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Song A, Gabriel R, Mohiuddin O, Whitaker D, Wisely CE, Kim T. Automated Eye Tracking Enables Saccade Performance Evaluation of Patients with Concussion History. Optom Vis Sci 2023; 100:855-860. [PMID: 38033013 DOI: 10.1097/opx.0000000000002090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
SIGNIFICANCE Automated eye tracking could be used to evaluate saccade performance of patients with concussion history, providing quantitative insights about the degree of oculomotor impairment and potential vision rehabilitation strategies for this patient population. PURPOSE To evaluate the saccade performance of patients with concussion history based on automated eye-tracking test results. METHODS We conducted a retrospective study of patients with concussion history, primarily from sports participation, who underwent oculomotor testing based on an eye-tracking technology at the Duke Eye Center vision rehabilitation clinic between June 30, 2017, and January 10, 2022. Patients' saccade test results were reviewed, including saccade fixation and saccade speed/accuracy ratio. The outcomes were compared with age-matched normative population data derived from healthy individuals. Multiple linear regression analyses were performed to identify factors associated with saccade performance among patients with concussion history. RESULTS On hundred fifteen patients with concussion history were included in the study. Patients with concussion, on average, had fewer fixations on self-paced horizontal and vertical saccade tests and lower horizontal and vertical saccade speed/accuracy ratios compared with normative ranges. Among patients with concussion history, multiple linear regression analyses showed that older age was associated with fewer fixations on horizontal and vertical saccade tests, whereas male sex was associated with more fixations on horizontal and vertical saccade tests (all P < .01). In addition, older age was associated with lower horizontal saccade speed/accuracy ratio, after adjusting for sex, number of concussion(s), and time from most recent concussion to oculomotor testing ( P < .001). CONCLUSIONS Patients with concussion history had lower saccade performance based on eye tracking compared with healthy individuals. We additionally identified risk factors for lower saccade performance among patients with concussion history. These findings support the use of saccade test results as biomarkers for concussion and have implications for post-concussion rehabilitation strategies.
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Affiliation(s)
- Ailin Song
- Duke University School of Medicine, Durham, North Carolina
| | - Rami Gabriel
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Omar Mohiuddin
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - Diane Whitaker
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | | | - Terry Kim
- Department of Ophthalmology, Duke University, Durham, North Carolina
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2
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Smith JL, Diekfuss JA, Dudley JA, Ahluwalia V, Zuleger TM, Slutsky-Ganesh AB, Yuan W, Foss KDB, Gore RK, Myer GD, Allen JW. Visuo-vestibular and cognitive connections of the vestibular neuromatrix are conserved across age and injury populations. J Neuroimaging 2023; 33:1003-1014. [PMID: 37303280 DOI: 10.1111/jon.13136] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/25/2023] [Accepted: 06/02/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND AND PURPOSE Given the prevalence of vestibular dysfunction in pediatric concussion, there is a need to better understand pathophysiological disruptions within vestibular and associated cognitive, affective, and sensory-integrative networks. Although current research leverages established intrinsic connectivity networks, these are nonspecific for vestibular function, suggesting that a pathologically guided approach is warranted. The purpose of this study was to evaluate the generalizability of the previously identified "vestibular neuromatrix" in adults with and without postconcussive vestibular dysfunction to young athletes aged 14-17. METHODS This retrospective study leveraged resting-state functional MRI data from two sites. Site A included adults with diagnosed postconcussive vestibular impairment and healthy adult controls and Site B consisted of young athletes with preseason, postconcussion, and postseason time points (prospective longitudinal data). Adjacency matrices were generated from preprocessed resting-state data from each sample and assessed for overlap and network structure in MATLAB. RESULTS Analyses indicated the presence of a conserved "core" network of vestibular regions as well as areas subserving visual, spatial, and attentional processing. Other vestibular connections were also conserved across samples but were not linked to the "core" subnetwork by regions of interest included in this study. CONCLUSIONS Our results suggest that connections between central vestibular, visuospatial, and known intrinsic connectivity networks are conserved across adult and pediatric participants with and without concussion, evincing the significance of this expanded, vestibular-associated network. Our findings thus support this network as a workable model for investigation in future studies of dysfunction in young athlete populations.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jed A Diekfuss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Jonathan A Dudley
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Vishwadeep Ahluwalia
- Georgia State University/Georgia Tech Center for Advanced Brain Imaging (CABI), Atlanta, Georgia, USA
