Dr. Uzma Samadani, Chief Neurosurgeon at VA New York Harbor Healthcare System, presented research findings suggesting that eye tracking performed while watching a music video may detect the amount of neurologic impairment associated with concussive brain injury. The presentation was made at the 82nd Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS) in San Francisco.
The association between abnormal eye movements and brain injury has been known for so long that it is described in the 3500 year old Edwin Smith papyrus. Advances in eye tracking technology over the last 30 years enable precise tracking of pupil position while a person watches television. Dr. Samadani’s laboratory has developed a way to use eye tracking while a subject watches television or a video to calculate how well the eyes move together in unison. She was the lead investigator on a study that enrolled patients who had undergone CT scanning of the brain for suspected brain injury and eye tracked them as they watched a music video or cartoon. Results were compared to normal healthy control subjects who had not had trauma, and a second group of negative controls that had sustained trauma to their bodies or limbs but did not meet emergency room criteria for obtaining a CT scan of the brain. All of the trauma patients also underwent testing with the concussion outcome measure SCAT3 which assesses severity of symptoms, cognitive function (thinking), memory, and balance.
Results showed that people who had hit their heads and had brain injury apparent on CT scans (positive controls) had eyes that did not move in unison as well as normal healthy controls. People who had hit their heads and required a CT scan but had no evidence of injury on the scan (concussion group) also had eyes that did not move in unison as well as normal healthy controls. Trauma patients who had injured their bodies and limbs and not required a head CT (negative controls) had eyes that moved together in unison just as well as non-injured healthy controls. The study also showed that the severity of concussion symptoms as measured by two subsets of the SCAT3 test correlated with the extent of inability to move the eyes together.
The results of this study, Eye Movement Tracking Detects Subclinical Disconjugate Gaze in Structural and Concussive Brain Injury, presented by Dr. Samadani at the AANS meeting remain preliminary until they are published in a peer-reviewed journal. The study represents a collaboration between Dr. Samadani’s laboratory, Paul Huang who is the Chief of Neurosurgery at Bellevue Hospital, and investigators from ophthalmology, emergency medicine and trauma surgery at Bellevue hospital, and computer science at the Courant Institute. The full list of coauthors is: Robert Ritlop Mech Eng, Marleen Reyes BS, Elena Nehrbass BS, Floyd Warren MD, Elizabeth Lamm BS, Julia Schneider, Radek Kolecki MS, Sameer Farooq, Michael Jureller BS, Anastasia Alex BS, Rebecca Tran, David Shimunov, Paige Burris, Chen Shi BS, Meng Qian PhD, Jason Huang MD FAANS, Christopher McStay MD, Paul Huang MD FAANS, S. Rob Todd MD, Robert Fergus PhD, R. Theodore Smith MD PhD and Douglas Kondziolka MD FAANS.