Stress Disorders, Post-Traumatic Clinical Trial
Official title:
Prospective Study of Concussion and PTSD in Structurally Brain Injured, Non-Structurally Brain Injured and Non-Brain Injured Trauma Victims in Bellevue HHC
Mild brain injury or concussion affects about four million Americans each year. Some people
recover completely while others, especially those with multiple concussions, develop chronic
headaches, neurodegenerative diseases and psychiatric disorders. One of the reasons that
concussion is difficult to treat is that it is difficult to detect. Radiographic studies such
as CT (computed tomography scan) are by definition unrevealing of structural injury in
concussed patients. Some MRI (magnetic resonance imaging) sequences may be useful adjuncts in
the diagnosis of concussion but even these are not consistently present in all patients with
symptoms. Clinical tests for concussion often require baseline studies, and thus are
generally reserved for athletes and others at highest risk for concussion.
The investigators have developed a novel eye movement tracking algorithm performed while
subjects watch television or a music video that determines whether the eyes are moving
together (conjugate) or are subtly not together (disconjugate). The investigators preliminary
data shows that people with lesions in their brain or recovering from brain injury have
disconjugate gaze that is not detectable by ophthalmologic examination but is detected by our
algorithm.
The purpose of this study is to test the validity of this eye tracking algorithm for
detecting structural (visible on CT scan) and non-structural (concussive) brain injury. The
study will recruit brain injured subjects and non-brain injured controls from the Bellevue
Hospital Emergency Department and neurosurgery services for eye-tracking as well as studies
that assess the extent of brain injury. The investigators will determine if disconjugate gaze
on eye tracking is significantly associated with abnormal functional, neuro-cognitive, and
psychiatric outcomes.
The investigators hypothesize that individuals who demonstrate sustained disconjugate gaze on
the eye tracking task from the time of injury to 1 month will have elevated functional
impairment in multiple domains of life (work, interpersonal relationships), will be poor
performers on neuro-cognitive tasks (working memory, executive functioning, verbal memory,
impulsivity), and will be significantly more symptomatic of posttraumatic stress disorder
(PTSD) and depression than those who demonstrate conjugate eye tracking in the normal range
at one month. Achievement of the investigators aims will provide the first evidence that eye
tracking is a valid physiologic outcome measure for brain injury.
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