title: Dynamic motor tracking is sensitive to subacute mTBI.
abstract: Effective screening for mild traumatic brain injury (mTBI) is critical to accurate diagnosis, intervention, and improving outcomes. However, detecting mTBI using conventional clinical techniques is difficult, time intensive, and subject to observer bias. We examine the use of a simple visuomotor tracking task as a screening tool for mTBI. Thirty participants, 16 with clinically diagnosed mTBI (mean time since injury: 36.4 ± 20.9 days (95 % confidence interval); median = 20 days) were asked to squeeze a hand dynamometer and vary their grip force to match a visual, variable target force for 3 min. We found that controls outperformed individuals with mTBI; participants with mTBI moved with increased variability, as quantified by the standard deviation of the tracking error. We modeled participants' feedback response-how participants changed their grip force in response to errors in position and velocity-and used model parameters to classify mTBI with a sensitivity of 87 % and a specificity of 93 %, higher than several standard clinical scales. Our findings suggest that visuomotor tracking could be an effective supplement to conventional assessment tools to screen for mTBI and track mTBI symptoms during recovery.
authors.affiliation: The MITRE Corporation, 7525 Colshire Dr., M/S H205, Mclean, VA, 22102, USA. mfine@mitre.org.
authors.forename: Michael S
authors.identifier: 0000-0001-5717-179X
authors.initials: MS
authors.lastname: Fine
authors.affiliation: The MedStar National Rehabilitation Hospital, 102 Irving Street, Washington, DC, 20010, USA.|Biomedical Engineering, Pangborn Hall, Room 131, The Catholic University of America, 620 Michigan Ave NE, Washington, DC, 20064, USA.|Washington D.C. Veterans Affairs Medical Center, Washington, DC, 20010, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Lum
authors.affiliation: The MITRE Corporation, 7525 Colshire Dr., M/S H205, Mclean, VA, 22102, USA.
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Brokaw
authors.affiliation: The MITRE Corporation, 7525 Colshire Dr., M/S H205, Mclean, VA, 22102, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Caywood
authors.affiliation: The MedStar National Rehabilitation Hospital, 102 Irving Street, Washington, DC, 20010, USA.|Biomedical Engineering, Pangborn Hall, Room 131, The Catholic University of America, 620 Michigan Ave NE, Washington, DC, 20064, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Metzger
authors.affiliation: The MedStar National Rehabilitation Hospital, 102 Irving Street, Washington, DC, 20010, USA.|Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC, 20007, USA.|Washington D.C. Veterans Affairs Medical Center, Washington, DC, 20010, USA.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Libin
authors.affiliation: The MedStar National Rehabilitation Hospital, 102 Irving Street, Washington, DC, 20010, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Terner
authors.affiliation: Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room A1036, Bethesda, MD, 20814, USA.|University of Tennessee Health Science Center, Memphis, TN, 38163, USA.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Tsao
authors.affiliation: Naval Medical Research Center, 503 Robert Grant Avenue, Silver Spring, MD, 20910, USA.
authors.forename: Jacob N
authors.initials: JN
authors.lastname: Norris
authors.affiliation: The MedStar National Rehabilitation Hospital, 102 Irving Street, Washington, DC, 20010, USA.|Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC, 20007, USA.
authors.forename: David
authors.initials: D
authors.lastname: Milzman
authors.affiliation: Naval Health Research Center, 160 Sylvester Road, San Diego, CA, 92106, USA.
authors.forename: Diane
authors.initials: D
authors.lastname: Williams
authors.affiliation: The MITRE Corporation, 7525 Colshire Dr., M/S H205, Mclean, VA, 22102, USA.
authors.forename: Jeff
authors.initials: J
authors.lastname: Colombe
authors.affiliation: The MedStar National Rehabilitation Hospital, 102 Irving Street, Washington, DC, 20010, USA.|Georgetown University School of Medicine, 3900 Reservoir Rd NW, Washington, DC, 20007, USA.|Washington D.C. Veterans Affairs Medical Center, Washington, DC, 20010, USA.
authors.forename: Alexander W
authors.initials: AW
authors.lastname: Dromerick
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis*; D016022:Case-Control Studies; D005260:Female; D018737:Hand Strength / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D053581:Muscle Strength Dynamometer; D009483:Neuropsychological Tests; D017711:Nonlinear Dynamics; D015599:Trauma Severity Indices; D014796:Visual Perception / Q000502:physiology*; D055815:Young Adult
keywords: Concussion; Head trauma; Visuomotor tracking; mTBI