Unravelling the Complex Relationship Between Frontal Sinus Pneumatization and Paranasal Sinus Anatomical Variants: Insights from CT Imaging.

The aim of this study was to analyse the relationship between frontal sinus pneumatization and its effect on various variations of paranasal sinuses on paranasal sinus CT scan. A total number of 100 patients (51 males, 49 females) were included in this study. Patients were divided into three groups on the basis of their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia). The prevalence of various variations like pneumatization of upper and middle turbinate, presence of agger nasi, Haller and Onodi cell, maxillary sinus hypoplasia, extent of sphenoid sinus pneumatization, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve types were ascertained and compared within each group. The prevalence of Onodi cell, anterior clinoid process and greater wing of sphenoid pneumatization and optic nerves type 3 and 4 were higher in Type 3 frontal sinus pneumatization group as compared with other groups. Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between these variations preoperatively for avoiding complications.

Sinonasal Inflammation or Neoplasm: Raise the Red Flagsǃ-A Pictorial Review.

Inflammatory pathology remains the most common indication for sinonasal imaging. However, sinonasal region is also the epicenter of a variety of neoplasms. These are often missed both clinically and radiologically owing to nonspecific signs and symptoms and subtle imaging pointers. An early diagnosis of sinonasal neoplasms is critical for timely management and hence better prognosis and survival rate. This pictorial review aims to acquaint the reader with the "red flag" signs on computed tomography that should raise suspicion for an underlying neoplastic pathology and also highlights the imaging features of common sinonasal neoplasms.

Clinical profile of hospitalised moderate category COVID-19 patients: Short study from a Tertiary Care Centre in Delhi.

Background: The clinical profile of hospitalized moderate-category COVID-19 patients has been understudied globally and in India. Aim: The present study was conducted to study the clinical profile and assess the proportions of patients who progressed to severe disease and its predictors among moderate COVID-19 patients. Materials and Methods: In this single-center observational study, 100 moderate-category COVID-19 patients as per Ministry of Health and Family Welfare (MoHFW) criteria of age ≥18 years of either sex, excluding pregnant females from February to November 2021, were studied by analyzing their clinical profiles and assessing Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score 2 (NEWS-2), and chest computed-tomography severity score (CTSS) to predict progression to severe disease. Severe disease was defined as per MoHFW criteria. Results: Out of 100 moderate-category COVID-19 patients, progression to severe disease was seen in 11 patients (11%), among which eight patients had expired, three patients were discharged, and the rest of the 89 patients (89%) who did not progress to severe disease were discharged. A higher age (62.2± 19.5 vs 54.8 ± 14.6 years), along with multivariate analysis revealing male sex (1.25 times), chronic kidney disease (2.86 times), leukocytosis (6.10 times), thrombocytopenia (1.04 times), anemia (9.3 times), a higher qSOFA score (3.6 times), and a higher NEWS-2 score on admission (1.56 times) had higher odds of progression to severe disease. A significant correlation (P < .05) of qSOFA score with serum LDH, ferritin, and hs-CRP levels; CT severity score with the serum ferritin, IL-6, and LDH levels; and NEWS-2 with serum LDH, hs-CRP, and ferritin levels were found. Moreover, the NEWS-2 score was found slightly better than qSOFA on receiver operating characteristic (ROC) curve analysis, with an area under the curve of 85.8% and 83.2%, respectively, predicting progression to severe disease. Conclusion: Our study revealed male gender, chronic kidney disease, leukocytosis, anemia, thrombocytopenia, a higher qSOFA and NEWS-2 score on admission, and further, NEWS-2 score better than qSOFA on ROC curve analysis, with an area under the curve of 85.8% and 83.2%, respectively, in predicting severe disease among hospitalized moderate COVID-19 patients.

Venous Malformation in the Breast: Imaging Features to Avoid Unnecessary Biopsies or Surgery.

Venous malformations are now categorised under the broad heading of slow flow vascular malformations. They comprise abnormally dilated venous channels that fail to involute. These may be superficial or deep in location. We describe two cases of venous malformation in breast. Both the patients presented with focal pain in one breast. On mammography, they appeared as equal density well circumscribed soft tissue masses. No sonographic correlate was found on initial ultrasound examination. Subsequent ultrasonography performed by an experienced radiologist with minimal probe pressure revealed dilated veins. On the basis of imaging findings, the diagnosis of venous malformation was established.

