Oculomotor Response as an Objective Assessment for Mild Traumatic Brain Injury in the Pediatric Population (2016-2017)

In children, brain injury is complex and common, and currently is the leading source of injury and death. Sports-related concussions in children and adolescents (5-18 years) account for 30 to 60 percent 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 sub-concussive (low-level) insults.

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

This Bass Connections project team assessed youth athletes with an oculomotor assessment routine that includes reflexive (pro-saccades), anti-saccades and memory-guided saccades and compared these data to in-season documentation of concussion. The sample population included youth athletes from five years of age to the high school level.

A prominent point of investigation was to assess how head impact exposure, both exposure that may lead to a diagnosed concussion as well as sub-concussive loading, may contribute to observable deficits in oculomotor response that can be tracked and potentially used for diagnostic purposes. Using an in-ear accelerometer called the DASHR, the team measured the intensity of hits to the head and tested players’ performance on eye-tracking tasks.

In May 2017, the Paul G. Allen Family Foundation announced a $9.25 million grant to study the underlying mechanisms of concussion and help uncover potential clinical interventions that could improve recovery. Cameron “Dale” Bass, a leader of this Bass Connections team, is part of the research team involved in the new grant.

Timing

Summer 2016 – Spring 2017

Team Outcomes

Tackling Concussions (presentation by Joost Op’t Eynde, Daniel O’Connell, Maddie Bernstein and Edward Hsieh, Bass Connections Showcase, April 20, 2017)

Project demo at Duke Institute for Brain Sciences (DIBS) Discovery Day (April 9, 2017)

O’Connell, D.J., J.F. Luck, A. Gade, I.V. Lake, H.C. Cutcliffe, K.P. Shah, E.E. Ginalis, C.M. Lambert, C.P. Eckersley, A.W. Yu, J.R. Kait, N. Christian, and C.R. Bass. 2017. Age related differences on a smooth pursuit task in high school and youth football participants. Abstract submitted for poster at the 2017 Human Movement Science and Biomechanics Research Symposium (HMSC), March 31, Chapel Hill.

McGovern, B., J.F. Luck, A. Gade, I.V. Lake, D. O’Connell, H.C. Cutcliffe, K.P. Shah, E.E. Ginalis, C.M. Lambert, N. Christian, J.R. Kait, A.W. Yu, C.P. Eckersley, and C.R. Bass. 2017.  Memory-guided oculomotor task in high school football players with ADHD, post-concussive injuries, and controls. Abstract submitted for poster at the 2017 Human Movement Science and Biomechanics Research Symposium (HMSC), March 31, Chapel Hill.

D’Angelo, J.T., A.F. Murray, J. Op’t Eynde, J.F. Luck, M.Z. Abrams, and C.R. Bass. 2017. Baseline drift removal with an electrooculography headset. Abstract submitted for poster at the 2017 Human Movement Science and Biomechanics Research Symposium (HMSC), March 31, Chapel Hill.

Christian, N., M.G. Bernstein, J.F. Luck, K.A. Matthews, J.R. Kait, A. Mehlenbacher, and C.R. Bass. 2017. Efficacy of “Thresholding Method” in identifying on-field impacts with DASHR device. Abstract submitted for poster at the 2017 Human Movement Science and Biomechanics Research Symposium (HMSC), March 31, Chapel Hill.

O’Connell, D.J., J.F. Luck, A. Gade, I.V. Lake, H.C. Cutcliffe, K.P. Shah, E.E. Ginalis, C.M. Lambert, C.P. Eckersley, A.W. Yu, J.R. Kait, N. Christian, and C.R. Bass. 2017.  Age related differences on a smooth pursuit task in high school and youth football participants. Abstract submitted for poster at the 2017 Visible Thinking Symposium, Duke University, April 13, Durham.

D’Angelo, J.T., A.F. Murray, J. Op’t Eynde, J.F. Luck, M.Z. Abrams, and C.R. Bass. 2017. Baseline drift removal with an electrooculography headset. Abstract submitted for poster at the 2017 Visible Thinking Symposium, Duke University, April 13, Durham.

Bernstein, M.G., N. Christian, J.F. Luck, K.A. Matthews, J.R. Kait, A. Mehlenbacher, and C.R. Bass. 2017. Efficacy of “Thresholding Method” in identifying on-field impacts with DASHR device. Abstract submitted for poster at the 2017 Visible Thinking Symposium, Duke University, April 13, Durham.

McGovern, B., J. Luck, A. Gade, I. Lake, D. O’Connell, H. Cutcliffe, K. Shah, E.E. Ginalis, C. Lambert, N. Christian, J. Kait, A. Yu, C. Eckersley, and C. Bass. 2017.  Memory-guided oculomotor task in high school football players with ADHD, post-concussive injuries, and controls. Abstract submitted for poster at the 2017 3rd Annual Spring Neuroscience Conference, Triangle Chapter – Society of Neuroscience, April 13, Raleigh.

O’Connell, D., J. Luck, A. Gade, I. Lake, H. Cutcliffe, K. Shah, E. Ginalis, C. Lambert, C. Eckersley, A. Yu, J. Kait, N. Christian, and C. Bass. 2017.  Age related differences on a smooth pursuit task in high school and youth football participants – implications for baseline concussion assessments. Abstract submitted for poster at the 2017 3rd Annual Spring Neuroscience Conference, Triangle Chapter – Society of Neuroscience, April 13, Raleigh.

Christian, N., et al. (2017) Efficacy of “Thresholding Method” in identifying on-field impacts with DASHR device. Master of Engineering (M.Eng.) project, Department of Biomedical Engineering, Duke University, Durham, NC.  April 11, 2017

Bernstein, M., et al. (2017) Differences in athletic exposure between high school football practices and games using “Thresholding Criteria”. Undergraduate Pratt Fellows & Senior Project, Department of Biomedical Engineering, Duke University, Durham, NC.  April 27, 2017

D’Angelo, J., et al. (2017) Removal of baseline drift from EOG headset signal. Undergraduate Graduation with Distinction Project, Department of Biomedical Engineering, Duke University, Durham, NC.  April 27, 2017

Age Related Differences on a Smooth Pursuit Task in High School and Youth Football Participants: Implications for Baseline Concussion Assessments (honors thesis by Daniel O’Connell, Biomedical Engineering)

This Team in the News

Duke Joins $9.25M Project to Understand Concussion and Improve Recovery

Students Present Their Research and Learn from Each Other at the Bass Connections Showcase

Students Share Research Journeys at Bass Connections Showcase

See related teams, Oculomotor Response as an Objective Assessment for Mild TBI in the Pediatric Population (2017-2018) and Oculomotor Response as an Objective Measurement for Mild Traumatic Brain Injury in the Pediatric Population (2015-2016).

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, Biomedical Engineering-MS
Nia Christian, Biomedical Engineering-MS
Joost Opt Enyde, Biomedical Engineering-MS
Amitha Gade, Biomedical Engineering-MS
Austin Murray, Biomedical Engineering-MS
Rachael NobbsPhysical Therapy
Jordan TylerPhysical Therapy

Undergraduate Team Members

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

Community Team Members

Cardinal Gibbons High School

* denotes team leader

Status

Completed, Archived