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Gold DM, Rizzo JR, Lee YSC, Childs A, Hudson TE, Martone J, Matsuzawa YK, Fraser F, Ricker JH, Dai W, Selesnick I, Balcer LJ, Galetta SL, Rucker JC. King-Devick Test Performance and Cognitive Dysfunction after Concussion: A Pilot Eye Movement Study. Brain Sci 2021; 11:brainsci11121571. [PMID: 34942873 PMCID: PMC8699706 DOI: 10.3390/brainsci11121571] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022] Open
Abstract
(1) Background: The King-Devick (KD) rapid number naming test is sensitive for concussion diagnosis, with increased test time from baseline as the outcome measure. Eye tracking during KD performance in concussed individuals shows an association between inter-saccadic interval (ISI) (the time between saccades) prolongation and prolonged testing time. This pilot study retrospectively assesses the relation between ISI prolongation during KD testing and cognitive performance in persistently-symptomatic individuals post-concussion. (2) Results: Fourteen participants (median age 34 years; 6 women) with prior neuropsychological assessment and KD testing with eye tracking were included. KD test times (72.6 ± 20.7 s) and median ISI (379.1 ± 199.1 msec) were prolonged compared to published normative values. Greater ISI prolongation was associated with lower scores for processing speed (WAIS-IV Coding, r = 0.72, p = 0.0017), attention/working memory (Trails Making A, r = −0.65, p = 0.006) (Digit Span Forward, r = 0.57, p = −0.017) (Digit Span Backward, r= −0.55, p = 0.021) (Digit Span Total, r = −0.74, p = 0.001), and executive function (Stroop Color Word Interference, r = −0.8, p = 0.0003). (3) Conclusions: This pilot study provides preliminary evidence suggesting that cognitive dysfunction may be associated with prolonged ISI and KD test times in concussion.
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Affiliation(s)
- Doria M. Gold
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
| | - John-Ross Rizzo
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
- Department of Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, NY 10016, USA; (Y.S.C.L.); (A.C.); (Y.K.M.); (J.H.R.)
- Department of Mechanical & Aerospace Engineering, New York University Tandon School of Engineering, New York, NY 11201, USA
- Department of Biomedical Engineering, New York University Tandon School of Engineering, New York, NY 11201, USA
| | - Yuen Shan Christine Lee
- Department of Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, NY 10016, USA; (Y.S.C.L.); (A.C.); (Y.K.M.); (J.H.R.)
| | - Amanda Childs
- Department of Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, NY 10016, USA; (Y.S.C.L.); (A.C.); (Y.K.M.); (J.H.R.)
| | - Todd E. Hudson
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
- Department of Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, NY 10016, USA; (Y.S.C.L.); (A.C.); (Y.K.M.); (J.H.R.)
| | - John Martone
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
| | - Yuka K. Matsuzawa
- Department of Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, NY 10016, USA; (Y.S.C.L.); (A.C.); (Y.K.M.); (J.H.R.)
| | - Felicia Fraser
- Department of Physical Medicine & Rehabilitation, MetroHeath System, Cleveland, OH 44109, USA;
| | - Joseph H. Ricker
- Department of Physical Medicine & Rehabilitation, New York University Grossman School of Medicine, New York, NY 10016, USA; (Y.S.C.L.); (A.C.); (Y.K.M.); (J.H.R.)
| | - Weiwei Dai
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
- Department of Electrical & Computer Engineering, New York University Tandon School of Engineering, New York, NY 11201, USA;
| | - Ivan Selesnick
- Department of Electrical & Computer Engineering, New York University Tandon School of Engineering, New York, NY 11201, USA;
| | - Laura J. Balcer
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Steven L. Galetta
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
| | - Janet C. Rucker
- Department of Neurology, New York University Grossman School of Medicine, New York, NY 10016, USA; (D.M.G.); (J.-R.R.); (T.E.H.); (J.M.); (W.D.); (L.J.B.); (S.L.G.)
- Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY 10016, USA
- Correspondence: ; Tel.: +1-212-263-7744
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Rizzo JR, Hudson TE, Martone J, Dai W, Ihionu O, Chaudhry Y, Selesnick I, Balcer LJ, Galetta SL, Rucker JC. How sandbag-able are concussion sideline assessments? A close look at eye movements to uncover strategies. Brain Inj 2021; 35:426-435. [PMID: 33529094 DOI: 10.1080/02699052.2021.1878554] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Sideline diagnostic tests for concussion are vulnerable to volitional poor performance ("sandbagging") on baseline assessments, motivated by desire to subvert concussion detection and potential removal from play. We investigated eye movements during sandbagging versus best effort on the King-Devick (KD) test, a rapid automatized naming (RAN) task.Methods: Participants performed KD testing during oculography following instructions to sandbag or give best effort.Results: Twenty healthy participants without concussion history were included (mean age 27 ± 8 years). Sandbagging resulted in longer test times (89.6 ± 39.2 s vs 48.2 ± 8.5 s, p < .001), longer inter-saccadic intervals (459.5 ± 125.4 ms vs 311.2 ± 79.1 ms, p < .001) and greater numbers of saccades (171.4 ± 47 vs 138 ± 24.2, p < .001) and reverse saccades (wrong direction for reading) (21.2% vs 11.3%, p < .001). Sandbagging was detectable using a logistic model with KD times as the only predictor, though more robustly detectable using eye movement metrics.Conclusions: KD sandbagging results in eye movement differences that are detectable by eye movement recordings and suggest an invalid test score. Objective eye movement recording during the KD test shows promise for distinguishing between best effort and post-injury performance, as well as for identifying sandbagging red flags.
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Affiliation(s)
- John-Ross Rizzo
- Department of Physical Medicine & Rehabilitation, NYU School of Medicine, New York, NY, United States.,Department of Neurology, NYU School of Medicine, New York, NY, United States.,Department of Mechanical & Aerospace Engineering, NYU Tandon School of Engineering, New York, NY, United States.,Department of Biomedical Engineering, NYU Tandon School of Engineering, New York, NY, United States
| | - Todd E Hudson
- Department of Physical Medicine & Rehabilitation, NYU School of Medicine, New York, NY, United States.,Department of Neurology, NYU School of Medicine, New York, NY, United States
| | - John Martone
- Department of Neurology, NYU School of Medicine, New York, NY, United States
| | - Weiwei Dai
- Department of Electrical & Computer Engineering, NYU Tandon School of Engineering, New York, NY, United States
| | - Oluchi Ihionu
- Department of Neurology, NYU School of Medicine, New York, NY, United States
| | - Yash Chaudhry
- Department of Neurology, NYU School of Medicine, New York, NY, United States
| | - Ivan Selesnick
- Department of Electrical & Computer Engineering, NYU Tandon School of Engineering, New York, NY, United States
| | - Laura J Balcer
- Department of Neurology, NYU School of Medicine, New York, NY, United States.,Department of Population Health, NYU School of Medicine, New York, NY, United States.,Department of Ophthalmology, NYU School of Medicine, New York, NY, United States
| | - Steven L Galetta
- Department of Neurology, NYU School of Medicine, New York, NY, United States.,Department of Ophthalmology, NYU School of Medicine, New York, NY, United States
| | - Janet C Rucker
- Department of Neurology, NYU School of Medicine, New York, NY, United States.,Department of Ophthalmology, NYU School of Medicine, New York, NY, United States
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Fallon S, Akhand O, Hernandez C, Galetta MS, Hasanaj L, Martone J, Webb N, Drattell J, Amorapanth P, Rizzo JR, Nolan-Kenney R, Serrano L, Rucker JC, Cardone D, Galetta SL, Balcer LJ. MULES on the sidelines: A vision-based assessment tool for sports-related concussion. J Neurol Sci 2019; 402:52-56. [DOI: 10.1016/j.jns.2019.04.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 04/03/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
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Rizzo JR, Hudson TE, Sequeira AJ, Dai W, Chaudhry Y, Martone J, Zee DS, Optican LM, Balcer LJ, Galetta SL, Rucker JC. Eye position-dependent opsoclonus in mild traumatic brain injury. Prog Brain Res 2019; 249:65-78. [PMID: 31325998 DOI: 10.1016/bs.pbr.2019.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
Opsoclonus consists of bursts of involuntary, multidirectional, back-to-back saccades without an intersaccadic interval. We report a 60-year-old man with post-concussive headaches and disequilibrium who had small amplitude opsoclonus in left gaze, along with larger amplitude flutter during convergence. Examination was otherwise normal and brain MRI was unremarkable. Video-oculography demonstrated opsoclonus predominantly in left gaze and during pursuit in the left hemifield, which improved as post-concussive symptoms improved. Existing theories of opsoclonus mechanisms do not account for this eye position-dependence. We discuss theoretical mechanisms of this behavior, including possible dysfunction of frontal eye field and/or cerebellar vermis neurons; review ocular oscillations in traumatic brain injury; and consider the potential relationship between the larger amplitude flutter upon convergence and post-traumatic ocular oscillations.
