Noninvasive rapid screening of mild traumatic brain injury using combination of subject's objective oculomotor, vestibular and reaction time analytic variables

• US 10,398,309 B2
• Filed: 04/15/2015
• Issued: 09/03/2019
• Est. Priority Date: 10/09/2008
• Status: Active Grant

• Current Assignee: Spryson Incorporated
• Original Assignee: Neuro Kinetics, Inc. (Neurolign Technologies, Inc.)
• Inventors: Ashmore, Robin C., Schroeder, Howison, Sweeney, Daniel, Kiderman, Alexander D, Sclabassi, Robert, Joos, Thomas, Frank, Greg, Baker, Thomas Vernon
• Primary Examiner(s): Hindenburg, Max F
• Application Number:
  US14/687,871
• Publication Number:
  US 20150335278A1
• Time in Patent Office: 1,602 Days
• CPC Class Codes: A61B 3/0041 characterised by display arrangements
• CPC Class Codes: A61B 3/113 for determining or recording eye movement
• CPC Class Codes: A61B 3/14 Arrangements specially adapted for eye photography apparatus or arrangements for taking photographs per se G03B
• CPC Class Codes: A61B 5/16 Devices for psychotechnics using teaching or educational appliances G09B1/00 - G09B7/00; Testing reaction times ; Devices for evaluating the psychological state
• CPC Class Codes: A61B 5/163 by tracking eye movement, gaze, or pupil change
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4863 Measuring or inducing nystagmus
• CPC Class Codes: A61B 5/6803 Head-worn items, e.g. helmets, masks, headphones or goggles
• CPC Class Codes: G02B 2027/0138 comprising image capture systems, e.g. camera
• CPC Class Codes: G02B 2027/014 comprising information/image processing systems
• CPC Class Codes: G02B 2027/0187 slaved to motion of at least a part of the body of the user, e.g. head, eye
• CPC Class Codes: G02B 27/0093 with means for monitoring data relating to the user, e.g. head-tracking, eye-tracking
• CPC Class Codes: G02B 27/017 Head mounted

Abstract

A portable VOG device is disclosed that will facilitate the effective and efficient screening for TBI in military personnel in forward deployed military settings or remote locations using minimally trained staff. This includes the establishment of a protocol that will provide cost effective pre-screening of military personnel prior to deployment to establish a baseline of brain function prior to possible future injury. The efficiency of the device will promote subsequent follow-up screening to assess the effectiveness of prescribed TBI treatment. Further protocols for diagnosis and rehabilitation applications using the same virtual reality portable device will allow more advanced usage for clinicians providing ongoing evaluation and treatment.

Claims

1. A method of diagnosis of mild traumatic brain injury or concussion comprising the steps of:

providing a head mounted goggle based stimulus generating eye tracking unit to the subject;

presenting visual stimulus to the subject, wherein the visual stimulus is in the head mounted goggle based system and forms the optical target stimulus for at least a nystagmus test;

obtaining objective physiologic response of the subject from the eye tracking within the head mounted goggle unit based upon each of the visual stimulus presented to the subject in each test; and

using the objective physiologic responses to diagnose the presence of mild traumatic brain injury or concussion.

2. The method of diagnosis of mild traumatic brain injury or concussion according to claim 1, further including the step of obtaining pre-trauma objective physiologic responses of the subject from the head mounted goggle unit based upon each of the visual stimulus presented to the subject, wherein the pre-trauma objective physiologic responses form a baseline for the subject.

3. The method of diagnosis of mild traumatic brain injury or concussion according to claim 2, wherein the step of using the objective physiologic responses to diagnose the presence of mild traumatic brain injury or concussion includes a determining whether at least one post-trauma objective physiologic responses of the subject differs from the associated pre-trauma objective physiologic response by greater than a preset threshold for that response.

4. The method of diagnosis of mild traumatic brain injury or concussion according to claim 1, wherein the visual stimulus presented to the subject includes at least one spontaneous nystagmus test.

5. The method of diagnosis of mild traumatic brain injury or concussion according to claim 1, wherein the visual stimulus presented to the subject further includes at least one horizontal nystagmus test, one vertical and one spontaneous nystagmus test.

