John-Ross Rizzo1, Todd E Hudson1, Weiwei Dai2, Ninad Desai3, Arash Yousefi4, Dhaval Palsana5, Ivan Selesnick2, Laura J Balcer6, Steven L Galetta7, Janet C Rucker8. 1. Department of Physical Medicine & Rehabilitation, NYU School of Medicine, New York, NY, United States; Department of Neurology, NYU School of Medicine, New York, NY, United States. 2. Department of Electrical & Computer Engineering, NYU Tandon School of Engineering, New York, NY, United States. 3. Department of Neurology, NYU School of Medicine, New York, NY, United States. 4. Department of Physical Medicine & Rehabilitation, NYU School of Medicine, New York, NY, United States. 5. Department of Mechanical Engineering, NYU Tandon School of Engineering, New York, NY, United States. 6. Department of Neurology, NYU School of Medicine, New York, NY, United States; Department of Population Health, NYU School of Medicine, New York, NY, United States; Department of Ophthalmology, NYU School of Medicine, New York, NY, United States. 7. Department of Neurology, NYU School of Medicine, New York, NY, United States; Department of Ophthalmology, NYU School of Medicine, New York, NY, United States. 8. Department of Neurology, NYU School of Medicine, New York, NY, United States; Department of Ophthalmology, NYU School of Medicine, New York, NY, United States. Electronic address: janet.rucker@nyumc.org.
Abstract
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. METHODS: Twelve healthy control subjects underwent quantitative eye tracking during digitized K-D testing. RESULTS: The total K-D reading time was 51.24 (±9.7) seconds. A total of 145 saccades (±15) per subject were generated, with average peak velocity 299.5°/s and average amplitude 8.2°. The average inter-saccadic interval was 248.4 ms. Task-specific horizontal and oblique saccades per subject numbered, respectively, 102 (±10) and 17 (±4). Subjects with the fewest saccades tended to blink more, resulting in a larger amount of missing data; whereas, subjects with the most saccades tended to make extra saccades during line transitions. CONCLUSIONS: Establishment of normal and objective ocular motor behavior during the K-D test is a critical first step towards defining the range of deficits underlying abnormal testing in concussion. Further, it sets the groundwork for exploration of K-D correlations with cognitive dysfunction and saccadic paradigms that may reflect specific neuroanatomic deficits in the concussed brain.
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. METHODS: Twelve healthy control subjects underwent quantitative eye tracking during digitized K-D testing. RESULTS: The total K-D reading time was 51.24 (±9.7) seconds. A total of 145 saccades (±15) per subject were generated, with average peak velocity 299.5°/s and average amplitude 8.2°. The average inter-saccadic interval was 248.4 ms. Task-specific horizontal and oblique saccades per subject numbered, respectively, 102 (±10) and 17 (±4). Subjects with the fewest saccades tended to blink more, resulting in a larger amount of missing data; whereas, subjects with the most saccades tended to make extra saccades during line transitions. CONCLUSIONS: Establishment of normal and objective ocular motor behavior during the K-D test is a critical first step towards defining the range of deficits underlying abnormal testing in concussion. Further, it sets the groundwork for exploration of K-D correlations with cognitive dysfunction and saccadic paradigms that may reflect specific neuroanatomic deficits in the concussed brain.
Authors: Mark S Dziemianowicz; Matthew P Kirschen; Bryan A Pukenas; Eric Laudano; Laura J Balcer; Steven L Galetta Journal: Curr Neurol Neurosci Rep Date: 2012-10 Impact factor: 5.081
Authors: Lisena Hasanaj; Sujata P Thawani; Nikki Webb; Julia D Drattell; Liliana Serrano; Rachel C Nolan; Jenelle Raynowska; Todd E Hudson; John-Ross Rizzo; Weiwei Dai; Bryan McComb; Judith D Goldberg; Janet C Rucker; Steven L Galetta; Laura J Balcer Journal: J Neuroophthalmol Date: 2018-03 Impact factor: 3.042
Authors: Clotilde Hainline; John-Ross Rizzo; Todd E Hudson; Weiwei Dai; Joel Birkemeier; Jenelle Raynowska; Rachel C Nolan; Lisena Hasanaj; Ivan Selesnick; Teresa C Frohman; Elliot M Frohman; Steven L Galetta; Laura J Balcer; Janet C Rucker Journal: J Neurol Date: 2017-04-07 Impact factor: 4.849
Authors: John-Ross Rizzo; Todd E Hudson; Prin X Amorapanth; Weiwei Dai; Joel Birkemeier; Rosa Pasculli; Kyle Conti; Charles Feinberg; Jan Verstraete; Katie Dempsey; Ivan Selesnick; Laura J Balcer; Steven L Galetta; Janet C Rucker Journal: Brain Inj Date: 2018-09-05 Impact factor: 2.311