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D5-03
TEST-RETEST REPEATABILITY AND REPRODUCIBILITY
OF MULTI-MODAL TESTING IN 3D HEAD MOUNTED DIS-
PLAY (HMD) WITH EYE TRACKING SYSTEM
Alexander Kiderman
1
, Jorge Gonza´lez
2
, Charles Gallagher
1
, Alyssa
Whinna
2
1
Neuro Kinetics, Inc., 128 Gamma Drive, Pittsburgh, USA
2
Bloomsburg University of Pennsylvania, Audiology & Speech Lan-
guage Pathology, Bloomsburg, USA
Mild traumatic brain injury (mTBI) is a public health concern gar-
nering increased public attention. Neurosensory effects are among the
most common sequella seen after mTBI, specifically balance-related
issues. Acute mTBI patients can be identified with greater than 85%
sensitivity and specificity utilizing a multi-modal battery of tests;
including oculomotor, vestibular, and reaction time tests.
Ongoing DOD trials using a multi-modal test battery on a neuro-
otologic test center demonstrate positive results. The device is not
portable and is in clinics that are far from site of event. This delays
diagnosis and possibly reduces an individual’s recovery. Utilizing a
portable goggle system with high speed eye tracking and 3D inte-
grated stimulus display can resolve this problem, with an evaluation of
an mTBI in the absence of a clinical setting.
The I-Portal -Portable Assessment System (I-Portal PAS), devel-
oped by Neuro Kinetics, Inc. (NKI), provides the means to present a
3D HMD stimulus, and measures variables of ocular motility, ves-
tibular and reaction time tests.
A test-retest repeatability analysis was performed at the Vestibular
laboratory at Bloomsburg University. Thirty individuals participated
in this evaluation. These participants were tested three times utilizing
randomized test protocols with three sets of PAS goggles. The time
between the sessions, protocol sequences and operators were varied to
evaluate the repeatability of the test protocols.
Variables for individual tests were collected, e.g. saccadic latencies,
accuracies, and velocities; pursuit gain, asymmetry and percentage of
saccadic intrusion, optokinetic gains, pupil constriction velocity, av-
erage and peak slow phase velocity. Results from each were compared
for test-retest repeatability, reproducibility and internal consistency
utilizing SPSS 21, IBM.
The analyses revealed that this multi-modal test battery utilizing a
portable 3D HMD system with integrated eye tracking generates re-
sults that are repeatable and reproducible and are not related to testers
or specific versions of the device.
Keywords: assessment, portable, mTBI, multi-modal
D5-04
NEUROSENSORY SYMPTOMS COMPLEXES AFTER
ACUTE MILD TRAUMATIC BRAIN INJURY
Michael Hoffer
1
, Carey Balaban
2
, Sara Murphy
1
, Alexander
Kiderman
3
1
University of Miami, Otolaryngology, MIAMI, USA
2
University of Pittsburgh, Neuroscience, Pittsburgh, PA
3
Neurokinetics, Inc., Engineering, Pittsburgh, PA
Study Objectives:
Mild traumatic brain injury is an increasingly
common public health issue. A great deal of work remains to be done
detailing the consequences of this injury and optimizing the man-
agement of this disorder. The objectives of this study were to examine
the type and relative frequency of neurosensory symptoms seen after
acute mild traumatic brain injury (mTBI).
Methods:
Fifty individuals with acute mild traumatic brain injury
(ages 18–45 years of age) were compared to 100 matched controls.
Acute patients were seen on average less than 48 hours after mTBI
and no more than six days after the event. Assessment of neurosensory
symptoms was performed using a structured history and physical,
specific balance and cognitive tests, standardized instruments, and
detailed balance testing.
Results:
Detailed analysis of this group of patients demonstrated
that neurosensory symptoms could be divided into five domains as
follows: dizziness, emotional, fatigue, headache and nausea. All of
these domains were significantly different in the TBI group as com-
pared to controls. The subjective complaints correlated with particular
instruments or tests used in standard mTBI evaluation panels but not
each domain was predicted by every standard test.
Conclusions:
Neurosensory symptoms are the most common
symptom of mTBI and are among the easiest symptoms to charac-
terize in the acute phase of this disorder. Understanding the neuro-
sensory symptoms complexes and how best to evaluate them has
enormous implications for the management of mTBI and may prove
to be a key diagnostic tool for injury detection as well as return to
work/play guidelines.
Keywords: traumatic brain injury, diagnosis, neurosensory symp-
toms, management
D5-05
CONDITIONED LOCOMOTION FOLLOWING THORACIC
SCI IN RATS: COMPARATIVE ASSESSMENT OF GAIT
ANALYSIS USING AUTOMATED DEVICES
Jiaqiong Wang
, Jeffery Datto, Jameson Wiener, Damien Pearse
University of Miami Miller School of Medicine, The Miami Project to
Cure Paralysis, Miami, USA
A number of automated devices exist to evaluate conditioned locomotion
in rodents after spinal cord injury (SCI). However, it remains unclear
which of these is most sensitive, reliable and reproducible in providing
injury and treatment-related data for gait analysis. In this study, we
subjected adult female Fischer rats to a T8 thoracic SCI using the
MASCIS impactor at a moderate severity (12.5mm) or a severe severity
(25.0mm) versus sham controls. At 9 weeks post injury, locomotor
function was evaluated using the Basso, Beattie, Bresnahan (BBB) score,
the Catwalk device or the KineticWeight Bearing (KWB) apparatus. The
Catwalk provides measurement of 208 gait parameters, of which 77
(37.01%) showed a difference in at least 1 pairwise group comparison, 51
(24.51%) showed a difference in at least 2 pairwise group comparisons,
and 10 showed a difference in all pairwise group comparisons. The KWB
measures 64 gait parameters, of which 13 (20.31%) showed a difference
in at least 1 pairwise group comparison, 10 (15.6%) showed a difference
in at least 2 pairwise group comparisons, and 5 showed a difference in all
pairwise group comparisons. Hierarchical Cluster analysis was then
employed to evaluate the reliability of each device. The Catwalk gait
analysis data showed that 81.2% of animals are clustered correctly with
their original group assignments, followed by the BBB score (76.4%) and
the KWB (52.9%). The coefficient of variation (CV) was next used to
evaluate the reproducibility of each test for measuring changes in loco-
motion. For the moderate SCI group, the severe SCI group and the sham
group, respectively, the BBB score had CVs of 0.07, 0.05 and 0, the
KWB had CVs of 0.157, 0.165 and 0.157, while the Catwalk had CVs of
0.267, 0.286 and 0.220. Conclusion: It appears that the Catwalk device is
the most sensitive and reliable for automated gait analysis to evaluate
locomotor function after thoracic SCI in rats.
Keywords: catwalk, Kinetic Weight Bearing, locomotion, gait
analysis, the Basso, Beattie, Bresnahan (BBB) score
A-108