Magnetic resonance imaging of rhino-orbito-cerebral mucormycosis: a pictorial review.

Rhino-orbito-cerebral mucormycosis is a potentially fatal disease requiring early magnetic resonance imaging (MRI) for disease evaluation and timely detection of intracranial complications. Angio-invasive nature leading to necrosis and infarction is the hallmark of mucormycosis. The disease follows a fulminant course extending from the paranasal sinuses to involve the orbit, deep neck spaces, skull base, facial bones, and intracranial compartment. Loss of vision either due to direct extension into the orbit or optic nerve infarction adds to disease morbidity. Prompt MRI using dedicated sequences can help in assessing the exact disease extent including early osseous and intracranial changes, which aid in precise disease management.

Visual Vestibular Conflict Mitigation in Virtual Reality Using Galvanic Vestibular Stimulation.

BACKGROUND: Virtual reality (VR) is an effective technique to reduce cost and increase fidelity in training programs. In VR, visual and vestibular cues are often in conflict, which may result in simulator-induced motion sickness. The purpose of this study is to investigate the integration of Galvanic Vestibular Stimulation (GVS) with a VR flight training simulator by assessing flight performance, secondary task performance, simulator sickness and presence.METHODS: There were 20 participants who performed 2 separate VR flight simulation sessions, with and without GVS (control). Flight performance, secondary task performance, and electrogastrogram were measured during VR flight simulation. The standardized simulator sickness and presence questionnaires were administered.RESULTS: Electrogastrogram measures such as dominant power instability coefficient (DPIC) and percentages of bradygastric waves (%B) were lower in the GVS session than the control session in the flight simulation (DPIC: 0.44 vs. 0.54; %B: 21.2% vs. 30.5%) and postflight (DPIC: 0.38 vs. 0.53; %B: 22.8% vs. 31.4%) periods. Flight performance (#hit-gates) was improved in the GVS session compared to the control (GVS: 17, Control: 15.5). Secondary task performance (%hits) was improved with GVS for the Easy task (GVS: 55.5%, Control: 43.1%).DISCUSSION: This study demonstrates the potential of synchronizing GVS with visual stimuli in VR flight training to reduce visual-vestibular sensory conflict to improve fidelity and performance. These results provide initial evidence, but continued research is warranted to further understand the benefits and applications of GVS in VR simulator training.Pradhan GN, Galvan-Garza RC, Perez AM, Stepanek J, Cevette MJ. Visual vestibular conflict mitigation in virtual reality using galvanic vestibular stimulation. Aerosp Med Hum Perform. 2022; 93(5):406-414.

Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report.

Background: Necrotizing colitis (NC) with perforation is a rare complication of the obstructive cancer of the right colon. Case description: We report here a case of a 45-year-old female patient of mucinous adenocarcinoma of ascending colon, which presented as acute NC with perforation proximal to obstructing colonic carcinoma with their imaging features on computed tomography (CT). The purpose of this article is to highlight the role of CT in distinguishing an ischemic and a tumoral segment in the carcinomas complicated by proximal bowel ischemia. Conclusion: Imaging plays a great role in distinguishing an ischemic and a tumoral segment in carcinomas complicated by proximal bowel ischemia. The identification of NC will help to accurately stage colonic cancer. How to cite this article: Satyam S, Jain K, Pradhan G. Necrotizing Colitis with Perforation Proximal to Obstructive Ascending Colon Cancer: A Case Report. Euroasian J Hepato-Gastroenterol 2022;12(2):95-97.

Congenital Aural Atresia: What the Radiologist Needs to Know?

Congenital aural atresia (CAA) is characterized by hypoplasia or aplasia of external auditory canal associated with auricular deformity. It also embodies a spectrum of temporal bone abnormalities including anomalies of middle ear, ossicles, facial nerve, oval window, round window, mastoid pneumatization, temporomandibular joint and occasionally inner ear and vascular anomalies. The management in such patients is variable and consists of rehabilitative hearing aids or surgical correction depending on various patient factors like associated temporal bone abnormalities, degree of hearing impairment and laterality. Surgical management if planned, depends on the extent of associated temporal bone anomalies and hence necessitates comprehensive knowledge about the normal and abnormal anatomy of these structures. High resolution computed tomography (HRCT) is the optimal investigation which provides required anatomical information and plays a pivotal role in deciding the management strategy. This pictorial review aims to review the spectrum of anomalies involving critical structures in CAA on HRCT along with their clinical significance.

