Methods and kits for assessing neurological and ophthalmic function and localizing neurological lesions
Inventors
Assignees
New York University NYU • US Department of Veterans Affairs
Publication Number
US-10966669-B2
Publication Date
2021-04-06
Expiration Date
2034-06-17
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Abstract
The invention provides methods and kits for detecting, screening, quantifying or localizing the etiology for reduced or impaired cranial nerve function or conduction; localizing a central nervous system lesion; detecting, diagnosing or screening for increased intracranial pressure, pressure or disruption of central nervous system physiology as seen with concussion; or detecting, diagnosing, monitoring progression of or screening for a disease or condition featuring increased intracranial pressure or concussion by tracking eye movement of the subject. The invention also provides methods and kits useful for detecting, screening for or quantitating disconjugate gaze or strabismus, useful for diagnosing a disease characterized by disconjugate gaze or strabismus in a subject, useful for detecting, monitoring progression of or screening for a disease or condition characterized by disconjugate gaze or strabismus in a subject or useful for quantitating the extent of disconjugate gaze or strabismus. Further, the invention provides methods for assessing or quantifying structural and non-structural traumatic brain injury or diagnosing a disease characterized by or featuring structural and non-structural traumatic brain injury.
Core Innovation
The invention provides methods and kits for detecting, screening, quantifying, or localizing the etiology of reduced or impaired cranial nerve function or conduction, localizing central nervous system lesions, and detecting or diagnosing increased intracranial pressure or concussion by tracking eye movement of a subject. It also enables quantitating disconjugate gaze or strabismus for diagnosing diseases characterized by such ocular motility disorders and for assessing or quantifying structural and non-structural traumatic brain injury (TBI).
The invention addresses the problem of diagnosing elevated intracranial pressure (ICP), central nervous system lesions, concussion, and other neurological conditions using conventional methods which rely on history, physical exam, imaging, or invasive procedures. These methods often lack sensitivity and require calibration processes that presume intact ocular motility which can mask deficits. Traditional approaches may not detect subtle or early neurological impairments. The invention presents non-spatially calibrated eye movement tracking during naturalistic viewing to detect physiological dysfunction of cranial nerves II, III, IV, and VI, thus overcoming limitations of prior art and enabling detection of neurologic impairments, including elevated ICP and concussion, with greater sensitivity and objectivity.
Claims Coverage
The patent claims encompass methods and kits for detecting, diagnosing, screening, and quantifying neurological and ophthalmic conditions through eye movement tracking, with detailed inventive features disclosed across multiple independent claims.
Method for detecting, diagnosing, or screening for concussion using eye movement analysis
Tracking eye movement of at least one eye or both eyes of a subject, collecting x and y coordinates of pupil position over at least 100 seconds, analyzing the data by comparing eye movement of both eyes or to control subjects, calculating statistical tests including metrics such as variance, skew, box dimensions, and conjugacy measures, and diagnosing concussion based on these statistical analyses.
The claims principally cover advanced eye movement tracking methods that utilize non-spatially calibrated pupil position data and statistical analysis to detect concussion and related neurological conditions by quantifying ocular motility irregularities.
Stated Advantages
Provides a high sensitivity method to detect elevated intracranial pressure and concussion where conventional exams or imaging may show normal results.
Enables assessment of cranial nerve function II, III, IV and VI non-invasively and without requiring patient cooperation for calibration.
Facilitates localization of central nervous system lesions and differentiation between focal and diffuse intracranial pathologies.
Allows longitudinal monitoring of neurological status in various settings including hospital, outpatient, or home environments.
Offers a rapid, objective, and quantitative assessment tool useful in emergency and clinical settings where specialized expertise or equipment may not be available.
Documented Applications
Screening, detection, diagnosis, and monitoring of elevated intracranial pressure caused by trauma, cerebrovascular accident, aneurysm, tumors, infections, inflammatory diseases, pseudotumor, hydrocephalus, or idiopathic causes.
Detection, diagnosis, and screening of concussion and non-structural traumatic brain injury including blast injury and subconcussion.
Assessment and quantitation of structural traumatic brain injury using eye movement metrics.
Localization of central nervous system lesions by comparative eye movement analysis.
Quantitating and diagnosing diseases characterized by disconjugate gaze or strabismus including trauma, demyelination, inflammation, infection, degenerative diseases, metabolic and vascular disorders, and ophthalmologic diseases.
Use in neurological integrity and cognitive function assessment.
Application in emergency care, sports medicine, neurosurgery, neuro-ophthalmology, and rehabilitation.
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