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.

Timing

Summer 2015 – Spring 2016

Team Outcomes

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.

Video

Bass Connections in Brain & Society: Brain Week 2016

Reflections

Elizabeth Ginalis, Neuroscience ’16

This Team in the News

From Lab to Museum, Students Share Their Brain Research

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

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

Hattie Cutcliffe, Pratt - Biomedical Engineering

Undergraduate Team Members

Elizabeth Ginalis, Neuroscience (BS)
Isabel Lake, Biology (BS)
Daniel O'Connell, Neuroscience (BS)

Community Team Members

Multiple Contributors, Cardinal Gibbons High School

* denotes team leader

Status

Completed, Archived