Using Dynamics of Eye Movements, Speech Articulation and Brain Activity to Predict and Track mTBI Screening Outcomes

James R Williamson,Thomas F Quatieri,Joseph Lacirignola,Trey E Shenk,Kristin J Heaton,Hrishikesh M Rao,Thomas M Talavage,Trina Vian,Sophia Yuditskaya,Doug Sturim

doi:10.3389/fneur.2021.665338

Abstract

Repeated subconcussive blows to the head during sports or other contact activities may have a cumulative and long lasting effect on cognitive functioning. Unobtrusive measurement and tracking of cognitive functioning is needed to enable preventative interventions for people at elevated risk of concussive injury. The focus of the present study is to investigate the potential for using passive measurements of fine motor movements (smooth pursuit eye tracking and read speech) and resting state brain activity (measured using fMRI) to complement existing diagnostic tools, such as the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), that are used for this purpose. Thirty-one high school American football and soccer athletes were tracked through the course of a sports season. Hypotheses were that (1) measures of complexity of fine motor coordination and of resting state brain activity are predictive of cognitive functioning measured by the ImPACT test, and (2) within-subject changes in these measures over the course of a sports season are predictive of changes in ImPACT scores. The first principal component of the six ImPACT composite scores was used as a latent factor that represents cognitive functioning. This latent factor was positively correlated with four of the ImPACT composites: verbal memory, visual memory, visual motor speed and reaction speed. Strong correlations, ranging between r = 0.26 and r = 0.49, were found between this latent factor and complexity features derived from each sensor modality. Based on a regression model, the complexity features were combined across sensor modalities and used to predict the latent factor on out-of-sample subjects. The predictions correlated with the true latent factor with r = 0.71. Within-subject changes over time were predicted with r = 0.34. These results indicate the potential to predict cognitive performance from passive monitoring of fine motor movements and brain activity, offering initial support for future application in detection of performance deficits associated with subconcussive events.

Highlights

Over the past decade, awareness and concern regarding the adverse effects of subconcussive head injuries has grown, in the areas of sport and the military [1]
An exploratory analysis was conducted of the pattern of correlations between coordination complexity features and the ImPACT latent cognitive factor
Coordination complexity features were extracted from the eye tracking segments by constructing channel-delay correlation matrices, as described in Equations [1, 2], and extracting the eigenspectra of the matrices

Summary

Introduction

Awareness and concern regarding the adverse effects of subconcussive head injuries has grown, in the areas of sport and the military [1]. With ongoing diagnostic challenges in concussion screening assessment, medical professionals face difficult real-time decisions about whether or not it is safe for athletes or Soldiers to continue performing after experiencing head impacts during play or on the battlefield. An athlete with an undiagnosed concussion who is not removed from the field may experience subsequent repetitive head impacts during play, with even mild mechanical head impacts exacerbating the original injury and complicating recovery [4]. Over time, repeated subconcussive blows to the head during sports may have cumulative and long-lasting neurological effects [5, 6]

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Conclusion