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

Background

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.

Project Description

To bridge this gap we propose to 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. The sample population will include youth athletes from five years of age to the high school level. Multiple ages 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 follow participants from year one (2015-2016) to a second year of athletic participation, initiating the first steps of a long-term longitudinal study. A prominent point of investigation is 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. In 2015-16 we were able to instrument 20 high school participants with an ear piece data acquisition system called the DASHR. The data obtained over year one, coupled with data obtained in year two (19 of 20 current DASHR users will return) will help to inform quantitatively the questionnaire results obtained over the entire study population (100+ participants).

We anticipate instrumenting additional participants with the DASHR in year two, and we expect overall study participation to increase greatly due to the on-site relationships that were forged. Increased participation will lead to increased concussed vs. non-concussed comparison groups, ability to assess differences by age (increased numbers by age) and ability to assess differences by position (increased numbers by position).

Anticipated Outcomes

This team will generate data from local high school and Pop Warner athletes in-season, then present findings to the public and in a scientific context (posters, publications).

Timing

Summer 2016 – Spring 2017

Crediting

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

See earlier related team, 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 Luck, Pratt School - 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
Hattie Cutcliffe, Pratt - 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

Isabel Lake, Biology (BS)
Brynn McGovern, Neuroscience (BS), Computer Science (BS2)
Daniel O'Connell, Neuroscience (BS)

* denotes team leader

Status

Active