Differentiation of Benign From Malignant Sinonasal Masses Using Diffusion Weighted Imaging and Dynamic Contrast Enhanced Magnetic Resonance Imaging.

BACKGROUND: The sinonasal region is affected by a variety of neoplasms. A differentiation between benign and malignant masses is essential both for management and prognostication. Morphological analysis often does not allow this differentiation. OBJECTIVES: This article aims to assess the value of advanced MRI (diffusion [DWI] and dynamic contrast enhanced MRI [DCE-MRI]) in differentiation of benign and malignant sinonasal masses. METHODS: This prospective study included 40 patients with sinonasal masses who underwent advanced MR on 3T MR scanner. The lesions were analyzed based on morphological characteristics, qualitative, quantitative diffusion parameters, and time signal intensity curves. Apparent diffusion coefficient (ADC) values were acquired using b values of 50 and 1000 s/mm2. The accuracy of DWI, DCE-MRI, and combined DWI/DCE-MRI in differentiating benign from malignant sinonasal masses were analyzed. RESULTS: Perineural extension and growth pattern of the tumor were the best morphological discriminators. Mean ADC values for benign and malignant lesions were 1.675 ± 0.561 and 0.903 ± 0.405 × 10-3 mm2/sec, ,respectively. ROC revealed that ADC cutoff value of 1.005 × 10-3 mm2/sec provided an accuracy of 92.5% in differentiating benign from malignant masses (P value <.01). On excluding the benign vascular masses (Juvenile Nasopharyngeal Angiofibroma and hemangioma), the time signal intensity curve showed 78% accuracy (P value <.001). The highest diagnostic performance was achieved by combining DWI and DCE-MRI (95% accuracy). CONCLUSION: DWI has higher accuracy than DCE-MRI. Quantitative DWI is preferable over qualitative DWI. Accuracy of DCE-MRI can be increased by excluding vascular masses with characteristic imaging features. DWI and DCE-MRI have the highest accuracy when used in combination than either of them alone in differentiating benign from malignant sinonasal masses.

Incidentally Diagnosed Extraluminal Leiomyosarcoma of Infrarenal Inferior Vena Cava: A Case Report and Literature Review from a Radiologist's Perspective.

Background: Vascular leiomyosarcoma is a rare but most common vascular tumor of the inferior vena cava. Case presentation: We present the case of an incidentally diagnosed extraluminal leiomyosarcoma of the inferior vena cava in a 62 year old patient who presented with abdominal pain following blunt trauma. Ultrasonography showed a lobulated hypoechoic lesion in the upper abdomen. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a circumscribed lobulated near homogeneously enhancing retroperitoneal lesion in anterior relation to the infrarenal inferior vena cava, right paramedian in location with imperceptible vena caval lumen at the site of maximum contact. In positron emission tomography (PET) CT the lesion showed mild fluorodeoxyglucose (FDG) uptake with no distant metastases. CT guided biopsy with immunohistochemical analysis showed leiomyosarcoma. Patient underwent surgical resection with inferior vena cava reconstruction. Conclusions: Leiomyosarcoma of the inferior vena cava is a rare tumor of vascular origin. Imaging plays an imperative role in the diagnosis and preoperative evaluation. This article also provides a comprehensive literature review of the radiological features of inferior vena caval leiomyosarcoma that would aid in optimal preoperative characterization and evaluation.

Generating Flight Illusions Using Galvanic Vestibular Stimulation in Virtual Reality Flight Simulations.