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Affiliation(s)
- John-Ross Rizzo
- Department of Physical Medicine and Rehabilitation, New York University School of Medicine, New York, NY, United States; Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - Todd E Hudson
- Department of Physical Medicine and Rehabilitation, New York University School of Medicine, New York, NY, United States; Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - Alexandra J Sequeira
- Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - Weiwei Dai
- Department of Neurology, New York University School of Medicine, New York, NY, United States; Department of Electrical and Computer Engineering, New York University Tandon School of Engineering, New York, NY, United States
| | - Yash Chaudhry
- Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - John Martone
- Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - David S Zee
- Department of Neurology, The Johns Hopkins University, Baltimore, MD, United States
| | - Lance M Optican
- Laboratory of Sensorimotor Research, NEI, NIH, DHHS, Bethesda, MD, United States
| | - Laura J Balcer
- Department of Neurology, New York University School of Medicine, New York, NY, United States; Department of Ophthalmology, New York University School of Medicine, New York, NY, United States; Department of Population Health, New York University School of Medicine, New York, NY, United States
| | - Steven L Galetta
- Department of Neurology, New York University School of Medicine, New York, NY, United States; Department of Ophthalmology, New York University School of Medicine, New York, NY, United States
| | - Janet C Rucker
- Department of Neurology, New York University School of Medicine, New York, NY, United States; Department of Ophthalmology, New York University School of Medicine, New York, NY, United States.
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D'Amico A, Martone J, Previtali S, Baranello G, D'Angelo G, Berardinelli A, Messina S, Vita G, Pane M, Morandi L, Mercuri E, Catteruccia M, Bertini E, Bozzoni I. miRNAs as serum biomarkers for Duchenne muscular dystrophy: Correlation analysis in a multicentre study between miRNA levels and clinical status of DMD patients. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cesana M, Cacchiareli D, Martone J, Cazzella V, Pinnarò C, Legnini I, Bozzoni I. CS01-1. The biological relevance of non-coding RNAs. Cytokine 2011. [DOI: 10.1016/j.cyto.2011.07.300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bozzoni I, Cacchiareli D, Martone J, Cesana M, Cazzella V, Pinnarò C, Legnini I. D.I.2 Role of miRNA in muscle differentiation and in Duchenne Muscular Dystrophy. Neuromuscul Disord 2011. [DOI: 10.1016/j.nmd.2011.06.754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
PURPOSE The purpose of this study is to determine the prevalence of glaucoma in the population participating in the Beaver Dam Eye Study (n = 4926). METHODS All subjects were examined according to standard protocols, which included applanation tonometry, examination of the anterior chamber, perimetry, grading of fundus photographs of the optic disc, and a medical history interview. Visual field, cup-to-disc ratio, and intraocular pressure (IOP) criteria were used to define the presence of open-angle glaucoma. Definite open-angle glaucoma was defined by the presence of any two or all three of the following: abnormal visual field, large or asymmetric cup-to-disc ratio, high IOP. RESULTS The overall prevalence of definite open-angle glaucoma was 2.1%. The prevalence increased with age from 0.9% in people 43 to 54 years of age to 4.7% in people 75 years of age or older. There was no significant effect of sex after adjusting for age. Of the 104 cases of definite open-angle glaucoma, 33 had IOPs less than 22 mmHg in the involved eye. Hemorrhage on the optic disc was found in 46 people; 2 of these had glaucoma. Narrow-angle glaucoma was rare, with two definite cases in the population. CONCLUSION The prevalence of open-angle glaucoma in Beaver Dam is similar to that in other white populations. Findings from this study re-emphasize the notion that estimates of glaucoma prevalence should be based on assessing multiple risk indicators.
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Affiliation(s)
- B E Klein
- Department of Ophthalmology, University of Wisconsin, Madison 53792
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Slade S, Martone J, Kory R, Laukitis S, Konzuk P. Project ORBIS: cornea transplantation in the 90s. Refract Corneal Surg 1991; 7:477-8. [PMID: 1782178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- S Slade
- Plaza Medical Center, Houston, TX 77004
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Martone J. Bone Marrow Smearing Technique. Lab Med 1977. [DOI: 10.1093/labmed/8.12.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Martone J. Demonstration of Hb C Crystals. Lab Med 1977. [DOI: 10.1093/labmed/8.3.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Martone J. Check Pressure Gauges At a Glance. Lab Med 1976. [DOI: 10.1093/labmed/7.3.31b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martone J. Use Idle Equipment for Quality Control at Night. Lab Med 1976. [DOI: 10.1093/labmed/7.1.40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Martone J. Marbles Curb Splashes. Lab Med 1974. [DOI: 10.1093/labmed/5.9.65] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Martone J. Printout Cards for the Coulter Models. Lab Med 1974. [DOI: 10.1093/labmed/5.1.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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