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Systems Analysis of the Neuroinflammatory and Hemodynamic Response to Traumatic Brain Injury
Published on: May 27, 2022
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Detecting simulated versus bona fide traumatic brain injury using pupillometry.
Sarah D Patrick1, Lisa J Rapport1, Robert J Kanser1
1Department of Psychology.
Neuropsychology
|May 20, 2021
Summary
Pupillometry, measuring pupil dilation, can help identify individuals faking traumatic brain injury (TBI). This biometric approach adds valuable information beyond standard memory tests for accurate TBI assessment.
Area of Science:
- Neuroscience
- Psychology
- Biometrics
Background:
- Pupil dilation patterns offer insights into cognitive processes like deception and effort.
- Assessing malingered cognitive impairment, particularly feigned traumatic brain injury (TBI), remains a challenge in clinical settings.
Purpose of the Study:
- To investigate the added value of pupillometry during the Test of Memory Malingering (TOMM) for differentiating verified TBI, simulated TBI, and healthy controls.
- To explore pupillary responses related to cognitive load and familiarity in these groups.
Main Methods:
- 177 adults participated: verified TBI (n=53), simulated TBI (SIM, n=52), and healthy comparisons (HC, n=72).
- Pupillometry data was collected during TOMM performance.
- Logistic regression and ROC analyses were used to assess group discrimination.
Main Results:
- Pupillometry significantly discriminated between verified TBI and simulators, providing incremental utility beyond accuracy scores.
- Simulators exhibited higher cognitive load compared to HC and TBI groups.
- The familiarity-induced pupil dilation response was diminished in simulators, potentially due to cognitive effort during deception, but still present in nearly half of their trials.
Conclusions:
- Multimethod assessment, incorporating biometrics like pupillometry with traditional accuracy scores, is strongly supported for improved diagnostic accuracy.
- Pupillometry shows promise in identifying individuals feigning TBI who may evade detection by standard performance validity tests.
