EYE TRACKING AS A BIOMARKER FOR CONCUSSION MELISSA HUNFALVAY PHD - - PowerPoint PPT Presentation

EYE TRACKING AS A BIOMARKER FOR CONCUSSION

MELISSA HUNFALVAY PHD

CHIEF SCIENCE OFFICER, RIGHTEYE, LLC. MELISSA@RIGHTEYE.COM

Reduce Costs – Improve Processes – Please Participants

DISCLOSURES

Dr Hunfalvay is an owner of the company RightEye, LLC.

LEARNING OUTCOMES

At the conclusion of this activity, participants will be able to:

• 1. Attendees will be able to learn oculomotor behavior specifically reflecting mTBI using eye

tracking

• 2. Attendees will be able to identify oculomotor metrics of importance related to brain

mapping mTBI locations

• 3. Attendees will be able to discuss or translate opportunities into specific oculomotor

therapies to improve symptomology

HOW TO CLAIM CE CREDIT

If you would like to receive continuing education credit for this activity, please visit:

nabis.cds.pesgce.com

The Eyes and the Brain

• The eye is not independent
• f the brain
• The retina is part of the brain
• The brain is highly involved in

vision and visual processing

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The Process

1. Examine

• 2. Therapy

& Training

• 3. Re-

examine

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Fixation

A stopping point of the eye

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Fixation Stability – Control

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Fixation Stability – Severe TBI RED level

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Fixation Stability – Dysfunctional: Brain Location

Neural Integrator/Brain Stem Neural Integrator/Brain Stem

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Fixation Stability – mTBI: ORANGE level

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Primary Role of Brain Areas Identified

• Brain Stem:
• Specific areas of the brain stem involved in fixations are:
• Reticular formation in basal ganglia
• Superior Colliculus
• Fixation is an active process and includes microsaccades,

microdrifts and microtremors.

• Neural Integrator: integrate eye velocity and eye position

information to allow image stabilization.

• Brain areas for fixation also include eye fields, dorsolateral prefrontal

cortex and areas of the thalamus (V5 & 5A).

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Fixation Stability – Dysfunctional: Lifestyle

• Eyes are not working optimally when having to focus on a moving
• bject.
• The brain area that may be affected is the brain stem.
• Typical symptoms: gaze stability, motion sensitivity, disorientation,

confusion, fatigue, low energy, sleep disturbances, nervousness, anxiousness.

• Typical risks: falling, clumsiness, inaccurate reach, impaired hand-eye

coordination.

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Pursuits

Eye movements that follow a target

Vertical Pursuits Horizontal Pursuits Circular Pursuits

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Circular Smooth Pursuit – Control

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Circular Smooth Pursuit – Severe TBI: RED level

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Pursuit – Dysfunctional: Brain Location

Cerebellum and/or parietal lobe Cerebellum and/or parietal lobe

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Circular Smooth Pursuit – mTBI: ORANGE level

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Primary Role of Brain Areas Identified

• Parietal Lobe: This dorsal stream has been called both the "where" stream (as

in spatial vision) and the "how" stream (as in vision for action). The posterior parietal cortex (PPC) receives somatosensory and/or visual input, which then, through motor signals, controls movement of the arm, hand, as well as eye movements.

• Cerebellum:
• Receives and regulates eye movements
• guarantees the precision of ocular movements to optimize visual

performance and occupies a central role in all classes of eye movements both in real-time control and in long-term calibration and learning (i.e., adaptation).

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Pursuit – Dysfunctional: Lifestyle

• Eyes are not working optimally when having to track an object.
• The brain area that may be affected are the cerebellum and/or

parietal lobe.

• Typical symptoms: impaired tracking abilities, sensory disturbances.
• Typical risks: misjudging speed of moving objects (e.g. cars when

driving), catching a ball, left and right field of view differences.

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Saccades

Fast eye movements designed to reorient focal gaze

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Horizontal Saccades – Control

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Horizontal Saccades: Severe TBI: RED level

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Horizontal Saccades – Dysfunctional: Brain Location

Cerebellum and/or frontal lobe Cerebellum and/or frontal lobe

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Horizontal Saccades: mild TBI: ORANGE level

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Primary Role of Brain Areas Identified

• Frontal Lobe: The cortical area called frontal eye field (FEF) plays an important

role in the control of visual attention and eye movements. Electrical stimulation in the FEF elicits saccadic eye movements. The FEF have a topographic structure and represents saccade targets in retinotopic coordinates.

• Cerebellum:
• Receives and regulates eye movements
• guarantees the precision of ocular movements to optimize visual

performance and occupies a central role in all classes of eye movements both in real-time control and in long-term calibration and learning (i.e., adaptation).

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Horizontal Saccades– Dysfunctional: Lifestyle

• Eyes are not working optimally when they need to move quickly and

may affect accuracy when targeting objects (hypometria or hypermetria).

• The brain areas that may be affected are the cerebellum, brain stem

and frontal lobe.

• Typical symptoms: fatigue, slow to react, slower information

processing, impaired executive function, multi-tasking issues, lack of mental clarity, brain “fog”, emotional lability.

• Typical risks: reading difficulties, slower to complete tasks (e.g.

student may need extra time for exams), quicker to anger, more impulsive.

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