| | - Taylor M Zuleger
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio, USA
| | - Alexis B Slutsky-Ganesh
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Weihong Yuan
- Pediatric Neuroimaging Research Consortium, Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kim D Barber Foss
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
| | - Russell K Gore
- Mild TBI Brain Health and Recovery Lab, Shepherd Center, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | - Gregory D Myer
- Emory Sports Performance and Research Center (SPARC), Flowery Branch, Georgia, USA
- Emory Sports Medicine Center, Atlanta, Georgia, USA
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, Georgia, USA
- Youth Physical Development Centre, Cardiff Metropolitan University, Wales, UK
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
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3
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Jain D, Huber CM, Patton DA, McDonald CC, Wang L, Ayaz H, Master CL, Arbogast KB. Use of functional near-infrared spectroscopy to quantify neurophysiological deficits after repetitive head impacts in adolescent athletes. Sports Biomech 2023:1-15. [PMID: 37430440 PMCID: PMC10776807 DOI: 10.1080/14763141.2023.2229790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 06/21/2023] [Indexed: 07/12/2023]
Abstract
There is concern that repetitive head impact exposure (RHIE) may lead to neurophysiological deficits in adolescents. Twelve high school varsity soccer players (5 female) completed the King-Devick (K-D) and complex tandem gait (CTG) assessments pre- and post-season while wearing a functional near-infrared spectroscopy (fNIRS) sensor. The average head impact load (AHIL) for each athlete-season was determined via a standardised protocol of video-verification of headband-based head impact sensor data. Linear mixed effect models were used to determine the effects of AHIL and task condition (3 K-D cards or 4 CTG conditions) on the change in mean prefrontal cortical activation measured by fNIRS, and performance on K-D and CTG, from pre- to post-season. Although there was no difference in the pre- to post-season change in K-D or CTG performance, greater AHIL was associated with greater cortical activation at post-season in comparison to pre-season during the most challenging conditions of K-D (p = 0.003) and CTG (p = 0.02), suggesting that greater RHIE necessitates increased cortical activation to complete the more challenging aspects of these assessments at the same level of performance. These results describe the effect of RHIE on neurofunction and suggest the need for further study of the time course of these effects.
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Affiliation(s)
- Divya Jain
- Department of Bioengineering, University of Pennsylvania, PA, USA
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Colin M. Huber
- Department of Bioengineering, University of Pennsylvania, PA, USA
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Declan A. Patton
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Catherine C. McDonald
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lei Wang
- College of Computing and Informatics, Drexel University, Philadelphia, PA, USA
- Data Science and Biostatistics Unit, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hasan Ayaz
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
- Data Science and Biostatistics Unit, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
- Department of Psychology, College of Arts and Sciences, Drexel University, Philadelphia, PA
| | - Christina L. Master
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Drexel Solutions Institute, Drexel University, Philadelphia, PA
| | - Kristy B. Arbogast
- Center for Injury Research and Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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4
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McDonald MA, Tayebi M, McGeown JP, Kwon EE, Holdsworth SJ, Danesh-Meyer HV. A window into eye movement dysfunction following mTBI: A scoping review of magnetic resonance imaging and eye tracking findings. Brain Behav 2022; 12:e2714. [PMID: 35861623 PMCID: PMC9392543 DOI: 10.1002/brb3.2714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 12/01/2022] Open
Abstract
Mild traumatic brain injury (mTBI), commonly known as concussion, is a complex neurobehavioral phenomenon affecting six in 1000 people globally each year. Symptoms last between days and years as microstructural damage to axons and neurometabolic changes result in brain network disruption. There is no clinically available objective biomarker to diagnose the severity of injury or monitor recovery. However, emerging evidence suggests eye movement dysfunction (e.g., saccades and smooth pursuits) in patients with mTBI. Patients with a higher symptom burden and prolonged recovery time following injury may show higher degrees of eye movement dysfunction. Likewise, recent advances in magnetic resonance imaging (MRI) have revealed both white matter tract damage and functional network alterations in mTBI patients, which involve areas responsible for the ocular motor control. This scoping review is presented in three sections: Section 1 explores the anatomical control of eye movements to aid the reader with interpreting the discussion in subsequent sections. Section 2 examines the relationship between abnormal MRI findings and eye tracking after mTBI based on the available evidence. Finally, Section 3 communicates gaps in our knowledge about MRI and eye tracking, which should be addressed in order to substantiate this emerging field.
