Category: Brain Injury; Technology (e.g. robotics, assistive technology, mHealth); Cross-Cutting
Objective :
To evaluate a mobile BEAM system for rapid identification of cognitive impairment among military service members receiving rehabilitation for mild TBI.
Design :
Criterion standard.
Setting :
Outpatient TBI rehabilitation clinic at a military treatment facility in the Southwestern U.S.
Participants (or Animals, Specimens, Cadavers) :
Consecutively-referred military personnel (n=57) completing intake evaluations.
Interventions :
Not applicable.
Main Outcome Measure(s) :
Bethesda Eye & Attention Measure (BEAM) eye tracking and a brief battery of conventional neuropsychological tests (TMT, SDMT, and NAB Number-Letter, Digit Span, and Story Memory subtests) were administered/scored by separate personnel who were blinded to other test results.
Results :
After controlling for age and education, BEAM metrics (particularly executive control and inhibition metrics) were highly correlated with neuropsychological measures of visual attention, processing speed, task switching, working memory, and executive functions. Correlations with measures of learning/memory, which are not assessed by BEAM, were somewhat weaker. ROC analyses evaluated BEAM composite metrics for detecting overall neuropsychological impairment, defined as >=3 (of 8) tests with tpp=.001, and sensitivity/specificity of .69/.68.
Conclusions :
Previous research has shown that BEAM neurocognitive eye tracking is uniquely sensitive to chronic effects of mild TBI. In this study of military personnel with mild TBI, BEAM performed well as a rapid (10 minute) tool for screening and detection of cognitive impairment, particularly in the domains of processing speed, working memory, attention, and/or executive function. Results also highlighted the potential value of developing a new eye tracking test module to evaluate learning/memory.
Mark Ettenhofer
– Director of Research Operations, Defense and Veterans Brain Injury Center, Naval Medical Center San Diego, San Diego, California
Lars Hungerford
– Senior Clinical Director, Defense and Veterans Brain Injury Center, Naval Medical Center San Diego, San Diego, CaliforniaEvelyn Cordero
– Research Associate, Henry M. Jackson Foundation, San Diego, CaliforniaLynita Mullins
– Director, TBI Clinic, Naval Medical Center San Diego, San Diego, California