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Feasibility of Mild Traumatic Brain Injury Assessment Based on Cardiovascular Response to Postural Change
Katie N Russell1, Edward A Preble, Meghan Hegarty-Craver
1Defense and Veterans Brain Injury Center, Fort Bragg, North Carolina (Ms Russell and Mr Arrieux); Center for Data Science (Dr Preble), Engineered Systems (Drs Hegarty-Craver, Grego, and Gilchrist), and Military and Veteran Health Research (Ms Rae Olmsted), RTI International, Research Triangle Park, North Carolina; Departments of Brain Injury Medicine (Ms Russell, Mr Arrieux, and Dr Cole) and Medicine (Dr Choi), Womack Army Medical Center, Fort Bragg, North Carolina; and General Dynamics Information Technology, Fairfax, Virginia (Ms Russell and Mr Arrieux). Ms Russell is now with Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio. Dr Grego is now with Center for WaSH-AID, Duke University, Durham, North Carolina.
Objective:
To determine the feasibility of short-term cardiovascular responses to postural change as a screening tool for mild traumatic brain injury (mTBI), using heart rate metrics that can be measured with a wearable electrocardiogram sensor.
Setting:
Military TBI clinic.
Design:
Data collected from active-duty service members who had sustained a medically diagnosed mTBI within the prior 72 hours and from age- and sex-matched controls. Cardiac data collected while participants performed a sequence of postural changes.
Main Measures:
Model classification compared with clinical mTBI diagnosis.
Results:
Cardiac biomarkers of mTBI were identified and logistic regression classifiers for mTBI were developed from different subsets of biomarkers. The best model achieved 90% sensitivity and 69% specificity using data from 2 different postural changes.
Conclusion:
Noninvasive measurement of cardiovascular response to postural change is a promising approach for field-deployable post-mTBI screening.
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