Repeatability Assessment of Neurovisual Tasks for the Construction of a New Concussion Monitoring Tool (SPORTICARE)
Condition: Traumatic Brain Injury
MeSH terms: Brain Injuries; Brain Injuries, Traumatic
Study type: Observational

Summary: 
      Traumatic brain injury (TBI) is a condition that occurs when a mechanical blow to the head
      causes damage to the brain. The diagnosis of this pathology requires the evaluation of
      several dimensions, including clinical symptoms, physical signs, cognitive disorders,
      behavioral and sleep disturbances and state of consciousness. This multidimensional approach
      provides a comprehensive and accurate assessment of head injury and its severity.

      The Berlin Consensus of the International Conference on Concussion in Contact Risk Sports
      held in Berlin in 2016 (McCrory et al., 2017) emphasized that the management of a CTE must be
      multimodal and multidisciplinary.

      This expert consensus converged on a tool that is now the most widely used in protocols
      studying concussion in sports at risk of BTI. This tool, the SCAT 5 (Sports Concussion
      Assessment Tool), combines symptom assessment, cognitive examination, neurological
      examination (oculomotricity, balance) and immediate and delayed memory.

      However, it requires the intervention of a medical expert to assess the clinical signs of the
      concussed athlete. Hänninen et al (2021) showed that test-retest reproducibility was very
      good for the clinical symptomatology subscore, but poor or average for the subscores
      summarizing cognitive tests and balance assessment.

      Clinicians now need to be able to better assess the severity of damage following head injury,
      and to monitor the patient's progress. This will improve the management of concussed athletes
      right up to their eventual return to sporting activity.

      The ultimate aim of our project is to develop and optimize an easily exportable multimodal
      concussion assessment tool, based on the use of a virtual reality headset, which will enable
      us to objectively characterize the state and evolution of a subject after a TCE. This will
      enable the assessment of neuro-visual functions and compensations in the concussed patient,
      revealing a higher attentional cost characterized by instability of orthostatic control,
      higher blink frequency and larger pupil size.

      The multimodal tool will be built from the results of various tests:

        -  Standardized oculomotor tasks(pro-saccades, anti-saccades, smooth pursuit, memory guided
           saccades, self paced saccades)

        -  Orthostatic balance control to assess postural compensations and estimate attentional
           cost during oculomotor tasks.

        -  Pupil dynamics using the Pupil Cycle Time (PCT) test. The aim of this exploratory study
           is to determine the repeatability of measurements provided by the SPORTiCARE virtual
           reality headset during different tasks.
    


Intervention name(s): multimodal oculomotor measurements
Intervention type(s): Other
Intervention description(s): Visual assessment to ensure that the subject meets the inclusion and non-inclusion criteria, including anamnesis and the following visual tests: Lang stereotest, H-test ocular motility, convergence, masking and accommodative rock.
Evaluation by experimenter A (60 min)
Neuro-ophthalmological tests on screen
Neuro-ophthalmological tests in VR headset
Evaluation by experimenter B (60 min)
Neuro-ophthalmological tests on screen
Neuro-ophthalmological tests in VR helmet The sequence of experimenters A-B or B-A will be randomized.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Group of 25 healthy volunteers