Background: Vestibular flight illusions remain a significant source of concern for aviation training. Most fixed-based simulation training environments, including new virtual reality (VR) technology, lack the ability to recreate vestibular flight illusions as vestibular cues cannot be provided without stimulating the vestibular end organs. Galvanic vestibular stimulation (GVS) has long been used to create vestibular perception. The purpose of this study is to evaluate the ability of GVS to simulate common flight illusions by intentionally providing mismatched GVS during flight simulation scenarios in VR. Methods: Nineteen participants performed two flight simulation tasks-take off and sustained turn-during two separate VR flight simulation sessions, with and without GVS (control). In the GVS session, specific multi-axis GVS stimulation (i.e., electric currents) was provided to induce approximate somatogravic and Coriolis illusions during the take-off and sustained turn tasks, respectively. The participants used the joystick to self-report their subjective motion perception. The angular joystick movement along the roll, yaw, and pitch axes was used to measure cumulative angular distance and peak angular velocity as continuous variables of motion perception across corresponding axes. Presence and Simulator Sickness Questionnaires were administered at the end of each session. Results: The magnitude and variability of perceived somatogravic illusion during take-off task in the form of cumulative angular distance (p < 0.001) and peak velocity (p < 0.001) along the pitch-up axis among participants were significantly larger in the GVS session than in the NO GVS session. Similarly, during the sustained turn task, perceived Coriolis illusion in the form of cumulative angular distances (roll: p = 0.005, yaw: p = 0.015, pitch: p = 0.007) and peak velocities (roll: p = 0.003, yaw: p = 0.01, pitch: p = 0.007) across all three axes were significantly larger in the GVS session than in the NO GVS session. Subjective nausea was low overall, but significantly higher in the GVS session than in the NO GVS session (p = 0.026). Discussion: Our findings demonstrated that intentionally mismatched GVS can significantly affect motion perception and create flight illusion perceptions during fixed-based VR flight simulation. This has the potential to enhance future training paradigms, providing pilots the ability to safely experience, identify, and learn to appropriately respond to flight illusions during ground training.

Loes Score: Clinical and Radiological Profile of 22 Patients of X-Linked Adrenoleukodystrophy: Case Series from a Single Center.

Introduction X-linked adrenoleukodystrophy (X-ALD) is a devastating disease with a wide spectrum of presentation ranging from asymptomatic to a rapidly progressive childhood cerebral form. The gene responsible for adrenoleukodystrophy is ABCD1 gene, required for ß oxidation of fatty acids in various tissues. While biochemical and molecular techniques are available to confirm the diagnosis, brain magnetic resonance imaging (MRI) utilizing Loes score has been used for both prognosis and timely direction of hematopoietic stem cell therapy. Materials and Methods During the study period of 2016 to 2020, 22 individuals including 19 individuals with features suggestive of X-ALD and 3 asymptomatic siblings were evaluated from a single center in North India. After biochemical and molecular confirmation of the disease, detailed clinical and radiological findings using MRI brain were documented. A radiological scoring pattern proposed by Loes was employed to identify the severity of the disorder. Results The most common clinical presentations were visual difficulty and muscular weakness (58%). All symptomatic individuals had classic neuroimaging findings in the form of hyperintensities involving the parieto-occipital area and splenium of corpus callosum. Severe involvement in the form of global atrophy was observed in 52.6% of individuals. Asymptomatic siblings also showed neurological involvement based on MRI with highest Loes score of 9 in one individual. Conclusion This case series describes the clinical and radiological profile and employment of Loes score in individuals with X-ALD. Early identification of asymptomatic individuals by neuroimaging and use of Loes severity score for monitoring and disease progression will help in making therapeutic decisions in a timely manner.

Using Biometric Technology for Telehealth and Telerehabilitation.

This article discusses the use of physical and biometric sensors in telerehabilitation. It also discusses synchronous tele-physical assessment using haptics and augmented reality and asynchronous physical assessment using remote pose estimation. The article additionally focuses on computational models that have the potential to monitor and evaluate changes in kinematic and kinetic properties during telerehabilitation using biometric sensors such as electromyography and other wearable and noncontact sensors based on force and speed. And finally, the article discusses how virtual reality environments can be facilitated in telerehabilitation.

Oculometric Feature Changes During Acute Hypoxia in a Simulated High-Altitude Airdrop Scenario.

