Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli

Danna-Dos-Santos, Alessander; Mohapatra, Sambit; Santos, Maria M.; Degani, Adriana M.

doi:10.1038/s41598-018-22825-5

Cited by 33 publications

(31 citation statements)

References 48 publications

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“…Vestibular testing in conjunction with eye-tracking represents a noninvasive method of assessing the peripheral and central deficits in the vestibular and ocular motor systems in many neurological conditions, including brain injury. Work from our group and findings from other studies have shown the utility of ocular motor and vestibular testing in the detection, diagnosis, and monitoring of mTBI, 24,27,28,44,47,48 vestibular, neurotological, and neurological conditions. 12,[21][22][23]35 Appropriate tools for diagnosis and monitoring of the mTBI/concussion have gained significant interest in recent years.…”

Section: Discussionmentioning

confidence: 82%

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Normative data for ages 18‐45 for ocular motor and vestibular testing using eye tracking

Kullmann

Ashmore

Braverman

et al. 2021

Laryngoscope Investig Oto

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Objective Eye tracking technology has been employed in assessing ocular motor and vestibular function following vestibular and neurologic conditions, including traumatic brain injury (TBI). Assessments include tests that provide visual and motion (rotation) stimuli while recording horizontal, vertical, and torsional eye movements. While some of these tests have shown diagnostic promise in previous studies, their use in clinical practice is limited by the lack of normative data. The goal of this study was to construct normative reference ranges to be used when comparing patients' results. Methods Optokinetic response, subjective visual horizontal and vertical, and rotation tests were administered to male and female volunteers, ages 18‐45, who were free from neurological, vestibular disorders, or other head injuries. Tests were administered using either a rotatory chair or a portable virtual reality‐like goggle equipped with video‐oculography. Results Reference values for eye movements in response to different patterns of stimuli were analyzed from 290 to 449 participants. Analysis of gender (self‐reported) or age when grouped as pediatric (late adolescent; 18‐21 years of age) and adult (21‐45 years of age) revealed no effects on the test metrics. Data were pooled and presented for each test metric as the 95% reference interval ( RI ) with 90% confidence intervals ( CI ) on upper and lower limits of the RI. Conclusions This normative database can serve as a tool to aid in diagnosis, treatment, and/or rehabilitation protocols for vestibular and neurological conditions, including mild TBI (mTBI). This database has been cleared by the FDA for use in clinical practice (K192186). Level of evidence 2b

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Section: Discussionmentioning

confidence: 82%

“…These tests are commonly used to evaluate ocular motor and vestibular deficits following mTBI and/or other neurological conditions. 24 , 27 , 41 , 42 , 43 , 44 , 45 Metrics describing different components of eye movement (e.g., gain, phase) for each test were computed (detailed description of each metric is included in Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Normative data for ages 18‐45 for ocular motor and vestibular testing using eye tracking

Kullmann

Ashmore

Braverman

et al. 2021

Laryngoscope Investig Oto

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“…Lee et al, 2018). Other relevant findings of our previous research on individuals who had experienced mTBI include poorer accuracy and velocity of rapid eye movements (Danna-Dos-Santos, Mohapatra, Santos, & Degani, 2018), poorer episodic memory (H. Lee et al, 2018), diminished attention and concentration (Carbonar et al, unpublished), and more severe anxiety and sleep disturbance (H.…”

Section: Mtbi and Postural Controlmentioning

confidence: 82%

Proof-of-Concept Testing of a Real-Time mHealth Measure to Estimate Postural Control During Walking: A Potential Application for Mild Traumatic Brain Injuries

