Citation

Samadani U, Ritlop R, Reyes M, Nehrbass E, Li M, Lamm E, Schneider J, Shimunov D, Sava M, Kolecki R, Burris P, Altomare L, Mehmood T, Smith RT, Huang J, McStay C, Todd SR, Qian M, Kondziolka D, Wall S, Huang P. J. Neurotrauma 2015; 32(8): 548-556.

Affiliation

New York University School of Medicine, Neurosurgery , 423 E. 23rd St MC 112 , New York, New York, United States , 10010 ; uzma.samadani@nyumc.org.

Copyright

(Copyright © 2015, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2014.3687

PMID

25582436

Abstract

INTRODUCTION: Disconjugate eye movements have been associated with traumatic brain injury since ancient times. Ocular motility dysfunction may be present in up to 90% of patients with concussion or blast injury.

METHODS: We developed an algorithm for eye tracking in which the Cartesian coordinates of the right and left pupils are tracked over 200 seconds and compared to each other as a subject watches a short film clip moving inside an aperture on a computer screen. We prospectively eye tracked 64 normal healthy non-injured control subjects and compared findings to 75 trauma subjects with either a positive head CT (n=13), negative head CT (n=39) or non-head injury (n=23) to determine whether eye tracking would reveal the disconjugate gaze associated with both structural brain injury and concussion. Tracking metrics were then correlated to the clinical concussion measure SCAT3 in trauma patients.

RESULTS: Five out of five measures of horizontal disconjugacy were increased in positive and negative head CT patients relative to non-injured control subjects. Only one of five vertical disconjugacy measures was significantly increased in brain injured patients relative to controls. Linear regression analysis of all 75 trauma patients demonstrated that three metrics for horizontal disconjugacy negatively correlated with SCAT3 symptom severity score and positively correlated with total Standardized Assessment of Concussion (SAC) score. Abnormal eye tracking metrics improved over time towards baseline in brain injured subjects seen in follow-up.

CONCLUSIONS: Eye tracking may help quantify the severity of ocular motility disruption associated with concussion and structural brain injury.

Language: en