Effects of Mild Traumatic Brain Injury on 3D Multiple Object Tracking Performance

To evaluate the efficacy of short-term cognitive and motor training aimed on visual-motor integration in PFT survivors using training devices.

63 children cancer survivors between the ages of 6 and 17 years were tested for baseline levels on cognitive and motor functions. The patients were then split into a no-intervention group and an intervention group who undertook 6 sessions of cognitive motor training (NeuroTracker and Dynavision) over 2 weeks. Both groups were then baselined again.

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Primary results revealed that the cognitive motor training intervention increased gross and fine motor skills, motor coordination, visual-motor integration, and visual processing. Secondary results showed that age was a sensitive factor in the cancer-related decline in cognitive, motor and eye functions, as well as the specific characteristics of the cancer. The researchers concluded that such short-term rehabilitation methods can be useful in pediatric oncological practice.

To address current research gaps in the clinical management of pediatric mTBI and to see if use of NeuroTracker can help overcome such gaps.

As a first stage 213 children were rigorously assessed within 10 days of sustaining an mTBI injury to determine if such assessments could be predictive of recovery time. A second stage assessed the feasibility of 10 mTBI symptomatic children tolerating 6 NeuroTracker sessions. The third stage of the study compared differences in NeuroTracker learning rates between 20 post-mTBI children and 14 healthy children. The fourth stage compared 10 children clinically recovered from mTBI with 10 healthy children. The final stage compared NeuroTracker learning rates between 10 clinically recovered mTBI children and 12 children at various stages of recovery.

The first stage found that a combined post­‐concussion symptom score was effective at predicting delayed recovery. The second stage found NeuroTracker training training was well tolerated and considered to be safe in symptomatic pediatric mTBI. The third stage found both groups improved on NeuroTracker with training, but that initial learning rates were lower for the mTBI group. The fourth stage found no differences in NeuroTracker learning between clinically recovered mTBI children and healthy children. The final phase found children in various stages of recovery had lower initial NeuroTracker learning rates compared to the clinically recovered group. The researcher concluded NeuroTracker to be a safe and promising tool in the management of pediatric mTBIs.

To investigate the performance of NeuroTracker multiple object tracking (MOT) training in 2D and 3D environments, in both healthy and concussed individuals, across three study environments.

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86 participants between the age of 8 and 91 years of age, completed 30 NeuroTracker sessions over the course of ten visits. The individuals were assigned to one of three studies: an environment comparison of 2-D vs 3-D training (n=58), a comparison of 3-D training among aging populations (n=38), or a comparison of 3-D training among concussed populations (n=34; non-concussed, recently concussed and prolonged concussed).

NeuroTracker training in 3-D showed benefit across age groups and concussed populations, demonstrating that all individuals could increase performance. When comparing learning performance between aged individuals, NeuroTracker learning rates increased at a lesser rate (p<0.05). Trends were similar for the concussed group, where the longer an individual was suffering from concussion symptoms, the lower the initial NeuroTracker score. However, they also showed a higher rate of learning performance throughout training. Of particular interest was the response to the 2-D and 3-D training environments. Significant differences were apparent when the environments were compared, with participants in the 3-D environment outperforming the individuals in the 2-D environment. Additionally, switching from the 3-D to the 2-D environment was shown to be detrimental to performance.

The author concluded that it appears the brain does not process monocular cues (2-D) for a 3-D environment, at the same rate or skill level, as it can binocular cues for a 3-D environment (3-D). As the participants training in 3-D showed a higher learning curve throughout the training program, these findings further demonstrate the added benefit and learning potential when training MOT in a 3-D environment.

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To examine baseline relationships between the Sport Concussion Assessment Tool 3 (SCAT3), the King-Devick Test (KDT) and 3D Multiple Object Tracking (NeuroTracker).

304 healthy, non-concussed, athletes (101 females, 203 males), ranging in age from 11-20 years old, completed the SCAT3, KDT and NeuroTracker in a single visit. The results were analysed to see if any aspects of the SCAT3 or the KDT predicted 3D NeuroTracker baselines.

Component tests of the SCAT3 and KDT explained a significant amount of the variance in NeuroTracker speed thresholds. King Devick Test, Delayed Recall, and coordination tests had the highest predictive validity for NeuroTracker baselines. The authors suggest that these correlations could lead to valuable information to better inform clinicians responsible for making Return to Play determinations.

To examine NeuroTracker learning effects in youth with and without mTBI, and investigate if NeuroTracker can train visual perception after mTBI for stimulating recovery and informing return to activity decisions.

34 male and female participants, aged 9–18 years, completed 18 NeuroTracker Core sessions spread out over 6 visits. 20 of the participants were controls, with no history of mTBI. 14 participants had a recent history of mTBI, but were symptom free.

Both groups improved on the NeuroTracker task over time. The control group showed a strong learning curve, with a 79% increase in speed thresholds over the course of the training. The mTBI group showed minimal learning over the first 6 sessions, then a similarly strong learning curve over the following 12 sessions, with a 66% increase in overall speed thresholds. The difference in learning over the first 6 sessions suggests that cognitive deficits persist at a symptom free stage of post-mTBI, and that better clinical assessments are needed to reveal such functional deficits. The results showed that both healthy youth and youth with mTBI can benefit from NeuroTracker training with significant learning effects. This study suggests that NeuroTracker could serve as an inexpensive and easily accessible tracker of recovery for pediatric mTBIs, and that children may benefit from the training following mTBI.

To investigate the potential for NeuroTracker scores to be a marker of functional recovery after mild traumatic brain injury (mTBI).

Twenty child and adolescent participants completed 18 NeuroTracker sessions over the course of 6 visits. Ten participants in the experimental group had previously sustained a concussion (between 2014-2017) and had obtained clearance for complete return to activities, determined by standardized testing from a multi-disciplinary team. Ten participants in the healthy control group had no previous history of mTBI. A pre-post assessment of clinical measures validated for the mTBI population was administered, including balance and coordination (balance and bilateral coordination subtests of the Bruinkinks Oseretsky test of Motor Proficiency), self-reported fatigue (Peds-QL multidimensional fatigue scale), self-efficacy on athletic skills and mTBI presentation related to physical activity, and a computerized cognitive test battery (ImPACT).

Children across both groups displayed similar learning curves with the NeuroTracker task, showing no significant differences in training response and speed threshold scores. Similarly, no significant differences were found in the clinical measures between groups for the initial and final visits. Findings suggest that children who are deemed clinically recovered from a specialized mTBI clinic achieve gains in NeuroTracker performance similar to that of healthy controls. This highlights the importance of appropriate clinical management following mTBI, as well as the potential use of NeuroTracker to track injury progression and be used as a clinical marker of recovery.