Oculomotor Response as an Objective Assessment for Mild TBI in the Pediatric Population (2018-2019)

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 subconcussive 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, and compare these data to in-season documentation of concussion and level of impact/practice exposure. The sample population will include youth athletes from five years of age to the high school level. This will be Year 4 of an ongoing study.

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 subconcussive insults to the pediatric brain.

The fall semester will include extensive off-site work associated with assessments and DASHR data collection, while the spring semester and summer bring a focus on data analysis and involve weekly team meetings and sub-group meetings associated with specific data set analysis. 

Anticipated Outcomes

Manuscripts, abstracts, presentations or posters at a local conference (UNC Chapel Hill)

Student Opportunities

The team will likely comprise 8-10 undergraduates as well as a number of graduate students. All students will participate in study design iteration and iteration of presentation materials for meetings with the community youth/high school programs. Undergraduates will iterate the existing youth league oculomotor instructional video based on lessons learned.

Students will engage in acquiring data in the field (oculomotor assessments and DASHR) and in all data analysis aspects. They will produce results and formulate discussion suitable for inclusion in abstracts for academic conferences/meetings. Graduate students will use knowledge gained to set the foundation for development of additional grant proposals. Jason Luck will serve as project manager.

For undergraduates, evaluation will be closely aligned with their ability to meet collectively-determined milestones.

Duke undergraduates and graduate students can apply for this project team beginning on January 24. The priority deadline is February 16 at 5:00 p.m.

Timing

Spring 2018 – Spring 2019  

  • Spring 2018: Amendments to IRB protocols completed, submitted and iterated; new team members integrated into 2017-18 team activities as schedules allow
  • Summer 2018: Current oculomotor assessments revisited and any technical changes addressed; youth league oculomotor instructional video revisited for potential improvements; progress toward increased portability of existing in-house oculomotor test setup; out-of-season oculomotor assessment; orientation meeting with coaches, parents/guardians and athletes; July/August baseline and follow-up Year 4 oculomotor assessment and DASHR fitting/deployment; DASHR participants molded for personalized earpieces and deployed for pre-season practice
  • Fall 2018: Analysis of oculomotor assessments, baseline through end-of-season
  • Spring 2019: 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 TBI in the Pediatric Population (2017-2018).

Faculty/Staff Team Members

Cameron Bass, Pratt School of Engineering-Biomedical Engineering*
Bruce Capehart, School of Medicine-Psychiatry*
John D'Angelo, Pratt School of Engineering-Biomedical Engineering
Jennifer Groh, Arts & Sciences-Psychology and Neuroscience*
Jason Luck, Pratt School - Biomedical Engineering*
Adam Mehlenbacher, School of Medicine-Surgery: Otolaryngology - Head and Neck Surgery*

Graduate Team Members

Joost Opt Enyde, Biomedical Engineering-MS
Austin Murray, Biomedical Engineering-MS

Undergraduate Team Members

Mitchell Abrams, Biomedical Engineering (BSE)
Divya Chowbey, Biomedical Engineering (BSE)
Connor Hile, Neuroscience (BS), Chemistry (BS2)
Edward Hsieh, Biomedical Engineering (BSE)
Aalin Izhar, Biology (BS)
Ekaterina Khlystova, Chemistry (AB), Linguistics (AB2)
Drew Levy, Biomedical Engineering (BSE)
Brynn McGovern, Neuroscience (BS), Computer Science (BS2)
Daniel O'Connell, Neuroscience (BS)
Marguerite Rooney, Neuroscience (AB)

Community Team Members

Cardinal Gibbons High School
Durham Eagles Pop Warner Youth Football

* denotes team leader

Status

Active, New