King-Devick Test Performance and Cognitive Dysfunction after Concussion: A Pilot Eye Movement Study

Gold, Doria M.; Rizzo, John-Ross; Lee, Yuen Shan Christine; Childs, Amanda; Hudson, Todd E.; Martone, John; Matsuzawa, Yuka; Fraser, Felicia; Ricker, Joseph H.; Dai, Weiwei; Selesnick, Ivan; Balcer, Laura J.; Galetta, Steven; Rucker, Janet C.

doi:10.3390/brainsci11121571

Cited by 3 publications

(7 citation statements)

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“…In short, the KD test is a 1–2-min, rapid number naming test, often used to assist cognitive impairment in multiple sclerosis or after concussion ( Galetta et al, 2015 ; Gold et al, 2021 ). Notably, it also has clinical utility in other conditions such as Parkinson’s disease and AD.…”

Section: Gaze: An Indirect Link To Neural and Cognitive Functionsmentioning

confidence: 99%

Eye-tracking paradigms for the assessment of mild cognitive impairment: a systematic review

et al. 2023

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Mild cognitive impairment (MCI), representing the ‘transitional zone’ between normal cognition and dementia, has become a novel topic in clinical research. Although early detection is crucial, it remains logistically challenging at the same time. While traditional pen-and-paper tests require in-depth training to ensure standardized administration and accurate interpretation of findings, significant technological advancements are leading to the development of procedures for the early detection of Alzheimer’s disease (AD) and facilitating the diagnostic process. Some of the diagnostic protocols, however, show significant limitations that hamper their widespread adoption. Concerns about the social and economic implications of the increasing incidence of AD underline the need for reliable, non-invasive, cost-effective, and timely cognitive scoring methodologies. For instance, modern clinical studies report significant oculomotor impairments among patients with MCI, who perform poorly in visual paired-comparison tasks by ascribing less attentional resources to novel stimuli. To accelerate the Global Action Plan on the Public Health Response to Dementia 2017–2025, this work provides an overview of research on saccadic and exploratory eye-movement deficits among older adults with MCI. The review protocol was drafted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Electronic databases were systematically searched to identify peer-reviewed articles published between 2017 and 2022 that examined visual processing in older adults with MCI and reported gaze parameters as potential biomarkers. Moreover, following the contemporary trend for remote healthcare technologies, we reviewed studies that implemented non-commercial eye-tracking instrumentation in order to detect information processing impairments among the MCI population. Based on the gathered literature, eye-tracking-based paradigms may ameliorate the screening limitations of traditional cognitive assessments and contribute to early AD detection. However, in order to translate the findings pertaining to abnormal gaze behavior into clinical applications, it is imperative to conduct longitudinal investigations in both laboratory-based and ecologically valid settings.

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Section: Gaze: An Indirect Link To Neural and Cognitive Functionsmentioning

confidence: 99%

Eye-tracking paradigms for the assessment of mild cognitive impairment: a systematic review

et al. 2023

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“…They reported median ISI in the 300 ms to 400 ms range, number of saccades in a 130-172 range, and average peak velocities of 299.5°/s. Gold et al 65 assessed the relation between ISI prolongation and prolonged K-DT testing with results showing median ISI values of 379 + 199 ms which they contrasted to their previous research showing 235 + 119 ms 60 and 286 + 49 ms, 26 respectively. The Hecimovich et al 31 study with male youth Australian football participants reported mean saccadic measurements of 151 to 168 and 4 to 7 blinks per test Tejani et al 48 study on baseline eye movements and visual contrast acuity noted an average number of saccades per card (over all three K-DT tests) between 56.9 + 14 and 101 + 41.…”

Section: Discussionmentioning

confidence: 91%

“…Average saccade velocity was mentioned in Tad et al 63 study, however, the usefulness of these two metrics needs to be established in the literature. There have been several studies 26,60,64,65 that have utilized the rapid number naming component of the K-DT with other eye tracking units. The results reported in these studies, such as the number of saccades and ISI, are similar to ones reported in the current study.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 92%

“…studies26,60,64,65 that have utilized the rapid number naming component of the K-DT with other eye tracking units. The results reported in these studies, such as the number of saccades and ISI, are similar to ones reported in the current study.…”

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An investigation into the measurement properties of the King-Devick Eye Tracking system

