Eye Tracking: Objective Assessment for Mild Traumatic Brain Injury in Youth Athletes (2020-2021)

Background

In children and adolescents traumatic brain injury (TBI) is a leading cause of disability and death. Some estimates suggest that up to 80 percent of TBIs are categorized as mild traumatic brain injury (mTBI). A concussion, sometimes referred to as an mTBI – while at other times considered a subset of injury within the category of mTBI – is estimated to account for 70-90 percent TBI-related emergency department visits. Sports-related concussions (SRC) in children and adolescents (5-18 years) may account for up to 60 percent of all pediatric concussions.

Although mTBI is an important public health issue for both the general pediatric population and youth athletes, there are still many challenges in obtaining objective diagnoses of mTBI or quantifying the physiological implications of cumulative subconcussive (low-level) insults.

Establishing a link between the clinical diagnoses and objective diagnostic tools that are sensitive over a spectrum of pathophysiologies (from a minimally subconcussed child to those that experience many subconcussive events or are clinically diagnosed with a concussion) are crucial in developing mitigation strategies.

Project Description

This project team will assess how head impact exposure may contribute to observable deficits in oculomotor response that can be tracked and used for diagnostic purposes. Ultimately, changes in oculomotor response will be assessed as an objective tool for diagnosing concussion and quantifying the pathophysiology of cumulative subconcussive insults to the pediatric brain.

To accomplish this, the project team will assess local youth athletes with an oculomotor assessment routine that includes reflexive (pro-saccades), anti-saccades and memory-guided saccades, and compare these data to in-season documentation of concussions and levels of impact/practice exposure.

Quantification of head impact exposure experienced by participants will require the use of questionnaires and an earpiece sensor (DASHR) developed at Duke. The sample population will include youth athletes from five years of age to the high school level.

This will be the sixth year of an ongoing longitudinal study. On a yearly basis, the team has observed a relatively low number of concussions within the study population. However, tracking and combining data on concussed individuals over multiple years will strengthen the team’s ability to ascertain differences between concussed and non-concussed populations across multiple ages and levels of play.

Anticipated Outputs

Manuscripts; conference presentations and posters

Timing

Summer 2020 – Spring 2021

  • Summer 2020 (optional): Begin initial community engagement; complete participant recruitment; continue data acquisition
  • Fall 2020: Complete in-season oculomotor test; begin end-of-season oculomotor assessment
  • Spring 2021: Complete out-of-season oculomotor assessments

See earlier related team, Oculomotor Response as an Objective Assessment for Mild TBI in the Pediatric Population (2019-2020).

 

Image: Youth Football, by Jamie Williams, licensed under CC BY-ND 2.0

Football.

Team Leaders

  • Cameron Bass, Pratt School of Engineering-Biomedical Engineering
  • Bruce Capehart, School of Medicine-Psychiatry and Behavioral Sciences
  • Jason Luck, Pratt School of Engineering-Biomedical Engineering
  • Adam Mehlenbacher, School of Medicine-Surgery: Otolaryngology - Head and Neck Surgery and Communication Sciences

/undergraduate Team Members

  • /undergraduate
  • Beau Blass, Neuroscience (BS)
  • Elisabeth Blitch
  • Alec Deakin
  • Sydney Gaviser
  • Arjun Lakhanpal, Economics (BS), French Studies (AB2)
  • Kristy Lieu
  • Patrick Liu, Electrical & Computer Egr(BSE), Computer Science (BSE2)
  • Ayoub Mahdar
  • Varun Nukala, Neuroscience (BS)
  • Wesley Pritzlaff, Neuroscience (BS)
  • Alexandra Putka, Neuroscience (BS)
  • Alix Rosenberg, Biology (BS)
  • Arthi Vaidyanathan

/yfaculty/staff Team Members

  • Jennifer Groh, Arts & Sciences-Psychology and Neuroscience
  • Jason Kait, Pratt School of Engineering-Biomedical Engineering

/zcommunity Team Members

  • Cardinal Gibbons High School
  • Durham Eagles Pop Warner Youth Football
  • Raleigh Revolution Middle School Youth Football