Eye movement dynamics: a rapid objective involuntary measure of concussion/mTBI

项目摘要 美国每年发生超过150万例与运动相关的轻度创伤性脑损伤（mTBI），其中包括25，000例 仅在高中运动员中。越来越多的媒体和医疗关注集中在这些伤害及其 可能导致长期的认知、身体和情感问题。当检测到低水平扩散时， 通过mTBI造成的损害需要准确和快速地发生，评估方法已经 被批评为不够敏感，容易受到动机和其他外部因素的影响。最近 研究表明眼运动性能（例如，眼球运动，如扫视和平滑追踪） 可能代表mTBI的敏感生物标志物，但它还有待在真实的世界运动环境中进行测试。的 本研究的第一个目的是建立并验证一个便携式、低成本和可用的边线眼动仪 在阳光直射下。使用边线眼动仪，我们将评估眼动仪的临床效用 作为女性和男性高中生mTBI的快速，客观和准确的边线测量的表现 大学水平的运动员。具体来说，我们建议进行双重病例对照，纵向 比较60名脑震荡运动员、60名匹配的非脑震荡运动员对照组和60名匹配的非运动员 控制了两个赛季的体育比赛，检查了所有三组的眼运动表现和广泛的 使用mTBI诊断神经心理学测量（ImPACTTM测试）。两个运动员团体将接受测试 在基线（受伤前），受伤后，和赛季后的延迟。非运动员对照组将在 基线和季后赛延迟。本研究将探讨眼动测验的重测信度 变量，记录mTBI后较基线的任何变化，探索眼运动性能如何与 认知表现（ImPACT测试）和三个受试者组之间的差异，并检查是否 相对于基线的变化预测恢复率（恢复比赛前的天数）。最后，我们将进行初步的 检查眼运动表现的多变量统计模型是否可以将受试者分为 脑震荡组和非脑震荡组。

Project Summary Over 1.5 million sport-related mild traumatic brain injuries (mTBI) occur annually in the US, including 25,000 in high school athletes alone. Increased media and medical attention is focusing on these injuries and their potential to cause long-term cognitive, somatic and affective problems. While detection of the low level diffuse damage incurred through mTBI needs to take place accurately and quickly, assessment methods have been criticized as insufficiently sensitive and susceptible to motivational and other extraneous factors. Recent research suggests that ocularmotor performance (e.g., eye movements such as saccades and smooth pursuit) may represent a sensitive biomarker of mTBI, yet it has yet to be tested in the real world athletic setting. The first aim of this study is to build and validate a sideline eye tracker that would be portable, low cost, and usable in direct sunlight. Using the sideline eye tracker, we will then evaluate the clinical utility of ocularmotor performance as a rapid, objective, and accurate sidelines measure of mTBI among female and male high school and college level athletes. Specifically, we propose to conduct a double case-controlled, longitudinal comparison of 60 concussed athletes, 60 matched non-concussed athlete controls and 60 matched non-athlete controls over two seasons of athletic play, examining all three groups on ocularmotor performance and a widely used mTBI diagnostic neuropsychological measure (the ImPACTTM test). The two athlete groups will be tested at baseline (pre-injury), post-injury, and post-season delay. The non-athlete control group will be tested at baseline and post-season delay. We will investigate the test-retest reliability of the ocularmotor performance variables, document any change from baseline following mTBI, explore how ocularmotor performance relates to cognitive performance (ImPACT test) and differs between the three subject groups, and examine whether change from baseline predicts recovery rate (days till return to play). Finally, we will conduct a preliminary examination of whether a multi-variate statistical model of ocularmotor performance can classify subjects into concussed and non-concussed groups.