Oculomotor Response as an Objective Measurement for Mild Traumatic Brain Injury in the Pediatric Population (2015-2016)
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) represent 30-60% of all pediatric concussions. Though mild traumatic brain injury (mTBI), commonly referred to as a concussion, is an important public health issue for parents, pediatricians and athletes, an accurate mTBI diagnosis is challenged by the lack of objective physical findings in a single concussive event or the cumulative effect of sub-concussive (low-level) insults.
In a wider context, children suffering these head injuries often experience social and medical consequences as diverse as loss of camaraderie and social status conferred by participation in sports to severe developmental delays and need for extensive rehabilitation. Without a solid link between the clinical diagnoses and objective diagnostic data—across a range of injury events from the minimally sub-concussed child to the child with an obvious concussion—clinicians cannot design, build, implement or evaluate clinical interventions for mTBI.
To bridge this gap, this project assesses youth athletes with an oculomotor assessment routine that includes reflexive (pro-saccades), anti-saccades and memory-guided saccades (MGS) and compares these data to in-season documentation of concussion. The sample population includes youth athletes from five years of age to the high school level. Changes in oculomotor response when compared to documented injury are assessed as an objective tool for diagnosing concussion and quantifying the pathophysiology of cumulative sub-concussive insults to the pediatric brain.
The team created instructional videos for high school and youth participants, tested a variety of different tools for measuring traumatic brain injuries and began building mechanisms to help evaluate clinical interventions for mTBI. Team members have made progress toward using a head-mounted portable system. The target is to deploy an iteration of this system to the field in Fall 2016.
Summer 2015 – Spring 2016
Differences in Performance on the Antisaccade Task in Football Athletes during Childhood and Late Adolescence (poster by Elizabeth E. Ginalis, Chalette M. Lambert, Jason F. Luck, Kaustav P. Shah, Isabel V. Lake, Hattie C. Cutcliffe, Daniel J. O’Connell, Christopher P. Eckersley, Allen W. Yu, Jason R. Kait, Amitha Gade, Adam Mehlenbacher, Cameron R. “Dale” Bass)
Differences in Performance on the Antisaccade Task in Football Athletes during Childhood and Late Adolescence (poster by Elizabeth E. Ginalis, Jason F. Luck, Chalette M. Lambert, Kaustav P. Shah, Isabel V. Lake, Hattie C. Cutcliffe, Daniel J. O’Connell, Christopher P. Eckersley, Allen W. Yu, Jason R. Kait, Amitha Gade, Adam Mehlenbacher, Cameron R. “Dale” Bass)
Memory Guided Saccade Task Performance in Adolescent Football Players Post-concussion (poster by Chalette Lambert)
Project team demo at DIBS Discovery Day, Brain Awareness Week at Duke (April 3, 2016)
Shah, K.P., J.F. Luck, C. M. Lambert, I.V. Lake, H.C. Cutcliffe, E.E. Ginalis, D.J. O’Connell, C.P. Eckersley, A. Yu, J.R. Kait, A. Mehlenbacher, and C.R. Bass. 2015. Oculomotor Analysis for mTBI in High School Football Players. Presented at the 2015 BMES Annual Meeting, October 7-10, Tampa, FL.
O’Connell, D.J, J.F. Luck, I.V. Lake, H.C. Cutcliffe, K.P. Shah, E.E. Ginalis, C.M. Lambert, C.P. Eckersley, A.W. Yu, J.R. Kait, A. Gade, A. Mehlenbacher, and C.R. Bass. 2016. Assessing differences in smooth pursuit performance between concussed and non-concussed high school football players. Presented at the 2016 Human Movement Science and Biomechanics Research Symposium (HMSC), February 26, Chapel Hill, NC.
Ginalis, E.E, J.F. Luck, C.M. Lambert, K.P. Shah, I.V. Lake, H.C. Cutcliffe, D.J. O’Connell, C.P. Eckersley, A.W. Yu, J.R. Kait, A. Gade, A. Mehlenbacher, and C.R. Bass. 2016. Differences in performance on the antisaccade task in football athletes during childhood and late adolescence. Presented at the 2016 Human Movement Science and Biomechanics Research Symposium (HMSC), February 26, Chapel Hill, NC.
This Team in the News
- Cameron Bass, Pratt School of Engineering-Biomedical Engineering
- Bruce Capehart, School of Medicine-Psychiatry and Behavioral Sciences
/graduate Team Members
Hattie Cutcliffe, Biomedical Engineering (BSE)
/undergraduate Team Members
Elizabeth Ginalis, Neuroscience (BS)
Isabel Lake, Biology (BS)
Daniel O'Connell, Neuroscience (BS)
/yfaculty/staff Team Members
Jason Luck, Pratt School - Biomedical Engineering
Adam Mehlenbacher, School of Medicine-Surgery: Otolaryngology - Head and Neck Surgery
Carrie Muh, School of Medicine-Neurosurgery
/zcommunity Team Members
Cardinal Gibbons High School