Vertical smooth pursuit as a diagnostic marker of traumatic brain injury

doi:10.2217/cnc-2019-0013

. 2020 Jan 14;5(1):CNC69.

doi: 10.2217/cnc-2019-0013.

Vertical smooth pursuit as a diagnostic marker of traumatic brain injury

Melissa Hunfalvay¹, Claire-Marie Roberts², Nicholas P Murray³, Ankur Tyagi¹, Kyle W Barclay⁴, Takumi Bolte¹, Hannah Kelly⁵, Frederick R Carrick^{6

7

8

9}

Affiliations

¹ RightEye LLC, 7979 Old Georgetown Rd, Suite 801, Bethesda, MD 20814, USA.
² Department of Psychology, Senior Research Fellow, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, England.
³ Department of Kinesiology, East Carolina University, Minges Coliseum 166, Greensville, NC 27858, USA.
⁴ Case Western Reserve University, 10501 Streamview Court, Potomac, MD 20854, USA.
⁵ Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA.
⁶ Centre for Mental Health Research in association with University of Cambridge, Cambridge UK.
⁷ Department of Neurology, University of Central Florida College of Medicine, Orlando, FL 32827, USA.
⁸ MGH Institute for Health Professions, Boston, MA, USA.
⁹ Carrick Institute, Cape Canaveral, FL 32920, USA.

PMID: 32266081
PMCID: PMC7136983
DOI: 10.2217/cnc-2019-0013

Vertical smooth pursuit as a diagnostic marker of traumatic brain injury

Melissa Hunfalvay et al. Concussion. 2020.

. 2020 Jan 14;5(1):CNC69.

doi: 10.2217/cnc-2019-0013.

Authors

Melissa Hunfalvay¹, Claire-Marie Roberts², Nicholas P Murray³, Ankur Tyagi¹, Kyle W Barclay⁴, Takumi Bolte¹, Hannah Kelly⁵, Frederick R Carrick^{6

7

8

9}

Affiliations

¹ RightEye LLC, 7979 Old Georgetown Rd, Suite 801, Bethesda, MD 20814, USA.
² Department of Psychology, Senior Research Fellow, University of the West of England, Coldharbour Lane, Bristol, BS16 1QY, England.
³ Department of Kinesiology, East Carolina University, Minges Coliseum 166, Greensville, NC 27858, USA.
⁴ Case Western Reserve University, 10501 Streamview Court, Potomac, MD 20854, USA.
⁵ Emory University, 201 Dowman Dr, Atlanta, GA 30322, USA.
⁶ Centre for Mental Health Research in association with University of Cambridge, Cambridge UK.
⁷ Department of Neurology, University of Central Florida College of Medicine, Orlando, FL 32827, USA.
⁸ MGH Institute for Health Professions, Boston, MA, USA.
⁹ Carrick Institute, Cape Canaveral, FL 32920, USA.

PMID: 32266081
PMCID: PMC7136983
DOI: 10.2217/cnc-2019-0013

Abstract

Aim: Neural deficits were measured via the eye tracking of vertical smooth pursuit (VSP) as markers of traumatic brain injury (TBI). The present study evaluated the ability of the eye tracking tests to differentiate between different levels of TBI severity and healthy controls.

Methodology: Ninety-two individuals divided into four groups (those with mild, moderate or severe TBI and healthy controls) participated in a computerized test of VSP eye movement using a remote eye tracker.

Results: The VSP eye tracking test was able to distinguish between severe and moderate levels of TBI but unable to detect differences in the performance of participants with mild TBI and healthy controls.

Conclusion: The eye-tracking technology used to measure VSP eye movements is able to provide a timely and objective method of differentiating between individuals with moderate and severe levels of TBI.

Keywords: TBI; concussion; eye tracking; vertical smooth pursuit.

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Conflict of interest statement

Financial & competing interests disclosures Melissa Hunfalvay, Ankur Tyagi and Takumi Bolte are all full-time employees with RightEye and have relevant affiliations and financial involvement. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.

Figures

**Figure 2.. Mean values of smooth pursuit variance at each level of TBI severity, with 95% CI.**
For smooth pursuit variance metrics, a lower value is better. TBI: Traumatic brain injury.

**Figure 3.. Mean values of smooth pursuit percentage at each level of TBI severity, with 95% CI.**
For smooth pursuit percentage metrics, a higher value is better. TBI: Traumatic brain injury.

**Figure 4.. Receiving operating characteristic for vertical smooth pursuit (smooth pursuit variance and smooth pursuit [%]) – no-traumatic brain injury versus traumatic brain injury.**
AUC: Area under the curve.

See this image and copyright information in PMC

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References

1. Dewan MC, Rattani A, Gupta S. et al. Estimating the global incidence of traumatic brain injury. J. Neurosurg. 130(4), 1039–1408 (2018). - PubMed
1. Bedell HE, Stevenson SB. Eye movement testing in clinical examination. Vision Res. 90(20), 32–37 (2013). - PubMed
1. Johnson B, Zhang K, Hallett M, Slobounov S. Functional neuroimaging of acute oculomotor deficits in concussed athletes. Brain Imaging Behav. 9(3), 564–573 (2015). - PubMed
1. Land MF, Tatler BW. Looking and Acting: Vision and Eye Movements in Natural Behaviour. Oxford University Press, Oxford, UK: (2009).
1. Komogortsev OV, Karpov A. Automated classification and scoring of smooth pursuit eye movements in the presence of fixations and saccades. Behav. Res. Methods 45(1), 203–215 (2013). - PubMed

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[1] Dewan MC, Rattani A, Gupta S. et al. Estimating the global incidence of traumatic brain injury. J. Neurosurg. 130(4), 1039–1408 (2018). - PubMed

[2] Dewan MC, Rattani A, Gupta S. et al. Estimating the global incidence of traumatic brain injury. J. Neurosurg. 130(4), 1039–1408 (2018). - PubMed

[3] Bedell HE, Stevenson SB. Eye movement testing in clinical examination. Vision Res. 90(20), 32–37 (2013). - PubMed

[4] Bedell HE, Stevenson SB. Eye movement testing in clinical examination. Vision Res. 90(20), 32–37 (2013). - PubMed

[5] Johnson B, Zhang K, Hallett M, Slobounov S. Functional neuroimaging of acute oculomotor deficits in concussed athletes. Brain Imaging Behav. 9(3), 564–573 (2015). - PubMed

[6] Johnson B, Zhang K, Hallett M, Slobounov S. Functional neuroimaging of acute oculomotor deficits in concussed athletes. Brain Imaging Behav. 9(3), 564–573 (2015). - PubMed

[7] Land MF, Tatler BW. Looking and Acting: Vision and Eye Movements in Natural Behaviour. Oxford University Press, Oxford, UK: (2009).

[8] Land MF, Tatler BW. Looking and Acting: Vision and Eye Movements in Natural Behaviour. Oxford University Press, Oxford, UK: (2009).

[9] Komogortsev OV, Karpov A. Automated classification and scoring of smooth pursuit eye movements in the presence of fixations and saccades. Behav. Res. Methods 45(1), 203–215 (2013). - PubMed

[10] Komogortsev OV, Karpov A. Automated classification and scoring of smooth pursuit eye movements in the presence of fixations and saccades. Behav. Res. Methods 45(1), 203–215 (2013). - PubMed

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Vertical smooth pursuit as a diagnostic marker of traumatic brain injury

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Vertical smooth pursuit as a diagnostic marker of traumatic brain injury

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