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Affiliation(s)
- Matthew A McDonald
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne, New Zealand
| | - Maryam Tayebi
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Joshua P McGeown
- Mātai Medical Research Institute, Gisborne, New Zealand.,Auckland University of Technology Traumatic Brain Injury Network, Auckland, New Zealand
| | - Eryn E Kwon
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne, New Zealand.,Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand
| | - Samantha J Holdsworth
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Mātai Medical Research Institute, Gisborne, New Zealand.,Department of Anatomy and Medical Imaging, University of Auckland, Auckland, New Zealand
| | - Helen V Danesh-Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand.,Eye Institute, Auckland, New Zealand
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5
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Du Y, He L, Wang Y, Liao D. The Neural Mechanism of Long-Term Motor Training Affecting Athletes’ Decision-Making Function: An Activation Likelihood Estimation Meta-Analysis. Front Hum Neurosci 2022; 16:854692. [PMID: 35517985 PMCID: PMC9062593 DOI: 10.3389/fnhum.2022.854692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/03/2022] [Indexed: 11/15/2022] Open
Abstract
Decision-making is an advanced cognitive function that promotes information processes in complex motor situations. In recent years, many neuroimaging studies have assessed the effects of long-term motor training on athletes’ brain activity while performing decision-making tasks, but the findings have been inconsistent and a large amount of data has not been quantitatively summarized until now. Therefore, this study aimed to identify the neural mechanism of long-term motor training affecting the decision-making function of athletes by using activation likelihood estimation (ALE) meta-analysis. Altogether, 10 studies were included and comprised a total of 350 people (168 motor experts and 182 novices, 411 activation foci). The ALE meta-analysis showed that more brain regions were activated for novices including the bilateral occipital lobe, left posterior cerebellar lobe, and left middle temporal gyrus (MTG) in decision-making tasks compared to motor experts. Our results possibly suggested the association between long-term motor training and neural efficiency in athletes, which provided a reference for further understanding the neural mechanisms of motor decision-making.
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Smith JL, Trofimova A, Ahluwalia V, Casado Garrido JJ, Hurtado J, Frank R, Hodge A, Gore RK, Allen JW. The "vestibular neuromatrix": A proposed, expanded vestibular network from graph theory in post-concussive vestibular dysfunction. Hum Brain Mapp 2021; 43:1501-1518. [PMID: 34862683 PMCID: PMC8886666 DOI: 10.1002/hbm.25737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/21/2021] [Accepted: 11/23/2021] [Indexed: 11/07/2022] Open
Abstract
Convergent clinical and neuroimaging evidence suggests that higher vestibular function is subserved by a distributed network including visuospatial, cognitive-affective, proprioceptive, and integrative brain regions. Clinical vestibular syndromes may perturb this network, resulting in deficits across a variety of functional domains. Here, we leverage structural and functional neuroimaging to characterize this extended network in healthy control participants and patients with post-concussive vestibular dysfunction (PCVD). Then, 27 healthy control subjects (15 females) and 18 patients with subacute PCVD (12 female) were selected for participation. Eighty-two regions of interest (network nodes) were identified based on previous publications, group-wise differences in BOLD signal amplitude and connectivity, and multivariate pattern analysis on affective tests. Group-specific "core" networks, as well as a "consensus" network comprised of connections common to all participants, were then generated based on probabilistic tractography and functional connectivity between the 82 nodes and subjected to analyses of node centrality and community structure. Whereas the consensus network was comprised of affective, integrative, and vestibular nodes, PCVD participants exhibited diminished integration and centrality among vestibular and affective nodes and increased centrality of visual, supplementary motor, and frontal and cingulate eye field nodes. Clinical outcomes, derived from dynamic posturography, were associated with approximately 62% of all connections but best predicted by amygdalar, prefrontal, and cingulate connectivity. No group-wise differences in diffusion metrics or tractography were noted. These findings indicate that cognitive, affective, and proprioceptive substrates contribute to vestibular processing and performance and highlight the need to consider these domains during clinical diagnosis and treatment planning.
