Oculomotor Response as an Objective Assessment for Mild TBI in the Pediatric Population (2017-2018)

Background

In children, brain injury is complex and common, and currently it is a leading source of injury and death. Sports-related concussions in children and adolescents (5-18 years) account for 30-60% of all pediatric concussions.

Though 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 that includes the minimally sub-concussed child to those that experience many sub-concussive events or are clinically diagnosed with a concussion are crucial in developing mitigation strategies.

Project Description

To bridge this gap, this Bass Connections project will assess youth athletes with an oculomotor assessment routine that includes reflexive (pro-saccades), anti-saccades and memory guided saccades (MGS) and compare these data to in-season documentation of concussion and level of impact/practice exposure.

The sample population includes youth athletes from five years of age to the high school level. Over a multi-year period, multiple age levels and levels of play will be assessed. Changes in oculomotor response when compared to documented injury will be assessed as an objective tool for diagnosing concussion and quantifying the pathophysiology of cumulative sub-concussive insults to the pediatric brain. This project team will generate data from local high school and Pop Warner athletes in-season.

Anticipated Outcomes

Findings presented to the public and in a scientific context (posters, publications); eventual manuscripts and in the interim numerous abstracts for national and regional conferences prepared; at least one opportunity for presentations or posters at a regional conference (UNC-Chapel Hill)

Student Opportunities

The fall semester will lead to extensive off-site work associated with assessments and DASHR data collection, while the summer and spring are focused on data analysis and involve weekly team meetings and subgroup meetings associated with specific data set analysis.

Undergraduate and graduate student participants will engage in the IRB process and assist postdocs and faculty team members in IRB amendment. They will participate in study design iteration and iteration of Year 2 presentation materials for meetings with the community youth/high school programs, and in discussing aspects of the study design during meetings with the community youth/high school programs. Undergraduates will iterate an existing youth league oculomotor instructional video based on lessons learned in the Year 2 study.

Undergraduate and graduate student participants will engage in acquiring data in the field (oculomotor assessments and DASHR) and in all data analysis aspects associated with study. They will produce results and formulate discussion suitable for inclusion in abstracts for academic conferences and meetings.

All team members will participate in academic manuscript development and submission. Graduate students will use knowledge gained from current study to set the foundation for development of additional grant proposals to further the current work.

Timing

Summer 2017 – Spring 2018

  • Summer 2017: Preferred Summer Internship to span Duke’s 2nd Summer Session, July 3 through August 13; opportunity exists to lengthen the internship in the weeks prior to July 3 as well as after August 13; further details can be obtained by contacting Jason Luck
  • Fall 2017: Mid-point Year 3 oculomotor assessment; end-of-season Year 3 oculomotor assessment; analysis of oculomotor assessments, baseline through end-of-season Year 3
  • Spring 2018: Out-of-season oculomotor assessment

Crediting

Independent study credit available for fall and spring semesters; summer funding

See earlier related team, Oculomotor Response as an Objective Assessment for Mild Traumatic Brain Injury in the Pediatric Population (2016-2017).

Faculty/Staff Team Members

Cameron Bass, Pratt School - Biomedical Engineering*
Bruce Capehart, School of Medicine - Psychiatry and Behavioral Sciences*
Jason Kait, Pratt - Biomedical Engineering
Jason Luck, Pratt School - Biomedical Engineering*
Kyle Matthews, Pratt - Biomedical Engineering
Adam Mehlenbacher, School of Medicine - Otolaryngology, Head & Neck Surgery*
Carrie Muh, School of Medicine - Neurosurgery*

Graduate Team Members

Katie Carroll, Pratt - Master of Biomedical Engineering
Nia Christian, Pratt - Master of Biomedical Engineering
Joost Opt Enyde, Pratt - Master of Biomedical Engineering
Amitha Gade, Master of Biomedical Engineering
Austin Murray, Pratt - Master of Biomedical Engineering
Rachael Nobbs, Doctor of Physical Therapy
Jordan Tyler, Doctor of Physical Therapy

Undergraduate Team Members

Madeleine Bernstein, Biomedical Engineering
John D'Angelo, Biomedical Engineering
Edward Hsieh
Isabel Lake, Biology (BS)
Brynn McGovern, Neuroscience (BS), Computer Science (BS2)
Daniel O'Connell, Neuroscience (BS)

Community Team Members

Multiple Contributors, Cardinal Gibbons High School
Multiple Contributors, Durham Eagles Pop Warner Youth Football

* denotes team leader

Status

Active, New