Development of a pediatric oculomotor and vestibular normative database as an essential tool for objective evaluation of concussion and return-to-school/play - Abstract
In current clinical practice, diagnosis of mild traumatic brain injury (mTBI)/concussion and
decision-making regarding return-to-school/play/work rely heavily on self-reported symptoms
and/or on other neurocognitive tests/assessments. These assessments require baseline testing,
which is not commonly done, thus greatly limiting their usefulness. Additionally for the pediatric
population, continuous and rapid brain development suggest baseline testing should be done
more frequently than in adults. Therefore, there is a large unmet need for developing appropriate
tools to evaluate brain dysfunction and recovery following mTBI/concussion that are not baseline
dependent and take into account age-dependent maturational changes.
Eye movement has been traditionally used as a non-invasive observational tool for
understanding neural development. Neuro Kinetics’ FDA-cleared I-Portal® technology assesses
oculomotor, vestibular, reaction time and cognitive (OVRT-C) capabilities and provides a highly
accurate objective measure of neural functions and brain injury-induced disturbances. The
technology consists of head mounted virtual reality goggles equipped with high speed cameras
to capture eye movements, a battery of specific OVRT-C tests that probe different parts of the
brain and a software platform, called VESTTM, that uses sophisticated algorithms to provide
OVRT-C parameters that quantify neural performance. This application seeks funding for
extending the applicability of this technology to the pediatric population. Phase I of the application
is to develop a new child prototype goggle and age appropriate software instructions, design and
algorithms. Phase II is to collect normative OVRT-C data from healthy males and females, ages
8 to 18. This database will reflect normal development as reported by the OVRT-C tests and will
serve as a tool for evaluating effects of mTBI/concussions, monitoring recovery and aiding in the
return-to-school/play decision. Additionally, it can serve as an objective screening tool for mental
health and neurological conditions that start early in childhood, as well as for assessing treatment
efficacy.
