Paul A Wetzel1,2, Anne S Lindblad3, Hardik Raizada3, Nathan James3, Caroline Mulatya3, Mary A Kannan2, Zoe Villamar2, George T Gitchel2, Lindell K Weaver4,5,6. 1. Lovelace Biomedical Research, Albuquerque, New Mexico, United States. 2. Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia, United States. 3. The Emmes Corporation, Rockville, Maryland, United States. 4. Division of Hyperbaric Medicine, Intermountain Medical Center, Murray, Utah, United States. 5. Intermountain LDS Hospital, Salt Lake City, Utah, United States. 6. Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States.
Abstract
Purpose: Standard physical, neurologic, and neuropsychologic examinations may not detect abnormalities after mild traumatic brain injury (mTBI). An analysis of eye movements may be more sensitive to neurologic dysfunction. Methods: We performed eye tracking assessments in 71 active duty and veteran military personnel with persistent postconcussive symptoms (3 months to 5 years after mTBI) and 75 volunteers with no history of brain injury. Both eyes were sampled at 500 Hz and analyzed for various eye measurement parameters during visual tasks involving the saccadic and smooth systems. Results: No difference between mTBI and normal participants in main sequence profiles was observed. On the circular task, intersaccadic interval duration was shorter in mTBI compared with normal subjects (horizontal: Cohen's D = -0.65; vertical: Cohen's D = -0.75). For reading, absolute saccadic amplitudes (Cohen's D = -0.76) and average forward saccadic amplitudes were lower (Cohen's D = -0.61). Absolute fixation velocity was higher (Cohen's D = 1.02), and overall fixation durations (Cohen's D = 0.58), regression durations (Cohen's D = 0.49), and forward saccadic durations (Cohen's D=0.54) were longer. mTBI participants had more fixations (Cohen's D = 0.54) and regressions per line (Cohen's D = 0.70) and read fewer lines (Cohen's D = -0.38) than normal subjects. On the horizontal ramp task, mTBI participants had lower weighted smooth pursuit gains (Cohen's D = -0.55). On the horizontal step task, mTBI participants had shorter mean fixation times (Cohen's D = -0.55). Conclusions: These results suggest vulnerability of the smooth pursuit and saccadic systems in mTBI. Eye tracking shows promise as an objective, sensitive assessment of damage after mTBI. (ClinicalTrials.gov number, NCT01611194, NCT01925963.).
Purpose: Standard physical, neurologic, and neuropsychologic examinations may not detect abnormalities after mild traumatic brain injury (mTBI). An analysis of eye movements may be more sensitive to neurologic dysfunction. Methods: We performed eye tracking assessments in 71 active duty and veteran military personnel with persistent postconcussive symptoms (3 months to 5 years after mTBI) and 75 volunteers with no history of brain injury. Both eyes were sampled at 500 Hz and analyzed for various eye measurement parameters during visual tasks involving the saccadic and smooth systems. Results: No difference between mTBI and normal participants in main sequence profiles was observed. On the circular task, intersaccadic interval duration was shorter in mTBI compared with normal subjects (horizontal: Cohen's D = -0.65; vertical: Cohen's D = -0.75). For reading, absolute saccadic amplitudes (Cohen's D = -0.76) and average forward saccadic amplitudes were lower (Cohen's D = -0.61). Absolute fixation velocity was higher (Cohen's D = 1.02), and overall fixation durations (Cohen's D = 0.58), regression durations (Cohen's D = 0.49), and forward saccadic durations (Cohen's D=0.54) were longer. mTBI participants had more fixations (Cohen's D = 0.54) and regressions per line (Cohen's D = 0.70) and read fewer lines (Cohen's D = -0.38) than normal subjects. On the horizontal ramp task, mTBI participants had lower weighted smooth pursuit gains (Cohen's D = -0.55). On the horizontal step task, mTBI participants had shorter mean fixation times (Cohen's D = -0.55). Conclusions: These results suggest vulnerability of the smooth pursuit and saccadic systems in mTBI. Eye tracking shows promise as an objective, sensitive assessment of damage after mTBI. (ClinicalTrials.gov number, NCT01611194, NCT01925963.).
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