Eye Tracking as a Biomarker for Concussion in Children

Area of Science:

• Neuroscience
• Ophthalmology
• Pediatric Medicine

Background:

• Concussion is a common brain injury in children, often leading to persistent symptoms.
• Objective assessment of mild traumatic brain injury (concussion) in pediatric patients is challenging.
• Eye movement abnormalities are associated with concussion and can indicate neurological dysfunction.

Purpose of the Study:

• To evaluate an automated eye-tracking algorithm as a biomarker for concussion in children.
• To assess the correlation between eye-tracking metrics and concussion symptoms.
• To determine the utility of eye tracking in identifying convergence insufficiency and accommodation dysfunction in pediatric concussion patients.

Main Methods:

• A cross-sectional case-control study involving 56 concussed children and 83 controls.
• Eye movements were recorded using an automated eye tracker while participants watched a video clip.
• Eye-tracking metrics were compared with clinical assessments, including Acute Concussion Evaluation (ACE) scores, near point of convergence (NPC), and accommodation amplitude.

Main Results:

• Twelve eye-tracking metrics significantly differed between concussed and non-concussed children.
• An eye-tracking model achieved an AUC of 0.854 for classifying concussion based on symptoms.
• Eye tracking demonstrated high specificity (95.8%) in identifying near point of convergence disability and correlated strongly with accommodation dysfunction (Spearman correlation = 0.752).

Conclusions:

• Automated eye tracking shows significant potential as an objective, noninvasive diagnostic aid for concussion in children.
• Eye tracking effectively correlates with concussion symptoms and detects visual abnormalities like convergence and accommodation dysfunction.
• This technology offers a rapid and reliable method to support the clinical diagnosis of pediatric concussion.