BACKGROUND: Severe acute hypoxia results in a rapid deterioration of cognitive functioning and thus poses a risk for human operations in high altitude environments. This study aimed at investigating the effects of oxygen system failure during a high-altitude high-opening (HAHO) parachute jump scenario from 30,000 ft (9144 m) on human physiology and cognitive performance using a noncontact eye-tracking task.METHODS: Nine healthy male volunteers (ages 27-48) were recruited from the Norwegian Special Operations Commandos. Eye-tracking data were collected to derive information on cognitive performance in the context of rapid dynamic changes in pressure altitude while performing a modified King-Devick test. The baseline data was collected at 8000 ft (2438 m) while breathing 100% oxygen during decompression. For every test, the corresponding arterial blood gas analysis was performed.RESULTS: The study subjects endured severe hypoxia, which resulted in significant prolongations of fixation time (range: 284.1-245.6 ms) until 23,397 ft (131 m) and fixation size (range: 34.6-32.4 mm) until 25,389 ft (7739 m) as compared to the baseline (217.6 ± 17.8 ms and 27.2 ± 4.5 mm, respectively). The increase in the saccadic movement and decrease in the saccadic velocity was observed until 28,998 ft and 27,360 ft (8839 and 8339 m), respectively.DISCUSSION: This is the first study to investigate cognitive performance from measured oculometric variables during severe hypobaric hypoxia in a simulated high-altitude airdrop mission scenario. The measurement of altered oculometric variables under hypoxic conditions represents a potential avenue to study altered cognitive performance using noncontact sensors that can derive information and serve to provide the individual with a warning from impending incapacitation.Pradhan GN, Ottestad W, Meland A, Kåsin JI, Høiseth LØ, Cevette MJ, Stepanek J. Oculometric feature changes during acute hypoxia in a simulated high-altitude airdrop scenario. Aerosp Med Hum Perform. 2021; 92(12):928-936.

Predicting outcome of advanced head-and-neck cancer by measuring tumor blood perfusion in patients receiving neoadjuvant chemotherapy.

PURPOSE: The purpose of this study was to correlate treatment response with tumor blood perfusion in patient of advanced head-and-neck cancer undergoing neoadjuvant chemotherapy. MATERIALS AND METHODS: A total of 40 patients of advanced head-and-neck cancer, who were planned for neoadjuvant chemotherapy, were included in the study. All patients underwent diagnostic computed tomography (CT) with perfusion study for staging and quantitative measurement of tumor volume as well as perfusion parameters (including tumor blood volume, blood flow, permeability, and time to peak enhancement), at baseline and after completion of neoadjuvant chemotherapy. Total 3 cycles of neoadjuvant chemotherapy with paclitaxel, cisplatin, and 5 fluorouracil were given. Tumor response was evaluated in terms of change in tumor volume and correlated with perfusion parameters. RESULTS: Out of 40 patients, 22 patients had more than 50% reduction in tumor volume, who were grouped as responder and remaining 18 patients had <50% decrease in tumor volume, grouped as nonresponder. Both the groups were similar in terms of age, gender, performance status, stage, nodal status, or addiction. Baseline CT scan shows a significant difference in tumor blood flow (P = 0.048) and marginal difference in time to peak enhancement (P = 0.058) in two groups. However, there is no difference in tumor blood volume (P = 0.32) and permeability surface area (P = 0.07). CONCLUSIONS: Evaluation of tumor blood flow by perfusion CT is helpful in predicting chemotherapy outcome and deciding appropriate treatment modality, but further evaluation with more number of patients is required for validating the predictive role of each perfusion parameters.

Supplemental CO2 improves oxygen saturation, oxygen tension, and cerebral oxygenation in acutely hypoxic healthy subjects.

Oxygen is viewed in medicine as the sole determinant of tissue oxygenation, though carbon dioxide homeostasis is equally important and clinically often ignored. The aims of this study were as follows: (a) to examine the effects of different acute hypoxic conditions on partial pressure of arterial oxygen ( PaO2 ), arterial oxygen saturation of hemoglobin ( SaO2 ), and regional cerebral saturation of hemoglobin (rSO2 ); and (b) to evaluate supplemental CO2 as a tool to improve oxygenation in acutely hypoxic individuals. We hypothesized that exposure to gas mixtures with added CO2 would improve oxygenation in hypoxic human subjects. Twenty healthy subjects were exposed to 5-min intervals of two gas mixtures: hypoxic gas mixture containing 8% oxygen, and a CO2 -enriched mixture containing 8% oxygen plus either 3% or 5% CO2 . Ten subjects received the 3% CO2 -enriched mixture, and the remaining 10 subjects received the 5% CO2 -enriched mixture. The order of exposure was randomized. Blood gases, pulse oximetry, end-tidal CO2 , and cerebral oximetry were measured. Compared to the purely hypoxic gas group, PaO2 was increased in the 3% and 5% CO2 -enriched groups by 14.9 and 9.5 mmHg, respectively. Compared to pure hypoxia, SaO2 was increased in the 3% and 5% CO2 -enriched groups by 16.8% and 12.9%, respectively. Both CO2 -enriched gas groups had significantly higher end-exposure rSO2 and recovered to baseline rSO2 within 1 min, compared to the pure hypoxic gas group, which returned to baseline in 5 min. These results suggest that in acutely hypoxic subjects, CO2 supplementation improves blood oxygen saturation and oxygen tension as well as cerebral oxygenation measures.

