Eye Tracking: Objective Assessment for Mild Traumatic Brain Injury in Youth Athletes (2022-2023)

Background

In children, brain injury is so common that it is a leading source of disability and death. Sports-related concussions in children and adolescents (5-18 years) account for up to 60% of all pediatric concussions. 

Although mild traumatic brain injury (mTBI) is an important public health issue for both the general pediatric population and youth athletes, challenges exist 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 pathophysiology is crucial in developing mitigation strategies. 

Project Description

Building on the work of previous teams, 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 eighth year of an ongoing longitudinal study. On a yearly basis, the team has seen a relatively low number of concussions within its study. However, tracking and combining data on concussed individuals over multiple years will strengthen the study’s ability to ascertain differences between concussed and nonconcussed populations across multiple ages and levels of play.

Anticipated Outputs

Peer-reviewed manuscripts; abstracts; presentations or posters at a local conference; national/international conferences; grant proposals

Student Opportunities

Ideally, the team will be comprised of 2-3 graduate students and 6-10 undergraduate students. Interested students will ideally be team-focused and friendly, able to work independently, enthusiastic about gaining new skills and eager to engage with community collaborators.

Graduate and undergraduate students will learn the Institutional Review Board (IRB) process from team leads and develop their grant writing abilities. Team members will have the opportunity to participate in study design and discussion during meetings with community collaborators. Team members will also develop skills in academic manuscript development, field data acquisition, data analysis and abstract presentation.

Undergraduate students will create goals and milestones throughout the summer and fall that align closely with the data acquisition and analysis components of the study. They will immerse themselves in the literature and are encouraged to suggest ideas.

The optional summer component is strongly encouraged for first-time team members; it will include initial community engagement, participant recruitment and data acquisition during mid to late summer (July/August) to mesh with the football season.  

Collaborative inquiry will be facilitated through regular meetings, field work and data analysis. The project team will meet at least once a week in person or virtually.

A graduate student may be selected to serve as the project manager.

Timing

Summer 2022 – Spring 2023

  • Summer 2022 (optional): Revisit current oculomotor assessments and make necessary adjustments; improve oculomotor instructional video; increase portability of existing in-house oculomotor test setup; hold orientation meeting; obtain documentation; conduct baseline/follow-up oculomotor assessment and DASHR fitting/deployment
  • Fall 2022: Conduct in-season and end-of-season oculomotor assessment; analyze oculomotor assessments and associated surveys and exposure data; conduct literature review; conduct scientific question development
  • Spring 2023: Conduct follow-up oculomotor assessment; analyze oculomotor assessments, associated surveys and exposure data; conduct literature review; conduct question development; introduce two additional cohorts to study

Crediting

Academic credit available for fall and spring semesters; summer funding available

See earlier related team, Eye Tracking: Objective Assessment for Mild Traumatic Brain Injury in Youth Athletes (2021-2022).

 

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

Youth 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-Head and Neck Surgery and Communication Sciences

/undergraduate Team Members

  • Erin Biddiscombe
  • Megan Christy, Biomedical Engineering (BSE)
  • Alec Deakin
  • Martha Deja
  • Rose DiPietro
  • Evan Glas
  • Carson Herman, Biology (BS)
  • Caroline Howley, Economics (BS)
  • Ruth Jones, Psychology (BS)
  • Mayari Merchant
  • Kishen Mitra
  • Michelle Tetro

/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
  • Raleigh Revolution Middle School Youth Football
  • The Durham Eagles Pop Warner football