create measureable changes in electroencephalogram (EEG) tracings. A Z-Bell SM test was performed on a participant to select optimal lenses. An EEG measurement was recorded before and after the participant wore the eyeglasses. Equivalent quantitative electroencephalography (QEEG) analyses (statistical analysis on raw EEG recordings) were performed and compared with baseline findings. With glasses on, the participant's readings were found to be closer to the normed database. The original objective of our investigation was met, and additional findings were revealed. The Z-bell SM test identified lenses to influence neurotypical brain activity, supporting the paradigm that eyeglasses can be utilized as a therapeutic intervention. Also, EEG analysis demonstrated that encephalographic techniques can be used to identify channels through which neuro-optomertric treatments work. This case study's preliminary exploration illustrates the potential role of QEEG analysis and EEG-derived brain imaging in neuro-optometric research endeavors to affect brain function.

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“…Accordingly, reliable and validated testing strategies are necessary to insure timely detection and removal from play for individuals suspected of concussion. Vision and visual motor problems are commonly reported among athletes following concussion [7][8][9][10][11][12][13][14][15]. This is to be expected as it is estimated that approximately 50% of the brain is devoted to vision and visual motor processing [16].…”

Section: Editorialmentioning

confidence: 99%

“…Ocular motility dysfunction is reported in approximately 90% of individuals with concussion [14]. Anatomical correlates for impaired eye movements are linked to the lesions of the anterior corona radiata (ACR), dorsolateral prefrontal cortex (DLPFC) and genu of the corpus callosum [36,37].…”

Section: Impaired Saccade and Pursuit Eye Movementsmentioning

confidence: 99%

Sports-Related Concussion: The Eyes Have It

Messner¹

2016

Optom open access

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EditorialConcussion is a form of mild traumatic brain injury (TBI) owing to structural, metabolic and functional changes involving white mater tracts of the central nervous system in the absence of macroscopic findings [1][2][3][4]. Sports-related concussion is a rapidly evolving condition stimulating interest among lay and scientific communities [3]. Recent studies have shown a high rate of underreporting of concussion signs and symptoms by athletes and sideline personnel [5,6]. Accordingly, reliable and validated testing strategies are necessary to insure timely detection and removal from play for individuals suspected of concussion. Vision and visual motor problems are commonly reported among athletes following concussion [7][8][9][10][11][12][13][14][15]. This is to be expected as it is estimated that approximately 50% of the brain is devoted to vision and visual motor processing [16]. As such, testing of vision and ocular motility function are critical to the evaluation of a concussed individual. While disorders of vision and ocular motility have been well-reported with TBI, most of these studies have focused on visual motor problems in the setting of combatrelated TBI resulting from blast injuries [8]. There are limited studies related to vision and visual motor abnormalities from sport-related concussion.While disorders of vision and ocular motility have been wellreported with TBI, most of these studies have focused on visual motor problems in the setting of combat-related TBI resulting from blast injuries [17]. There are limited studies related to vision and visual motor abnormalities from sport-related concussion.Common vision and visual motor problems in the setting of concussion include photophobia, convergence insufficiency, disorders of accommodation and disorders of saccades and pursuit eye movements (versional dysfunction). A comprehensive ocular examination with attention to these areas of vision and visual motor function is essential to the evaluation of a concussed individual. PhotophobiaPhotophobia and phonophobia are commonly reported in the setting of concussion [18][19][20][21]. It is speculated that the mechanism may be related to disturbance of the cortico-thalamic pathways with meningeal irritation in a manner similar to that reported with migraine [18]. Light-filtering lenses have shown benefit in reducing light intolerance and reading performance in patients with traumainduced photophobia [22]. Lynch et al. have recently reported on the therapeutic value of computer gaming lenses in the mitigation of photosensitivity and headache following concussion [23]. Vergence and accommodative disordersMilitary models of traumatic brain injury show a high prevalence of vergence and accommodative deficits in these populations. In a study of 40 soldiers with combat-related mild traumatic brain injury (mTBI), Capo-Aponte and colleagues reported on the proportion of near pointrelated visual-motor abnormalities as compared to age-matched controls [17]. Specific oculomotor abnormalities included high e...

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Eye Tracking Detects Disconjugate Eye Movements Associated with Structural Traumatic Brain Injury and Concussion

Cited by 122 publications

References 22 publications

Sports-related brain injuries: connecting pathology to diagnosis

Sports-related brain injuries: connecting pathology to diagnosis

Quantitative electroencephalograms and neuro-optometry: a case study that explores changes in electrophysiology while wearing therapeutic eyeglasses

Sports-Related Concussion: The Eyes Have It

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