Discovering Oculometric Patterns to Detect Cognitive Performance Changes in Healthy Youth Football Athletes.

In this paper, we focus on the application of oculometric patterns extracted from raw eye movements during a mental workload task to assess changes in cognitive performance in healthy youth athletes over the course of a typical sport season. Oculometric features pertaining to fixations and saccades were measured on 116 athletes in pre- and post-season testing. Participants were between 7 and 14 years of age at pre-season testing. Due to varied developmental rates, there were large interindividual performance differences during a mental workload task consisting of reading numbers. Based on different reading speeds, we classified three profiles (slow, moderate, and fast) and established their corresponding baselines for oculometric data. Within each profile, we describe changes in oculomotor function based on changes in cognitive performance during the season. To visualize these changes in multidimensional oculometric data, we also present a multidimensional visualization tool named DiViTo (diagnostic visualization tool). These experimental, computational informatics and visualization methodologies may serve to utilize oculometric information to detect changes in cognitive performance due to mild or severe cognitive impairment such as concussion/mild traumatic brain injury, as well as possibly other disorders such as attention deficit hyperactivity disorders, learning/reading disabilities, impairment of alertness, and neurocognitive function.

T1 and T2 mapping of articular cartilage and menisci in early osteoarthritis of the knee using 3-Tesla magnetic resonance imaging.

PURPOSE: 3-Tesla magnetic resonance imaging (MRI) T1 and T2 mapping to detect and quantify cartilage matrix and meniscal degeneration between normal healthy volunteers and early osteoarthritis patients. MATERIAL AND METHODS: A prospective study including 25 patients and 10 healthy volunteers was done. Patients with symptoms of early osteoarthritis and Kellgren-Lawrence grade I-II on plain radiograph were included for MRI knee. Patients with inflammatory arthritis, infection, trauma, and history of knee surgery were excluded. Healthy, normal adult volunteers (preferably age and sex matched) without symptoms of osteoarthritis of the knee were drawn from patient's relatives/hospital employees/colleagues for MRI knee. RESULTS: T1 and T2 relaxation time values of articular cartilage and menisci were significantly higher in osteoarthritis patients as compared to healthy volunteers. No significant difference was found in morphological thickness of articular cartilage and menisci in early osteoarthritis patients and healthy volunteers. CONCLUSIONS: T1 and T2 mapping are noninvasive MRI techniques reflecting changes in the biochemical composition of cartilage and menisci. T1 values reflect changes in proteoglycan content, and T2 values are sensitive to interaction between water molecules and collagen network. Mapping techniques assess early cartilage and meniscal matrix degeneration in osteoarthritis of the knee, and help in initiating treatment and monitoring disease progression. MRI is a sensitive modality for assessment of pathological changes in articular cartilage. With use of T1 and T2 mapping techniques, it is possible to evaluate the collagen network and proteoglycan content in articular cartilage and meniscal matrix.

Correlating Multi-dimensional Oculometrics with Cognitive Performance in Healthy Youth Athletes.

There is a need for a practical objective measure to detect mild changes in cognitive performance as early signs of concussion in youth or other special populations. In this paper, we propose a novel correlation model that establishes the relationship between oculometrics extracted from raw eye movements during a mental workload task and cognitive performance. We assessed differences in cognitive performance in terms of age for youth athletes based on oculometrics pertaining to fixations and saccades. In this cross-sectional study, oculometrics were measured on 440 healthy youth athletes aged 7 to 15 years. Oculometrics pertaining to fixations (fixation time, fixation size, and surface area of fixation) and saccades (total saccadic amplitude, average saccadic amplitude, and saccadic velocity) were measured and compiled into a multivariate oculometric database by age. We discovered that the combined power of fixations and saccades provided the strongest correlation with cognitive performance-a finding that is evident across all ages as well as all levels of mental workload difficulty. Specifically, the combined observations of fixation time, saccadic velocities, and saccadic amplitudes provided us an understanding of cognitive performance during different levels of mental workload difficulty across all age groups. This study is the first step towards establishing normative, multi-dimensional oculometrics for fixations and saccades in young athletes (7 to 15 years) who are at risk for concussion in sports and recreational activities.