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Affiliation(s)
- Jeremy L Smith
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Anna Trofimova
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Vishwadeep Ahluwalia
- Georgia State University, Atlanta, Georgia, USA.,Center for Advanced Brain Imaging, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Jose J Casado Garrido
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA
| | | | | | | | - Russell K Gore
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.,Shepherd Center, Atlanta, Georgia, USA
| | - Jason W Allen
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia, USA.,Department of Neurology, Emory University School of Medicine Emory University Hospital, Atlanta, Georgia, USA
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7
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Leonard BT, Kontos AP, Marchetti GF, Zhang M, Eagle SR, Reecher HM, Bensinger ES, Snyder VC, Holland CL, Sheehy CK, Rossi EA. Fixational eye movements following concussion. J Vis 2021; 21:11. [PMID: 34940825 PMCID: PMC8709928 DOI: 10.1167/jov.21.13.11] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The purpose of this study was to evaluate fixational eye movements (FEMs) with high spatial and temporal resolution following concussion, where oculomotor symptoms and impairments are common. Concussion diagnosis was determined using current consensus guidelines. A retinal eye-tracking device, the tracking scanning laser ophthalmoscope (TSLO), was used to measure FEMs in adolescents and young adults following a concussion and in an unaffected control population. FEMs were quantified in two fixational paradigms: (1) when fixating on the center, or (2) when fixating on the corner of the TSLO imaging raster. Fixational saccade amplitude in recent concussion patients (≤ 21 days) was significantly greater, on average, in the concussion group (mean = 1.03°; SD = 0.36°) compared with the controls (mean = 0.82°; SD = 0.31°), when fixating on the center of the imaging raster (t = 2.87, df = 82, p = 0.005). These fixational saccades followed the main sequence and therefore also had greater peak velocity (t = 2.86, df = 82, p = 0.006) and peak acceleration (t = 2.80, df = 82, p = 0.006). These metrics significantly differentiated concussed from controls (AUC = 0.67-0.68, minimum p = 0.005). No group differences were seen for the drift metrics in either task or for any of the FEMs metrics in the corner-of-raster fixation task. Fixational saccade amplitudes were significantly different in the concussion group, but only when fixating on the center of the raster. This task specificity suggests that task optimization may improve differentiation and warrants further study. FEMs measured in the acute-to-subacute period of concussion recovery may provide a quick (<3 minutes), objective, sensitive, and accurate ocular dysfunction assessment. Future work should assess the impact of age, mechanism of injury, and post-concussion recovery on FEM alterations following concussion.