6. The method of diagnosis of mild traumatic brain injury or concussion according to claim 1, wherein the visual stimulus presented to the subject further includes at least one horizontal smooth pursuit test and at least one vertical smooth pursuit test.

7. The method of diagnosis of mild traumatic brain injury or concussion according to claim 1, wherein the visual stimulus presented to the subject further includes at least one horizontal saccades test and at least one vertical saccades test.

8. The method of diagnosis of mild traumatic brain injury or concussion according to claim 1, wherein the step of using the objective physiologic responses to diagnose the presence of traumatic brain injury includes a determining whether at least one post-trauma objective physiologic responses of the subject differs from an associated objective physiologic response of a normative database of similar subjects by greater than a preset threshold for that response.

9. A method of diagnosis of traumatic brain injury comprising the steps of:

providing a tracking goggle unit coupled to the subject having onboard digital cameras directed to the subjects eyes and onboard display generating stimulus for the subject;

presenting a plurality of visual stimulus to the subject on the goggle mounted display, wherein each visual stimulus Is presented in the eye tracking unit, wherein each visual stimulus provides a target stimulus for a distinct visual based neurologic test;

obtaining objective physiologic response of the subject from the eye tracking unit based upon each of neurologic test associated with each visual stimulus presented to the subject; and

using the objective physiologic responses to the neurologic tests to diagnose the presence of traumatic brain injury.

10. The method of diagnosis of traumatic brain injury according to claim 9, wherein the visual stimulus presented to the subject includes at least one nystagmus test.

11. The method of diagnosis of traumatic brain injury according to claim 9, wherein the visual stimulus presented to the subject includes at least one horizontal nystagmus test, one vertical and one spontaneous nystagmus test.

12. The method of diagnosis of traumatic brain injury according to claim 9, wherein the visual stimulus presented to the subject includes at least one horizontal smooth pursuit test and at least one vertical smooth pursuit test.

13. The method of diagnosis of traumatic brain injury according to claim 9, wherein the visual stimulus presented to the subject includes at least one horizontal saccades test and at least one vertical saccades test.

14. The method of diagnosis of traumatic brain injury according to claim 9, wherein the step of using the objective physiologic responses to diagnose the presence of traumatic brain injury includes a determining whether at least one post-trauma objective physiologic responses of the subject differs from an associated objective physiologic response of a normative database of similar subjects by greater than a preset threshold for that response.

15. The method of diagnosis of traumatic brain injury according to claim 9, further including the step of obtaining pre-trauma objective physiologic responses of the subject from the head mounted goggle unit based upon each of the visual stimulus presented to the subject, wherein the pre-trauma objective physiologic responses form a baseline for the subject.

16. The method of diagnosis of traumatic brain injury according to claim 15, wherein the step of using the objective physiologic responses to diagnose the presence of traumatic brain injury includes a determining whether at least one post-trauma objective physiologic responses of the subject differs from the associated pre-trauma objective physiologic response by greater than a preset threshold for that response.

17. The method of diagnosis of traumatic brain injury according to claim 16, wherein the visual stimulus presented to the subject includes at least one nystagmus test.

18. The method of diagnosis of traumatic brain injury according to claim 16, wherein the visual stimulus presented to the subject includes at least one horizontal nystagmus test, one vertical and one spontaneous nystagmus test.

19. The method of diagnosis of traumatic brain injury according to claim 17, wherein the visual stimulus presented to the subject includes at least one horizontal smooth pursuit test and at least one vertical smooth pursuit test.

20. A method of screening for mild traumatic brain injury or concussion comprising the steps of:

providing a head mounted goggle based stimulus generating eye tracking unit to the subject;

Performing a battery of tests on the subject through the head mounted goggle based stimulus generating eye tracking unit, the testing battery including at least one random saccade test;

at least one predictive saccade test;

at least one smooth pursuit test;

at least one gaze test, at least one anti-saccade test;

at least one of a subjective vertical or a subjective horizontal test; and

at least one reaction time test; and

Indicating an increased likelihood of mild traumatic brain injury or concussion based upon abnormal results to this battery of tests.