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Visual Tracking Synchronization as a Metric for Concussion Screening

Maruta, Jun PhD; Suh, Minah PhD; Niogi, Sumit N. PhD; Mukherjee, Pratik MD, PhD; Ghajar, Jamshid MD, PhD

Section Editor(s): Bazarian, Jeffrey J. MD, MPH

The Journal of Head Trauma Rehabilitation: July-August 2010 - Volume 25 - Issue 4 - p 293–305
doi: 10.1097/HTR.0b013e3181e67936

Our goal was to determine whether performance variability during predictive visual tracking can provide a screening measure for mild traumatic brain injury (mTBI). Seventeen subjects with chronic postconcussive syndrome and 9 healthy control subjects were included in this study. Eye movements were recorded with video-oculography as the subject visually tracked a target that moved through a circular trajectory. We compared the variability of gaze positional errors relative to the target with the microstructural integrity of white matter tracts as measured by the fractional anisotropy (FA) parameter of diffusion tensor imaging. Gaze error variability was significantly correlated with the mean FA values of the right anterior corona radiata (ACR) and the left superior cerebellar peduncle, tracts that support spatial processing and sustenance of attention, and the genu of the corpus callosum. Because the ACR and the genu are among the most frequently damaged white matter tracts in mTBI, the correlations imply that gaze error variability during visual tracking may provide a useful screening tool for mTBI. Gaze error variability was also significantly correlated with attention and working memory measures in neurocognitive testing; thus, measurement of visual tracking performance is promising as a fast and practical screening tool for mTBI.

Brain Trauma Foundation, New York (Drs Maruta and Ghajar); Department of Biological Science, Sungkyunkwan University, Suwon, Korea (Dr Suh); Departments of Radiology (Dr Niogi) and Neurological Surgery (Dr Ghajar), Weill-Cornell Medical College, New York; and Department of Radiology and Biomedical Imaging, University of California, San Francisco, California (Dr Mukherjee).

Corresponding Author: Jamshid Ghajar, MD, PhD, Brain Trauma Foundation, 7 World Trade Center, 34th Floor, 250 Greenwich St, New York, NY 10007 (

This study was supported by Department of Defense grants W81XWH-08-1-0646 and W81XWH-08-2-0177 and James S. McDonnell Foundation grant for the Cognitive Neurobiological Research Consortium in Traumatic Brain Injury. The authors thank Rachel Kolster and Ranjeeta Sarkar for technical assistance with eye movement and cognitive testing, and Drs. Carl Johnson and Robert Zimmerman for the clinical MRI analyses.

© 2010 Lippincott Williams & Wilkins, Inc.