Uzma Samadani (VA New York Harbor Healthcare System)
17 December 2014. Researchers at New York University Medical Center designed a technology that spots brain injuries in patients by tracking their eye movements while watching a few minutes of videos. The team led by neuroscience and physiology professor Uzma Samadani, with colleagues from other NYU departments and VA New York Harbor Healthcare System, published its proof-of-concept findings last week in Journal of Neurosurgery (paid subscription required).
Samadani — also Chief of Neurosurgery at VA New York Harbor Heathcare System — and colleagues were seeking faster and easier methods of diagnosing traumatic brain injuries, a continuing problem among returning Iraq and Afghanistan veterans, as well as the population in general. Centers for Disease Control and Prevention says in 2010 traumatic brain injuries led to 2.5 million hospitalizations and 50,000 deaths in the U.S. Some 4 in 10 cases are the result of falls, occurring more often in the oldest and youngest age categories. Unintentional blunt trauma, traffic accidents, and assaults each cause 10 to 15 percent of cases.
In the journal paper, the researchers recorded eye movements of 169 subjects with a commercial eye-tracking device while they watched a music video nearly 4 minutes in length. The subjects included 12 individuals with cranial nerve damage causing weakness in muscles controlling eye movement, alignment, and focus. The remaining 157 participants were neurologically healthy.
Cranial nerves emanate from the brainstem connecting the spinal cord to the brain, providing sensory and motor functions of vision and other senses. Among the causes of cranial nerve damage is head trauma.
People with functioning cranial nerves can move their eyes horizontally and vertically in about equal proportions, but when cranial nerves affecting vision are damaged, eyes cannot move in the direction of the damage. Eye-movement tests confirmed the hypothesis showing statistically reliable differences in movement patterns between people with damaged and healthy cranial nerves. The conditions of 9 patients with nerve damage were later treated with surgery, and in further tests showed normal eye movements.
“One of the reasons that clinical trials for treatment of brain injury have failed in the past,” says Samadani in an NYU statement, “is that brain injury is hard to classify and quantitate with existing technologies. This invention suggests a potential new method for classifying and quantitating the extent of injury.”
The test could be useful for diagnosing traumatic brain injuries caused by blasts or concussions, which can be difficult with standard imaging technologies. Other advantages of the technique are speed and ease of use. NYU says Samadani was able to assess 600 active military at Fort Campbell, Kentucky with the technology in the first week following their return from deployments in the Middle East.
Samadani and co-author Robert Ritlop founded the company Oculogica Inc. to commercialize the technology, with a device called Eyebox that they say can provide a faster, easier, more reliable, and less-invasive diagnosis for concussion and other traumatic brain injuries than imaging, blood and spinal fluid samples, physical exams, and congnitive tests. Oculogica won first prize in a technology venture competition at NYU in 2013 and received seed funding as well as more than $400,000 in grants.
Ritlop and Samadani tell more about the technology and company in the following video.
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