Oculomotor Response as an Objective Assessment for Mild TBI in the Pediatric Population (2019-2020)

Background

In children, brain injury is complex and common, and it is currently the leading source of injury and death. Sports-related concussions in children and adolescents (5-18 years) account for between 30% and 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 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 Bass Connections project 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 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 ear piece 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 fifth 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 team’s ability to ascertain differences between concussed and nonconcussed populations across multiple age levels and levels of play.

Anticipated Outputs

Manuscripts for publication; abstracts, presentations or posters at a conference at UNC-Chapel Hill; preliminary data to support proposals for extramural funding  

Timing

Summer 2019 – Spring 2020

  • Summer 2019: Complete and submit amendments to IRB protocols; integrate new team members; hold orientation meeting between project team, coaches, parents/guardians, student‐athletes to discuss project design; obtain appropriate consent/assent documentation; begin baseline Year 5 oculomotor assessment; undertake DASHR fitting/deployment; analyze oculomotor assessments
  • Fall 2019: In‐season Year 5 oculomotor assessment; analysis of oculomotor assessments; end‐of‐season Year 5 oculomotor assessment; analysis of oculomotor assessments
  • Spring 2020: Out-of-season oculomotor assessment; completion of Year 5 study

See earlier related team, Oculomotor Response as an Objective Assessment for Mild TBI in the Pediatric Population (2018-2019).

 

Image: SYC Football Game180, by Xanteen, licensed under CC BY-NC 2.0

SYC Football Game180, by Xanteen.

Team Leaders

  • Cameron Bass, Pratt School of Engineering-Biomedical Engineering
  • Bruce Capehart, School of Medicine-Psychiatry and Behavioral Sciences
  • Jason Luck, Pratt School - Biomedical Engineering

/yfaculty/staff Team Members

  • Jennifer Groh, Arts & Sciences-Psychology and Neuroscience
  • Connor Hile, Duke Institute for Brain Sciences
  • Adam Mehlenbacher, School of Medicine-Surgery: Otolaryngology - Head and Neck Surgery
  • Carrie Muh, School of Medicine-Surgery: Neurosurgery

/zcommunity Team Members

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