Research Reports - Differential eye movements in mild traumatic brain injury versus normal controls

J Head Trauma Rehabil. 2015 Jan-Feb;30(1):21-8

Cifu DX(1), Wares JR, Hoke KW, Wetzel PA, Gitchel G, Carne W

OBJECTIVES: Objective measures to diagnose and to monitor improvement of symptoms
following mild traumatic brain injury (mTBI) are lacking. Computerized eye
tracking has been advocated as a rapid, user friendly, and field-ready technique
to meet this need.
DESIGN: Eye-tracking data collected via a head-mounted, video-based binocular eye
tracker was used to examine saccades, fixations, and smooth pursuit movement in
military Service Members with postconcussive syndrome (PCS) and asymptomatic
control subjects in an effort to determine if eye movement differences could be
found and quantified.
PARTICIPANTS: Sixty Military Service Members with PCS and 26 asymptomatic
controls.
OUTCOME MEASURES: The diagnosis of mTBI was confirmed by the study physiatrist's
history, physical examination, and a review of any medical records. Various
features of saccades, fixation and smooth pursuit eye movements were analyzed.
RESULTS: Subjects with symptomatic mTBI had statistically larger position errors,
smaller saccadic amplitudes, smaller predicted peak velocities, smaller peak
accelerations, and longer durations. Subjects with symptomatic mTBI were also
less likely to follow a target movement (less primary saccades). In general,
symptomatic mTBI tracked the stepwise moving targets less accurately, revealing
possible brain dysfunction.
CONCLUSIONS: A reliable, standardized protocol that appears to differentiate mTBI
from normals was developed for use in future research. This investigation
represents a step toward objective identification of those with PCS. Future
studies focused on increasing the specificity of eye movement differences in
those with PCS are needed.

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