Hecimovich

Murphy

et al. 2022

Journal of Concussion

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Objectives Eye tracking has been gaining increasing attention as a possible assessment and monitoring tool for concussion. The King-Devick test (K-DT) was expanded to include an infrared video-oculography-based eye tracker (K-D ET). Therefore, the aim was to provide evidence on the reliability of the K-D ET system under an exercise condition. Methods Participants (N = 61; 26 male, 35 female; age range 19-25) were allocated to an exercise or sedentary group. Both groups completed a baseline K-D ET measurement and then either two 10-min exercise or sedentary interventions with repeated K-D ET measurements between interventions. Results The test-retest reliability of the K-D ET ranged from good to excellent for the different variables measured. The mean ± SD of the differences for the total number of saccades was 1.04 ± 4.01 and there was an observable difference (p = 0.005) in the trial number. There were no observable differences for the intervention (p = 0.768), gender (p = 0.121) and trial (p = 0.777) for average saccade’s velocity. The mean ± SD of the difference of the total fixations before and after intervention across both trials was 1.04 ± 3.63 and there was an observable difference in the trial number (p = 0.025). The mean ± SD of the differences for the Inter-Saccadic Interval and the fixation polyarea before and after intervention across both trials were 1.86 ± 22.99 msec and 0.51 ± 59.11 mm2 and no observable differences for the intervention, gender and trial. Conclusion The results provide evidence on the reliability of the K-D ET, and the eye-tracking components and demonstrate the relationship between completion time and other variables of the K-D ET system. This is vital as the use of the K-DT may be increasing and the combination of the K-DT and eye tracking as one single package highlights the need to specifically measure the reliability of this combined unit.

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Assessing Brain Processing Deficits Using Neuropsychological and Vision-Specific Tests for Concussion

Harper,

Soangra

2024

Sports

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Introduction: Since verbal memory and visual processing transpire within analogous cerebral regions, this study assessed (i) if a visual function can predict verbal memory performance. It also hypothesized whether neurocognitive (e.g., ImPACT) tests focusing on the Visual Memory and Cognitive Efficacy Index will predict Verbal Memory scores and (ii) if vision metrics and age can identify individuals with a history of concussion. Finally, it also hypothesized that King–Devick and near point of convergence scores alongside age considerations will identify candidates with a prior reported history of concussion. Materials and methods: This observational cohort assessed 25 collegiate ice hockey players prior to the competitive season considering age (19.76 ± 1.42 years) and BMI (25.9 ± 3.0 kg/cm2). Hypothesis 1 was assessed using a hierarchical (sequential) multiple regression analysis, assessing the predictive capacity of Visual Memory and Cognitive Efficacy Index scores in relation to Verbal Memory scores. Hypothesis 2 utilized a binomial logistic regression to determine if King–Devick and near point of convergence scores predict those with a prior history of concussion. Results: Hypothesis 1 developed two models, where Model 1 included Visual Memory as the predictor, while Model 2 added the Cognitive Efficacy Index as a predictor for verbal memory scores. Model 1 significantly explained 41% of the variance. Results from Model 2 suggest that the Cognitive Efficacy Index explained an additional 24.4%. Thus, Model 2 was interpreted where only the Cognitive Efficacy Index was a significant predictor (p = 0.001). For every 1 unit increase in the Cognitive Efficacy Index, Verbal Memory increased by 41.16. Hypothesis 2’s model was significant, accounting for 37.9% of the variance in those with a history of concussion. However, there were no significant unique predictors within the model as age (Wald = 1.26, p = 0.261), King–Devick (Wald = 2.31, p = 0.128), and near point of convergence (Wald = 2.43, p = 0.119) were not significant predictors individually. Conclusions: The conflicting findings of this study indicate that baseline data for those with a history of concussion greater than one year may not be comparable to the same metrics during acute concussion episodes. Young athletes who sustain a concussion may be able to overcompensate via the visual system. Future prospective studies with larger sample sizes are required using the proposed model’s objective metrics.

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King-Devick Test Performance and Cognitive Dysfunction after Concussion: A Pilot Eye Movement Study

Cited by 3 publications

References 62 publications

Eye-tracking paradigms for the assessment of mild cognitive impairment: a systematic review

Eye-tracking paradigms for the assessment of mild cognitive impairment: a systematic review

An investigation into the measurement properties of the King-Devick Eye Tracking system

Assessing Brain Processing Deficits Using Neuropsychological and Vision-Specific Tests for Concussion

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