Skip to main content

Military Health System

Important Notice about Pharmacy Operations

Change Healthcare Cyberattack Impact on MHS Pharmacy Operations. Read the statement to learn more. 

DVBIC eye-tracking tech may help service members with concussions

Image of Soldier sitting in front of a laptop with headphones on. Naval Reserve Officer ENS Carlos Monasterio, a member of the DVBIC Naval Medical Center San Diego research team, demonstrates the Fusion eye-tracking system. (DVBIC photo by Mark Ettenhofer)

An innovative technology, known as the Fusion Brain Assessment System, tracks eye movements in individuals and shows promise as an objective measure to diagnose and manage service members with concussions, and enhance force readiness, according to ongoing studies by researchers from the Defense and Veterans Brain Injury Center (DVBIC).

Diagnosing a concussion, also known as a mild traumatic brain injury, usually relies on a screening tool, such as the Military Acute Concussion Evaluation (MACE 2), used by the Department of Defense (DOD). These types of tools have a strong subjective element based on patient recall of past traumatic events.

By contrast, the Fusion technology is more objective by assessing eye reaction time that is often slower or more erratic for those who have experienced brain trauma. More than 400,000 active-duty service members have been diagnosed with TBI since 2000, according to figures from DVBIC.

“Through this program of research, we've developed and validated novel methods using eye tracking and measuring electrical brain signals to objectively measure effects of TBI on service members' cognitive, sensory and motor abilities,” said Mark Ettenhofer, a neuropsychologist at DVBIC’s Naval Medical Center San Diego research site in California, and one of the technology’s principal developers. DVBIC is the DOD’s traumatic brain injury center of excellence and a division of the Defense Health Agency Research and Development Directorate.

Ettenhofer and his colleagues tested eye movements to determine whether effects of brain injury among study participants would become more pronounced when performing more intellectually demanding tasks. All participants made eye movements as quickly as possible to look at circular images that appeared on a computer screen. As the tasks became more challenging, those with long-term effects from TBIs had greater difficulties than those without them. When combined with other tools, the eye-tracking system could help improve the accuracy of TBI diagnoses.

In the past, research psychologists have measured how quickly the brain processes visual images primarily by having subjects push a button in response. This requires the brain first to see the image, and then send a message to the finger to push the button.

“There is a lot that can happen between visual recognition of a signal [through images] and the pressing of a button,” said Army Major David Barry, a clinical psychologist and the co-inventor of the eye-tracker. He added, “If you are measuring how long it takes a person to look at something versus how long it takes a person to press a button, the eyes are always going to be faster and a more reliable indicator of neural activity.”

The Fusion technology has been used by TBI researchers at other institutions to assess a wide range of brain function. They have studied how TBI and PTSD affect the brain differently, how veterans’ brains changed over time during rehabilitation, and whether various therapies could improve cognition among military personnel and veterans with TBIs.

The DVBIC team in San Diego plans to further test the eye-tracking technology in a virtual reality setting. Participants would complete military-related tasks, such as walking and shooting, while in an immersive 3-D environment. Simultaneously, their eye movements, accuracy, and brain activities would be measured. Subjects with concussions would be compared to others who had not sustained TBIs to develop an objective measure of recovery. Researchers hope to develop tools that military commanders can use in the field to predict whether a service member is ready to return to duty or requires additional rest.

“Our goal is to use this technology to detect TBI-related problems earlier and more accurately, and to be able to track recovery over time to help injured service members return to duty when they're ready,” Ettenhofer said.

You also may be interested in...

Video
Jul 22, 2021

PRA Training Video 8: Clinical Case Scenario

Thumbnail image of PRA training video 8, clinical case scenario.

This is an interactive clinical case scenario to test your understanding in applying the Progressive Return to Activity (PRA). We hope this will help medical providers become more familiar with the PRA process when treating service members with concussion. Each video in the PRA training series is designed to support primary care providers' ability ...

Video
Jul 22, 2021

PRA Training Video 1: PRA Overview

Thumbnail image of PRA training video 1, PRA overview.

In the first of TBICoE's Progressive Return to Activity (PRA) video training series, you will learn about the reasons for using a progressive return to activity process and receive an overview of the 2021 PRA algorithm and its associated tools. By the end of lesson one, providers will better understand the PRA process, and explain that process to ...

Video
Jul 22, 2021

PRA Training Video 5: The Six Stages of the PRA

Thumbnail image for PRA training video 5, the six stages of the PRA

In this lesson, we cover the key activity objectives for each of the six stages of the Progressive Return to Activity (PRA) Clinical Recommendation and provide activity examples for each stage. Each stage is designed to gradually increase the intensity and duration of a service member's physical and cognitive activity as they advance in the PRA ...

Video
Jul 22, 2021

PRA Training Video 2: Six Major Changes

Thumbnail image of PRA Training Video 2, Six Major Changes

In this lesson we review the six major changes in the TBICoE's revised 2021 Progressive Return to Activity (PRA) Clinical Recommendation that differ from the original recommendation. The changes reflect the latest TBI research, and will make it easier for providers to manage the recovery process and return service members with concussion to full ...

Video
Jul 22, 2021

PRA Training Video 7: Symptom-Guided Management and Specialty Referral Guidance Tables

Thumbnail image of PRA training video 7, the symptom-guided management and specialty referral guidance tables.

This lesson covers how to use the Progressive Return to Activity, or PRA's Symptom-Guided Management and Specialty Referral Guidance tables. This lesson also details primary care management strategies for service members who are not progressing as expected in the PRA. Each video in the Progressive Return to Activity training series is designed to ...

Video
Jul 22, 2021

PRA Training Video 4: PRA Progression Criteria

Thumbnail image for PRA Training video 4, PRA progression criteria

In this lesson, we review the criteria for advancing through the stages of the Progressive Return to Activity (PRA) Clinical Recommendation. Each video in the PRA training series is designed to support primary care providers' ability to manage concussion/traumatic brain injury (TBI).

Video
Jul 14, 2021

Health Innovation

Health Innovation Month infographic

The Military Health System discusses how innovations in the healthcare community during COVID-19 have greatly affected us.

Last Updated: July 11, 2023
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on X Follow us on YouTube Sign up on GovDelivery