Evaluation of sport-related concussion using objective eye tracking

Evaluate EyeBOX in an adolescent sport-related concussion (SRC) population by comparing scores between concussed and non-concussed athletes, examining sensitivity/specificity, and assessing clinical recovery associations.

A prospective, unmatched case-control study examined concussed adolescents (11-22 years) treated in a sports concussion clinic who underwent EyeBOX testing. Concussed participants completed symptom scales and follow-up assessments. Analyses included t-tests comparing groups, sensitivity/specificity analyses, and models examining relationships between BOX scores and recovery outcomes, including initial post-concussion symptom severity (PCSS) scores, return to learn (RTL), symptom resolution (SR), and return to play (RTP).

Participants included 36 youth athletes with SRCs and 30 non-concussed controls. BOX scores were significantly higher in concussed participants (7.9 ± 5.2) compared to controls (5.4 ± 5.1; t = 2.062, p = 0.043, Cohen's d = 0.479). Sensitivity for detecting concussion ranged from 22% (BOX>10) to 61% (BOX>5), while specificity ranged from 63%-87%. Multivariable linear regression showed that higher BOX scores predicted higher initial PCSS scores (β = 0.323, p = 0.049) but did not predict RTL, SR, or RTP.

EyeBOX demonstrated moderate specificity but limited sensitivity for identifying SRC and scores were associated with initial symptom severity. While it may not be useful as a standalone diagnostic tool, EyeBOX may serve as an adjunct for confirming concussion in youth athletes.