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Affiliation(s)
- Bianca T Leonard
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,
| | - Anthony P Kontos
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,
| | | | - Min Zhang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,
| | - Shawn R Eagle
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,
| | - Hope M Reecher
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,
| | - Ethan S Bensinger
- Vision Science Group, University of California, Berkeley, Berkeley, CA, USA.,
| | - Valerie C Snyder
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,
| | - Cyndi L Holland
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, USA.,
| | - Christy K Sheehy
- Department of Neurology, University of California, San Francisco, San Francisco, CA, USA.,
| | - Ethan A Rossi
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh Swanson School of Engineering, Pittsburgh, PA, USA., rossilab.org
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Feller CN, Goldenberg M, Asselin PD, Merchant-Borna K, Abar B, Jones CMC, Mannix R, Kawata K, Bazarian JJ. Classification of Comprehensive Neuro-Ophthalmologic Measures of Postacute Concussion. JAMA Netw Open 2021; 4:e210599. [PMID: 33656530 PMCID: PMC7930925 DOI: 10.1001/jamanetworkopen.2021.0599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Symptom-based methods of concussion diagnosis in contact sports result in underdiagnosis and repeated head injury exposure, increasing the risk of long-term disability. Measures of neuro-ophthalmologic (NO) function have the potential to serve as objective aids, but their diagnostic utility is unknown. OBJECTIVE To identify NO measures that accurately differentiate athletes with and without concussion. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted among athletes with and without concussion who were aged 17 to 22 years between 2016 and 2017. Eye movements and cognitive function were measured a median of 19 days after injury among patients who had an injury meeting the study definition of concussion while playing a sport (retrospectively selected from a concussion clinic), then compared with a control group of participants without concussion (enrolled from 104 noncontact collegiate athlete volunteers without prior head injury). Data analysis was conducted from November 2019 through May 2020. EXPOSURE Concussion. MAIN OUTCOMES AND MEASURES Classification accuracy of clinically important discriminator eye-tracking (ET) metrics. Participants' eye movements were evaluated with a 12-minute ET procedure, yielding 42 metrics related to smooth pursuit eye movement (SPEM), saccades, dynamic visual acuity, and reaction time. Clinically important discriminator metrics were defined as those with significantly different group differences and area under the receiver operator characteristic curves (AUROCs) of at least 0.70. RESULTS A total of 34 participants with concussions (mean [SD] age, 19.7 [2.4] years; 20 [63%] men) and 54 participants without concussions (mean [SD] age, 20.8 [2.2] years; 31 [57%] men) completed the study. Six ET metrics (ie, simple reaction time, discriminate reaction time, discriminate visual reaction speed, choice visual reaction speed, and reaction time on 2 measures of dynamic visual acuity 2) were found to be clinically important; all were measures of reaction time, and none were related to SPEM. Combined, these 6 metrics had an AUROC of 0.90 (95% CI, 0.80-0.99), a sensitivity of 77.8%, and a specificity of 92.6%. The 6 metrics remained significant on sensitivity testing. CONCLUSIONS AND RELEVANCE In this study, ET measures of slowed visual reaction time had high classification accuracy for concussion. Accurate, objective measures of NO function have the potential to improve concussion recognition and reduce the disability associated with underdiagnosis.
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Affiliation(s)
- Christina N. Feller
- University of Rochester School of Medicine and Dentistry, Rochester, New York
- Medical College of Wisconsin, Milwaukee
| | | | - Patrick D. Asselin
- University of Rochester School of Medicine and Dentistry, Rochester, New York
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Kian Merchant-Borna
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Beau Abar
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Courtney Marie Cora Jones
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Rebekah Mannix
- Department of Pediatrics, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Keisuke Kawata
- Department of Kinesiology, Indiana University, Bloomington
| | - Jeffrey J. Bazarian
- Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York
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Caron B, Stuck R, McPherson B, Bullock D, Kitchell L, Faskowitz J, Kellar D, Cheng H, Newman S, Port N, Pestilli F. Collegiate athlete brain data for white matter mapping and network neuroscience. Sci Data 2021; 8:56. [PMID: 33574337 PMCID: PMC7878753 DOI: 10.1038/s41597-021-00823-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/14/2020] [Indexed: 12/13/2022] Open
Abstract
We describe a dataset of processed data with associated reproducible preprocessing pipeline collected from two collegiate athlete groups and one non-athlete group. The dataset shares minimally processed diffusion-weighted magnetic resonance imaging (dMRI) data, three models of the diffusion signal in the voxel, full-brain tractograms, segmentation of the major white matter tracts as well as structural connectivity matrices. There is currently a paucity of similar datasets openly shared. Furthermore, major challenges are associated with collecting this type of data. The data and derivatives shared here can be used as a reference to study the effects of long-term exposure to collegiate athletics, such as the effects of repetitive head impacts. We use advanced anatomical and dMRI data processing methods publicly available as reproducible web services at brainlife.io.
