Differential Eye Movements in Mild Traumatic Brain Injury Versus Normal Controls

Abstract

A reliable, standardized protocol that appears to differentiate mTBI from normals was developed for use in future research. This investigation represents a step toward objective identification of those with PCS. Future studies focused on increasing the specificity of eye movement differences in those with PCS are needed.

Characterizing effects of mild traumatic brain injury and posttraumatic stress disorder on balance impairments in blast-exposed servicemembers and Veterans using computerized posturography

“…They corroborate findings from sports concussion cohorts showing mTBI with PTA has a poorer prognosis than mTBI without PTA [42]. As one would expect given the high incidence of visual tracking deficits seen with mTBI [43], the CPT conditions targeting inaccurate visual feedback (condition 3) or deprived visual and proprioceptive feedback (condition 5) were particularly sensitive to mTBI with PTA. On the contrary, when normal visual inputs were available as in conditions 1 and 4, regardless of the presence of normal or altered proprioceptive input (a sense infrequently affected by mTBI), there were no group differences.…”

Quantification and analysis of saccadic and smooth pursuit eye movements and fixations to detect oculomotor deficits

“…It is therefore becoming more common to integrate oculomotor assessments into evaluations of neurophysiological and neurodegenerative (Crawford et al, 2005) disorders and injury. Oculomotor assessments are especially useful for detecting deficits that occur as a consequence of brain injury; it has been established that closed head injury can result in significant impairments in oculomotor and visuomotor function (Cifu et al, 2015;Heitger et al, 2004;Suh, et al, 2006a, b). Specifically, these common oculomotor impairments include reductions in spatial accuracy of saccadic eye movements, increased lag during smooth pursuit tracking, reduced peak saccade velocities and accelerations (Cifu et al, 2015), and delays and errors in planning, decision-making and other executive functions (Heitger et al, 2002(Heitger et al, , 2004.…”

Utility of a multimodal neurophysiologic assessment tool in distinguishing between individuals with and without a history of mild traumatic brain injury

“…The overall mean time since injury was 4.2 yr (SD = 4.9 yr). This compares to, for example, the study cohorts of Cifu et al [10], where the mean time since the most recent mTBI was 8.5 mo (SD = 6.58 mo) and Contreras et al [8] (2.2 yr ± 1.8 yr). One of the forward-looking results is the further enhancement of the sensitivity of the CBIAS through the modification and incorporation of other eye tests as well as the incorporation of neurocognitive tests into the CBIAS battery.…”

“…As noted by Contreras et al [13] and Cifu et al [10], two-dimensional SPEM tests demonstrated the highest effectiveness (AUC = 0.88). Furthermore, more challenging horizontal tests, such as the faster random sinusoidal assessment (AUC = 0.79), resolved differences better than less challenging assessments, specifically the simple sinusoidal as well as the slow random horizontal tests.…”

“…Based on preliminary data, the modalities chosen were computerized formats of eyetracking, balance and stability, and neurocognitive assessments. While all three modalities have been individually validated as being able to distinguish between concussed and nonconcussed populations [10][11][12][13], the goal of this study was to examine the enhancement in individual test discriminatory capability through the combination of all three assessment modality scores into a single, integrated multimodal system score. A secondary goal of the research was to assess the feasibility of developing a field-deployable system, with the compressed assessment, score compilation time, and portability that this application requires.…”