Eye tracking a biomarker for concussion in the paediatricpediatric population

Abstract

Objective The study aims to validate eye movement tracking performed without a baseline study as a biomarker for concussion in a paediatric population.DesignThis is a cross-sectional case control study of patients diagnosed with concussion in a referral centre compared to non-concussed controls.MethodsEye movements were recorded with an SR Research Eyelink 1000 eye tracker while a 220-second video was played. Eye tracking metrics were compared to Acute Concussion Evaluation (ACE) scores and clinical assessments of convergence and accommodation.Results56 children with concussions (mean age of 13 years), as defined by symptom presence following an impulsive injury to the brain were evaluated at a mean of 22 weeks post-injury. Twelve eye tracking metrics were significantly different between concussed children and 83 uninjured controls. A model built on a balanced sub-sample to classify concussion based on eye tracking achieved an AUC of 0.854 (sensitivity 71.9%; specificity 84.4%). Two metrics were significant predictors of abnormal near point convergence (NPC) and accommodation. The model built to classify concussion based on NPC status achieved a specificity of 95.8% and a sensitivity of 57.1%. Reduced binocular amplitude of accommodation had a spearman correlation of 0.752 (p-value<0.001) with NPC. Seven eye tracking metrics were found to have a strong correlation (R=0.781) with binocular amplitude of accommodation.ConclusionsEye tracking reliably detected concussion and convergence and accommodative abnormalities in the paediatric population. We propose that eye tracking without baseline assessment may serve as an objective measure of concussion in paediatric patients. Competing interestsUzma Samadani has submitted intellectual property describing the technology utilised in this paper.These patents are owned by NYU, the VA and HCMC and licensed to Oculogica Inc., a company in which all of the above parties have an equity interest

Eye tracking technology in sports-related concussion: a systematic review and meta-analysis

“…However, in sports concussion studies it is common to consider the movement of both eyes as conjugate. The two exceptions in the current review are the line of research pursued by Samadani et al (2017) who previously investigated the movement of the right and left eyes separately and found that the concussed population was less capable of generating coordinated eye movement , and the study by Danna-dos-Santos et al (2018) who measured both eyes separately and found no asymmetries between right and left eyes.…”

Objective Eye Tracking Deficits Following Concussion for Youth Seen in a Sports Medicine Setting

“…9,10 We selected 17 variables to analyze within this investigation based on prior work that has used this experimental setup to define eye movement velocity, movement distance, or trajectory areas. 5,9 Many of these variables possess moderate levels of reliability among uninjured adolescent athletes, 16 and evaluate the distance the eye traverses during the trial, the variability of movement of each eye, and the ratio of the movement and variability of the 2 eyes moving together. The total distance covered refers to the amount of measured eye movement in each plane along each side (top, bottom, left, and right) of the computer monitor.…”

“…Visual disturbances have been documented in recent investigations among the adolescent population with concussion. [4][5][6][7][8] Thus, quantifying the effect of concussion on vision in adolescents may help to specify areas of dysfunction.…”

The Selective Social Attention task in children with autism spectrum disorder: Results from the Autism Biomarkers Consortium for Clinical Trials (ABC‐CT) feasibility study

“…Eye tracking enables objective, quantifiable, dense, and repeatable measurement of oculomotor indices as the overt expression of neurobiological substates driving attentional processes (Posner & Petersen, 1990). There is a growing body of work examining the potential of eye tracking as a biomarker in conditions ranging from traumatic brain injury (Bin Zahid et al, 2020; Hunfalvay et al, 2021; Samadani et al, 2016, 2017; for review see McDonald et al, 2022), to Parkinson's disease (Ba et al, 2022; Blekher et al, 2009; Brien et al, 2023; Li et al, 2023; Tsitsi et al, 2021), to autism (Bradshaw et al, 2019; Del Valle Rubido et al, 2020; Frazier et al, 2021; Loth et al, 2017; Mason et al, 2021; Murias et al, 2018; Pierce et al, 2015; Shic et al, 2022; Wen et al, 2022), though discussions regarding nomenclature are ongoing, as they are for other similar classes of biomarkers (Ba et al, 2022; Hidalgo‐Mazzei et al, 2018; Li et al, 2023; Tsitsi et al, 2021).…”