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Affiliation(s)
- Bradley Caron
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
- School of Optometry, Indiana University, 800 E. Atwater Avenue, Bloomington, IN, 47405, USA
| | - Ricardo Stuck
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
| | - Brent McPherson
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
| | - Daniel Bullock
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
| | - Lindsey Kitchell
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
- Program in Cognitive Science, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
- Johns Hopkins University Applied Physics Laboratory, Laurel, MD, 20723, USA
| | - Joshua Faskowitz
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
| | - Derek Kellar
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
| | - Hu Cheng
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
| | - Sharlene Newman
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
- Alabama Life Research Institute, The University of Alabama, 1402E Northeast Medical Building, Box 870328, Tuscaloosa, AL, USA
| | - Nicholas Port
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA
- School of Optometry, Indiana University, 800 E. Atwater Avenue, Bloomington, IN, 47405, USA
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
- Program in Cognitive Science, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA
| | - Franco Pestilli
- Program in Neuroscience, Indiana University, 702 North Walnut Grove St, Bloomington, IN, 47405, USA.
- School of Optometry, Indiana University, 800 E. Atwater Avenue, Bloomington, IN, 47405, USA.
- Department of Psychological and Brain Sciences, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA.
- Program in Cognitive Science, Indiana University, 1101 East 10th Street, Bloomington, IN, 47405, USA.
- Department of Computer Science, School of Informatics, Indiana University, 700 North Woodlawn Avenue, Bloomington, IN, 47408, USA.
- Department of Intelligent Systems Engineering, School of Informatics, Indiana University, 700 North Woodlawn Avenue, Bloomington, IN, 47408, USA.
- Department of Psychology, The University of Texas at Austin, 108 E Dean Keeton St, Austin, TX, 78712, USA.
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10
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McNabb C, Reha T, Georgieva J, Jacques A, Netto K, Lavender AP. The Effect of Sub-Concussive Impacts during a Rugby Tackling Drill on Brain Function. Brain Sci 2020; 10:E960. [PMID: 33321843 DOI: 10.3390/brainsci10120960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 11/17/2022] Open
Abstract
Concussion is known to detrimentally affect brain health. Rugby tackles commonly occur with high collision force between tackler and ball carrier, and low impact head contact is not uncommon. Cognitive deficits following a bout of soccer ball heading has been attributed to the impact and termed sub-concussion. Although soccer ball heading studies provide evidence for acute effects of sub-concussion, it is unknown whether this phenomenon occurs following rugby tackles. This study investigates the acute effects of rugby tackles on brain function and balance in rugby players. Twenty-six volunteers were assigned to either the ball carrier (9), tackler (9) or control (8) group. Controls performed running without the tackle. Outcome measures included corticomotor function using transcranial magnetic brain stimulation (TMS) and balance was assessed by a series of tasks performed on a NeuroCom Balance Master before and immediately after a tackle training drill. Following the tackling bout, the cortical silent period (cSP) increased for the tacklers with no change for ball carrier and control groups, and no differences between groups for balance measures were observed. Lengthening of cSP observed in the tacklers following the bout has been reported in studies of concussion and may indicate long term detrimental effects.
