Oculomotor, vestibular, reaction time and cognitive eye-tracking mild traumatic brain injury assessment

Alex Kiderman, Michael Hoffer, Mikhaylo Szczupak, Hillary Snapp, Sara Murphy, Kate Marshall, James Crawford, Aura Kullmann, Robin Ashmore, Jane Chung, Carey Balaban

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: Can oculomotor, vestibular, reaction time and cognitive eye-tracking tests (OVRT-C) assess mild traumatic brain injury? BACKGROUND: OVRT-C tests using eye tracking technology have been employed in our previous studies for assessing mild traumatic brain injury (mTBI). Here we present a composite Concussion Assessment algorithm that incorporates these findings. DESIGN/METHODS: Concussion Assessment algorithm was based on a data analysis from 406 males and females 18-45 years old. The subjects included 106 patients diagnosed with mTBI and 300 healthy controls. Diagnosis of mTBI was made using accepted medical practice. The participants were tested with a battery of OVRT-C tests delivered on the I-Portal Neuro Otologic Test Center (Dx NOTC) device (Neurolign Technology). A logistic regression model was used to derive the algorithm using a random sample of 70% of the data-set and validated on the remaining 30% of the data-set. Device test-retest reliability and inter-rater variability were assessed in a separate study in healthy control volunteers, ages 19-43 (n = 30). Subjects were tested with OVRT-C tests using the Dx100 which is equivalent to the NOTC. Test-retest reliability was assessed using Intraclass Correlation Coefficient (ICC) and Cronbach's alpha; testers and devices influence were assessed using a random effect regression model. RESULTS: Test-retest reliability of OVRT-C tests using eye tracking technology was acceptable (ICC >0.6 for all variables). The Concussion assessment algorithm was based on six OVRT-C tests. In the validation data Concussion Assessment algorithm was able to separate concussed versus controls with a sensitivity of 78.6% and specificity of 72.3%. CONCLUSIONS: OVRT-C tests delivered on I-Portal devices are repeatable and reliable. The assessment can identify mTBI subjects within an acute time post-injury with high sensitivity and specificity. The results support the use of this eye tracking device as well as the assessment to aid in the diagnosis of mTBI for patients 18-45 year old.

Original languageEnglish (US)
Pages (from-to)S2
StatePublished - Nov 17 2020

ASJC Scopus subject areas

  • Clinical Neurology

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