Abstract
Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, intervention, and improving outcomes. However, detecting mTBI using conventional clinical techniques is difficult, time intensive, and subject to observer bias. We examine the use of a simple visuomotor tracking task as a screening tool for mTBI. Thirty participants, 16 with clinically diagnosed mTBI (mean time since injury: 36.4 ± 20.9 days (95 % confidence interval); median = 20 days) were asked to squeeze a hand dynamometer and vary their grip force to match a visual, variable target force for 3 min. We found that controls outperformed individuals with mTBI; participants with mTBI moved with increased variability, as quantified by the standard deviation of the tracking error. We modeled participants’ feedback response—how participants changed their grip force in response to errors in position and velocity—and used model parameters to classify mTBI with a sensitivity of 87 % and a specificity of 93 %, higher than several standard clinical scales. Our findings suggest that visuomotor tracking could be an effective supplement to conventional assessment tools to screen for mTBI and track mTBI symptoms during recovery.
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Acknowledgments
Funding was provided by Navy Contract Number QW911QY-09-0041-004, USAMRMC W81XWH-11-1-0632, and internal funding from the MITRE Corporation. The study protocol was approved by the MedStar Health Research Institutional Review Board in compliance with all applicable Federal regulations governing the protection of human subjects. Dr. Norris, Dr. Williams, and Dr. Tsao are employees of the US Government. This work was prepared as part of their official duties. Title 17 U.S.C. §105 provides that ‘Copyright protection under this title is not available for any work of the United States Government.’ Title 17 U.S.C. §101 defines a US Government work as a work prepared by a military service member or employee of the US Government as part of that person’s official duties. The views expressed here are those of the author(s) and should not be construed as the official policy or position of the Department of the Navy, Department of Defense, nor the US Government.
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The authors declare no competing financial interests. The following research is patented under PCT/US2013/058567 and US Patent Application 14/483,741.
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Fine, M.S., Lum, P.S., Brokaw, E.B. et al. Dynamic motor tracking is sensitive to subacute mTBI. Exp Brain Res 234, 3173–3184 (2016). https://doi.org/10.1007/s00221-016-4714-5
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DOI: https://doi.org/10.1007/s00221-016-4714-5