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11
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Yang C, Luo N, Liang M, Zhou S, Yu Q, Zhang J, Zhang M, Guo J, Wang H, Yu J, Cui Q, Chen H, Gao Q. Altered Brain Functional Connectivity Density in Fast-Ball Sports Athletes With Early Stage of Motor Training. Front Psychol 2020; 11:530122. [PMID: 33101115 PMCID: PMC7546905 DOI: 10.3389/fpsyg.2020.530122] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 08/25/2020] [Indexed: 12/02/2022] Open
Abstract
The human brain shows neuroplastic adaptations caused by motor skill training. Of note, there is little known about the plastic architecture of the whole-brain network in resting state. The purpose of the present study was to detect how motor training affected the density distribution of whole-brain resting-state functional connectivity (FC). Resting-state functional magnetic resonance imaging data was assessed based on a comparison of fast-ball student athletes (SA) and non-athlete healthy controls (NC). The voxel-wise data-driven graph theory approach, global functional connectivity density (gFCD) mapping, was applied. Results showed that the SA group exhibited significantly decreased gFCD in brain regions centered at the left triangular part of the inferior frontal gyrus (IFG), extending to the opercular part of the left IFG and middle frontal gyrus compared to the NC group. In addition, findings suggested the idea of an increased neural efficiency of athletes’ brain regions associated with attentional–motor modulation and executive control. Furthermore, behavioral results showed that in the SA group, faster executive control reaction time relates to smaller gFCD values in the left IFG. These findings suggested that the motor training would decrease the numbers of FC in IFG to accelerate the executive control with high attentional demands and enable SA to rapidly focus the attention to detect the intriguing target.
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Affiliation(s)
- Chengbo Yang
- The Third Department of Physical Education and Training, Chengdu Sport University, Chengdu, China
| | - Ning Luo
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Minfeng Liang
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Sihong Zhou
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Yu
- Exercise and Mental Health Laboratory, School of Psychology, Shenzhen University, Shenzhen, China
| | - Jiabao Zhang
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Mu Zhang
- Information Technology Center, Chengdu Sport University, Chengdu, China
| | - Jingpu Guo
- The Third Department of Physical Education and Training, Chengdu Sport University, Chengdu, China
| | - Hu Wang
- The Third Department of Physical Education and Training, Chengdu Sport University, Chengdu, China
| | - Jiali Yu
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- Ministry of Education Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China.,The Clinical Hospital of Chengdu Brain Science Institute, School of Life Sciences and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qing Gao
- School of Mathematical Sciences, University of Electronic Science and Technology of China, Chengdu, China
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12
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Agtzidis I, Meyhöfer I, Dorr M, Lencer R. Following Forrest Gump: Smooth pursuit related brain activation during free movie viewing. Neuroimage 2020; 216:116491. [DOI: 10.1016/j.neuroimage.2019.116491] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/13/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022] Open
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13
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Abstract
Subconcussive head injury represents a pathophysiology that spans the expertise of both clinical neurology and biomechanical engineering. From both viewpoints, the terms injury and damage, presented without qualifiers, are synonymously taken to mean a tissue alteration that may be recoverable. For clinicians, concussion is evolving from a purely clinical diagnosis to one that requires objective measurement, to be achieved by biomedical engineers. Subconcussive injury is defined as subclinical pathophysiology in which underlying cellular- or tissue-level damage (here, to the brain) is not severe enough to present readily observable symptoms. Our concern is not whether an individual has a (clinically diagnosed) concussion, but rather, how much accumulative damage an individual can tolerate before they will experience long-term deficit(s) in neurological health. This concern leads us to look for the history of damage-inducing events, while evaluating multiple approaches for avoiding injury through reduction or prevention of the associated mechanically induced damage.
