Biomarker in the diagnosis of mild traumatic brain injury by using the eye-tracking and virtual reality technology

Status:

completed 08/2022

Aims:

The aim of the research project was the systematic exploration of point-of-care biomarkers as diagnostic indicators for the detection and exclusion of mild traumatic brain injury using Eye Tracking (ET)/Virtual Reality (VR) technology.

Primary target group were accident victims within the scope of the Social Accident Insurance. In the interest of the research objectives, consecutive patients were also included in this study regardless of insurance status. In a prospective pilot study at the BG Clinic Hamburg and Unfallkrankenhaus Berlin, the markers in question were investigated with regard to their basic suitability for the detection and exclusion of mild traumatic brain injury.

Activities/Methods:

The BG Klinikum Unfallkrankenhaus Berlin and the BG Klinikum Hamburg participated in this explorative prospective single-arm accuracy study. In the emergency departments, D-Arzt-Ambulanzen or special consultations (e.g. for professional and competitive athletes) of the above-mentioned BG clinics, consecutive patients with a traumatic event that is likely to cause a mild traumatic brain injury were included and examined using ET/VR goggles (index test). After checking the entry criteria, patients were informed about the study, informed consent was obtained, baseline profile data were collected electronically, the examination was performed using ET/VR goggles, and special parameters were determined in the serum (NSE, S100). The SCAT3 was collected from all patients specifically for the study. All further steps corresponded to clinical routine (e.g. decision on hospital admission, imaging diagnostics, etc.). The examinations belonging to the index and reference tests were performed by examiners blinded to the results of the other test.

The clinical diagnosis of mild traumatic brain injury was made after completion of treatment and blinded, i.e., without knowledge of the results of the index test (i.e., the examination using ET/VR glasses) in the form of a clinical synopsis by consensus of two independent clinical experts. The diagnosis was made on the basis of all clinical, neurological, neurofunctional, neuropsychological, and imaging findings. Routine trauma and neurological history, examination, and findings were performed in each case.

All statistical analyses were performed with exploratory intent. The primary aim was to evaluate the markers for their suitability for the diagnosis of a mild traumatic brain injury in a consecutive cohort of patients exposed to an external force application and to test the practicality of the examination using ET/VR-goggles.

Results:

The use of ET/VR goggles was found to be predominantly unproblematic by those studied. The study results do not provide a basis for recommending the use of the ET/VR goggles for this purpose in view of the results on diagnostic accuracy with regard to the detection of a mild traumatic brain injury.

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