Eye Tracking as a Biomarker for Concussion in Children.
Accommodation, Ocular
/ physiology
Adolescent
Algorithms
Area Under Curve
Brain Concussion
/ diagnosis
Case-Control Studies
Checklist
Child
Child, Preschool
Convergence, Ocular
/ physiology
Cross-Sectional Studies
Eye Movements
/ physiology
Eye-Tracking Technology
Female
Humans
Male
Outcome Assessment, Health Care
Post-Concussion Syndrome
/ diagnosis
Sensitivity and Specificity
Statistics, Nonparametric
Symptom Assessment
/ methods
Young Adult
Journal
Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine
ISSN: 1536-3724
Titre abrégé: Clin J Sport Med
Pays: United States
ID NLM: 9103300
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
pubmed:
11
8
2018
medline:
24
4
2021
entrez:
11
8
2018
Statut:
ppublish
Résumé
Concussion is the most common type of brain injury in both pediatric and adult populations and can potentially result in persistent postconcussion symptoms. Objective assessment of physiologic "mild" traumatic brain injury in concussion patients remains challenging. This study evaluates an automated eye-tracking algorithm as a biomarker for concussion as defined by its symptoms and the clinical signs of convergence insufficiency and accommodation dysfunction in a pediatric population. Cross-sectional case-control study. Primary care. Concussed children (N = 56; mean age = 13 years), evaluated at a mean of 22-week post-injury, compared with 83 uninjured controls. Metrics comparing velocity and conjugacy of eye movements over time were obtained and were compared with the correlation between Acute Concussion Evaluation (ACE) scores, convergence, and accommodation dysfunction. Subjects' eye movements recorded with an automated eye tracker while they watched a 220-second cartoon film clip played continuously while moving within an aperture. Twelve eye-tracking metrics were significantly different between concussed and nonconcussed children. A model to classify concussion as diagnosed by its symptoms assessed using the ACE achieved an area under the curve (AUC) = 0.854 (71.9% sensitivity, 84.4% specificity, a cross-validated AUC = 0.789). An eye-tracking model built to identify near point of convergence (NPC) disability achieved 95.8% specificity and 57.1% sensitivity for an AUC = 0.810. Reduced binocular amplitude of accommodation had a Spearman correlation of 0.752(P value <0.001) with NPC. Eye tracking correlated with concussion symptoms and detected convergence and accommodative abnormalities associated with concussion in the pediatric population. It demonstrates utility as a rapid, objective, noninvasive aid in the diagnosis of concussion.
Identifiants
pubmed: 30095503
doi: 10.1097/JSM.0000000000000639
pii: 00042752-202009000-00002
doi:
Types de publication
Journal Article
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
433-443Références
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