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Affiliation(s)
- Eric A Nauman
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, USA; .,School of Mechanical Engineering, Purdue University, West Lafayette, Indiana 47907, USA.,Department of Basic Medical Sciences, Purdue University, West Lafayette, Indiana 47907, USA
| | - Thomas M Talavage
- Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana 47907, USA; .,School of Electrical and Computer Engineering, Purdue University, West Lafayette, Indiana 47907, USA
| | - Paul S Auerbach
- Department of Emergency Medicine, Stanford University, Palo Alto, California 94304, USA
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14
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Abstract
Smooth pursuit eye movements (SPEMs) and saccadic eye movements are both commonly impaired following sport-related concussion (SRC). Typical oculomotor assessments measure individual eye movements in a series of restrictive tests designed to isolate features such as response times. These measures lack ecological validity for athletes because athletes are adept at simple tasks designed for the general population. Yet, because eye movement metrics are sensitive and well-characterized neuroanatomically, it would be valuable to test whether athletes exhibit abnormal eye movements with more challenging tasks. To address this gap in knowledge, we collected eye-tracking data during a sport-like task to gain insight on gaze behavior during active self-motion. SPEMs and saccadic eye movements were recorded during a sport-like visual task within 24-48 h following SRC. Thirty-six Division I student-athletes were divided into SRC and control (CON) groups. All participants completed two blocks of the Wii Fit© soccer heading game (WF) while wearing a monocular infrared eye tracker. Eye movement classification systems quantified saccadic amplitude (SA), velocity (SV), and count (SC); as well as SPEM velocity (SPV) and amplitude (SPA). Separate Mann-Whitney U tests evaluated SPA and SC and found no significant effects (SPA, p = 0.11; SC, p = 0.10). A multi-variate analysis of variance (MANOVA) for remaining variables revealed SPV was significantly greater in CON (p < 0.05), but the SRC group had greater SA and SV (p < 0.05). These findings suggest that during a sport-like task, to maintain foveation SRC subjects used larger amplitude, faster saccades, but exhibited slower SPEMs. Measuring oculomotor function during ecologically valid, sport-like tasks may serve as a concussion biomarker and provide insights into eye movement control after SRC.
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Affiliation(s)
- Nicholas G. Murray
- School of Community Health Sciences, University of Nevada, Reno, Nevada
- Neuromechanics Laboratory, University of Nevada, Reno, Nevada
| | - Brian Szekely
- Neuromechanics Laboratory, University of Nevada, Reno, Nevada
- Psychology Department, University of Nevada, Reno, Nevada
| | - Arthur Islas
- School of Medicine, University of Nevada, Reno, Nevada
| | - Barry Munkasy
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, Georgia
| | - Russell Gore
- Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
- Complex Concussion Clinic, Shepherd Center, Atlanta, Georgia
| | - Marian Berryhill
- Programs in Cognitive and Brain Sciences and Neuroscience, Psychology Department, University of Nevada, Reno, Nevada
| | - Rebecca J. Reed-Jones
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
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15
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Zhang W, Zhao F, Qin W, Ma L. Altered Spontaneous Regional Brain Activity in the Insula and Visual Areas of Professional Traditional Chinese Pingju Opera Actors. Front Neurosci 2018; 12:450. [PMID: 30018534 PMCID: PMC6037822 DOI: 10.3389/fnins.2018.00450] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 06/12/2018] [Indexed: 01/08/2023] Open
Abstract
Recent resting-state fMRI studies have revealed neuroplastic alterations after long-term training. However, the neuroplastic changes that occur in professional traditional Chinese Pingju opera actors remain unclear. Twenty professional traditional Chinese Pingju opera actors and 20 age-, sex-, and handedness-matched laymen were recruited. Resting-state fMRI was obtained by using an echo-planar imaging sequence, and two metrics, amplitude of low frequency fluctuation (ALFF) and regional homogeneity (ReHo), were utilized to assess spontaneous neural activity during resting state. Our results demonstrated that compared with laymen, professional traditional Chinese Pingju actors exhibited significantly decreased ALFF in the bilateral calcarine gyrus and cuneus; decreased ReHo in the bilateral superior occipital and calcarine gyri, cuneus, and right middle occipital gyrus; and increased ReHo in the left anterior insula. In addition, no significant association was found between spontaneous neural activity and Pingju opera training duration. Overall, the changes observed in spontaneous brain activity in professional traditional Chinese Pingju opera actors may indicate their superior performance of multidimensional professional skills, such as music and face perception, dancing, and emotional representation.
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Affiliation(s)
- Weitao Zhang
- Department of Radiology, People’s Liberation Army General Hospital, Beijing, China
| | - Fangshi Zhao
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Lin Ma
- Department of Radiology, People’s Liberation Army General Hospital, Beijing, China
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