Lee

Salado

et al. 2018

Asian Pac Isl Nurs J

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Background: Most individuals with mild traumatic brain injury (mTBI) experience post-injury deficits in postural control. Currently available measures of postural control are lab-based or supervised, which may hinder timely symptom assessment for individuals with mTBI, including Asian populations, who do not seek initial screening post-injury. In this proof-of-concept testing study, we introduce a real-time mobile health (mHealth) system to measure postural control during walking. The proposed mHealth system can be used for home-based symptom assessment and management of mTBI. Methods: In our proposed mHealth system, a smartwatch, a smartphone, and a cloud server communicate to measure, collect, and store body balance data in real time. Specifically, we focus on the rotation vector data that have been reported to be the most effective in terms of differentiating balance control during walking across different participants. Results: Constant motion change in four participants (two females and two males; three healthy participants, and one individual with reduced physical mobility) was collected and analyzed. The results of our data analysis show that, compared to healthy participants, the individual was reduced physical mobility had a wider range of motion between right and left, up and down, and forward and backward while walking. We also found that female participants had narrower ranges of right-to-left and up-and-down motions than their male counterparts. Conclusions: Our results highlight the potential of the proposed real-time mHealth system for home-based symptom assessment and management of mTBI, which may benefit Asian and other nonwhite racial minority groups that appear to be more reluctant to access post-acute rehabilitation services.

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“…The authors' interpretation of these findings is that they reflect what could happen with poorly administered and inaccurate testing methods. On the other hand, a number of reports have demonstrated utility for reaction time as a concussion assessment (Warden et al, 2001;Willison and Tombaugh, 2006;Cole et al, 2018;Danna-Dos-Santos et al, 2018;Lange et al, 2018). Norris et al (2013) described the reaction time metric as having prognostic utility and others have proposed that reaction time could be used in the absence of baseline measures by just comparing to normative values (Schmidt et al, 2012), and the authors share that opinion based on our recent work.…”

Section: Discussionmentioning

confidence: 99%

Methodological Problems With Online Concussion Testing

Holden

Francisco

Tommerdahl

et al. 2020

Front. Hum. Neurosci.

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Reaction time testing is widely used in online computerized concussion assessments, and most concussion studies utilizing the metric have demonstrated varying degrees of difference between concussed and non-concussed individuals. The problem with most of these online concussion assessments is that they predominantly rely on consumer grade technology. Typical administration of these reaction time tests involves presenting a visual stimulus on a computer monitor and prompting the test subject to respond as quickly as possible via keypad or computer mouse. However, inherent delays and variabilities are introduced to the reaction time measure by both computer and associated operating systems that the concussion assessment tool is installed on. The authors hypothesized systems that are typically used to collect concussion reaction time data would demonstrate significant errors in reaction time measurements. To remove human bias, a series of experiments was conducted robotically to assess timing errors introduced by reaction time tests under four different conditions. In the first condition, a visual reaction time test was conducted by flashing a visual stimulus on a computer monitor. Detection was via photodiode and mechanical response was delivered via computer mouse. The second condition employed a mobile device for the visual stimulus, and the mechanical response was delivered to the mobile device's touchscreen. The third condition simulated a tactile reaction time test, and mechanical response was delivered via computer mouse. The fourth condition also simulated a tactile reaction time test, but response was delivered to a dedicated device designed to store the interval between stimulus delivery and response, thus bypassing any problems hypothesized to be introduced by computer and/or computer software. There were significant differences in the range of responses recorded from the four different conditions with the reaction time collected from visual stimulus on a mobile device being the worst and the device with dedicated hardware designed for the task being the best. The results suggest that some of the commonly used visual tasks on consumer grade computers could be (and have been) introducing significant errors for reaction time testing and that dedicated hardware designed for the reaction time task is needed to minimize testing errors.

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Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli

Cited by 33 publications

References 48 publications

Normative data for ages 18‐45 for ocular motor and vestibular testing using eye tracking

Normative data for ages 18‐45 for ocular motor and vestibular testing using eye tracking

Proof-of-Concept Testing of a Real-Time mHealth Measure to Estimate Postural Control During Walking: A Potential Application for Mild Traumatic Brain Injuries

Methodological Problems With Online Concussion Testing

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