— In studies relevant to the gridiron and other kinds of
battlefields, researchers hope to use a new test based on eye
movements to bring increased accuracy to the diagnosis of
research, by Allegheny Health Network and corporate partner
Neuro Kinetics Inc., involves the use of high-speed digital
photography and other technology to analyze a patient’s
tracking of dots of light or other visual stimuli, which are
projected against a light or dark background.
initial study of high school football players, those with
concussions had more difficulty tracking the images than a
control group without brain injury. Results of the study will
be among the promising developments in orthopedic medicine to
be highlighted this month on the website of the American
Academy of Orthopaedic Surgeons.
Allegheny Health Network’s involvement, O’Hara-based Neuro
Kinetics now is exploring a potential military application
with trials at Naval Medical Center San Diego and Madigan Army
Medical Center in Tacoma, Wash.
concern about the long-term effects of concussions has spawned
a flurry of new studies — including other research at
Allegheny Health and at the University of Pittsburgh and its
medical center — on how to better detect and manage
no single "confirmatory diagnostic test for
concussion," said Dr. Jeff Kutcher, director of Michigan
NeuroSport at the University of Michigan, who helped to write
the American Academy of Neurology’s sports concussion
broken bones, which show up on X-rays, or other conditions
that can be detected through imaging, concussions are not
readily observable. While doctors, athletic trainers and
professionals have balance and cognition tests to guide them,
diagnosis of concussions still relies partly on the
self-reporting of athletes who may just want to return to the
degree, "you are relying on patients telling you how they
feel," said Sam Akhavan, a sports medicine specialist at
Allegheny General Hospital who’s involved in the research of
the Neuro Kinetics technology, called I-Portal.
Howison Schroeder, Neuro Kinetics president and CEO, said he
hopes I-Portal will be more clinically precise than methods
now used to detect concussions, including the well-established
King-Devick Test, a 2-minute eye-movement test that measures
the speed and accuracy with which a person reads a sequence of
numbers. Eye-movement tests, including King-Devick, also are
used to assess people for multiple sclerosis, Parkinson’s
disease, dyslexia and other disorders.
are a major concern for the military, whose soldiers can
sustain the injury in combat, and for sports at the
scholastic, college and professional levels. The National
Football League faces a lawsuit from more than 4,000 former
players who claim they weren’t properly warned about, or
treated for, concussions. A judge last year rejected a
proposed $765 million settlement, saying she didn’t believe
the sum was sufficient.
I-Portal trial, researchers administered the eye-tracking test
to 292 high school football players with no record of brain
injury. Ten of those players later sustained concussions that
were diagnosed by the standard methods. When they were given
the eye-tracking test again, the 10 performed at a
significantly lower level than they or their peers had before.
fell well outside what the normal fit was," Dr. Akhavan
and Steven Broglio, director of the University of Michigan’s
NeuroSport Research Laboratory and lead author of the National
Athletic Trainers’ Association policy on concussions, said
I-Portal is less likely to be the magic bullet for diagnosing
concussions than another tool health professionals will have
available to them. To increase the accuracy of concussion
detection, he said, some professionals use multiple tests on a
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companies owning the King-Devick Test and Pittsburgh-based
ImPACT — which measures attention span, memory, reaction
time and problem-solving ability — do joint marketing. Both
products have a list of studies backing up their reliability,
but neither considers itself a stand-alone diagnostic test.
James S. Gyurke, chief marketing and sales officer for ImPACT,
said his team is among those searching for improved measures
of concussion detection.
the I-Portal research, Allegheny Health Network is helping to
evaluate a test, developed by a Cleveland Clinic Innovations
spinoff, that incorporates a patient’s vision, balance and
motor function into concussion detection.
one of 16 NFL-General Electric grants in January, UPMC is
working on the development of a new imaging technique that
would show concussion damage. Other grant recipients are
working on other imaging techniques and blood tests.