Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries

One of the first clinical signs differentiating the minimally conscious state from the vegetative state is the presence of smooth pursuit eye movements occurring in direct response to moving salient stimuli. Glasgow Coma Scale (GCS) is one of the most commonly used diagnostic tools for acute phase a...

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Main Authors: Michał Lech, Michał T. Kucewicz, Andrzej Czyżewski
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-01-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fneur.2019.00006/full
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author Michał Lech
Michał T. Kucewicz
Michał T. Kucewicz
Andrzej Czyżewski
author_facet Michał Lech
Michał T. Kucewicz
Michał T. Kucewicz
Andrzej Czyżewski
author_sort Michał Lech
collection DOAJ
description One of the first clinical signs differentiating the minimally conscious state from the vegetative state is the presence of smooth pursuit eye movements occurring in direct response to moving salient stimuli. Glasgow Coma Scale (GCS) is one of the most commonly used diagnostic tools for acute phase assessment of the level of consciousness, together with a neurological examination. These classic measures are limited to qualitative neurological examination without more quantitative measures provided from e.g., tasks with tracking position of the gaze. Among this and other limitations, it is prone to a relatively high rate of misdiagnosis. Here, we developed an interface for gaze tracking to enhance the assessment of consciousness in 10 patients with acquired brain injuries. According to the acute phase GCS assessment, nine of them were considered unaware and below the minimally conscious state. Chronic neurological examination confirmed six of them below the minimally conscious state. Our new Human Computer Interface (HCI) revealed that six patients were conscious enough to complete at least one of the gaze tracking tasks. Among these six patients, one was originally diagnosed as remaining in a vegetative state and one in coma. The patient diagnosed as remaining in a chronic vegetative state scored six GCS points acutely. Following assessment with our HCI the patient was re-diagnosed with a possible locked-in syndrome. Our HCI method provides a new complementary tool for clinical assessment of patients suffering from disorders of consciousness.
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spelling doaj.art-7800d1df3f5549dfa9a815ad7b69ebe42022-12-22T01:26:09ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-01-011010.3389/fneur.2019.00006416420Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain InjuriesMichał Lech0Michał T. Kucewicz1Michał T. Kucewicz2Andrzej Czyżewski3Multimedia Systems Department, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, Gdańsk, PolandMultimedia Systems Department, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, Gdańsk, PolandMayo Clinic, Department of Neurology, Rochester, MN, United StatesMultimedia Systems Department, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, Gdańsk, PolandOne of the first clinical signs differentiating the minimally conscious state from the vegetative state is the presence of smooth pursuit eye movements occurring in direct response to moving salient stimuli. Glasgow Coma Scale (GCS) is one of the most commonly used diagnostic tools for acute phase assessment of the level of consciousness, together with a neurological examination. These classic measures are limited to qualitative neurological examination without more quantitative measures provided from e.g., tasks with tracking position of the gaze. Among this and other limitations, it is prone to a relatively high rate of misdiagnosis. Here, we developed an interface for gaze tracking to enhance the assessment of consciousness in 10 patients with acquired brain injuries. According to the acute phase GCS assessment, nine of them were considered unaware and below the minimally conscious state. Chronic neurological examination confirmed six of them below the minimally conscious state. Our new Human Computer Interface (HCI) revealed that six patients were conscious enough to complete at least one of the gaze tracking tasks. Among these six patients, one was originally diagnosed as remaining in a vegetative state and one in coma. The patient diagnosed as remaining in a chronic vegetative state scored six GCS points acutely. Following assessment with our HCI the patient was re-diagnosed with a possible locked-in syndrome. Our HCI method provides a new complementary tool for clinical assessment of patients suffering from disorders of consciousness.https://www.frontiersin.org/article/10.3389/fneur.2019.00006/fullconsciousness level assessmentgaze trackingeye movementsawarenessCyber Eye
spellingShingle Michał Lech
Michał T. Kucewicz
Michał T. Kucewicz
Andrzej Czyżewski
Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries
Frontiers in Neurology
consciousness level assessment
gaze tracking
eye movements
awareness
Cyber Eye
title Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries
title_full Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries
title_fullStr Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries
title_full_unstemmed Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries
title_short Human Computer Interface for Tracking Eye Movements Improves Assessment and Diagnosis of Patients With Acquired Brain Injuries
title_sort human computer interface for tracking eye movements improves assessment and diagnosis of patients with acquired brain injuries
topic consciousness level assessment
gaze tracking
eye movements
awareness
Cyber Eye
url https://www.frontiersin.org/article/10.3389/fneur.2019.00006/full
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