Development of a Non-Invasive Blink Reflexometer

Nancey Trevanian Tsai, Jesse S Goodwin, Mark E Semler, Ronald T Kothera, Mark Van Horn, Bethany J Wolf, Dena P Garner, Nancey Trevanian Tsai, Jesse S Goodwin, Mark E Semler, Ronald T Kothera, Mark Van Horn, Bethany J Wolf, Dena P Garner

Abstract

Qualitative assessments of the blink reflex are used clinically to assess neurological status in critical care, operating room, and rehabilitative settings. Despite decades of literature supporting the use of quantitative measurements of the blink reflex in the evaluation of multiple neurological disorders, clinical adoption has failed. Thus, there remains an unmet clinical need for an objective, portable, non-invasive metric of neurological health that can be used in a variety of settings. We have developed a high-speed videography-based device to trigger, record, and analyze a blink reflex. A pilot study was performed to compare the device's measurements to the published literature of electromyographic measurements, currently the gold standard. The study results indicate that the device is a viable tool to obtain fast, objective, and quantitative metrics of a blink reflex, and has promise as a non-invasive diagnostic assessment of neurological health.

Keywords: Blink; brain; concussion; diagnostic; imaging; neurology; reflex.

Figures

FIGURE 1.
FIGURE 1.
Blink reflexometer housing unit and software interface. Tubing connected to the left end of the housing unit delivers a puff of compressed air to the subject’s eyes.
FIGURE 2.
FIGURE 2.
The housing unit has a center barrier to prevent inadvertent stimulation of the contralateral eye. Two arrays of IR LEDs provide scene illumination.
FIGURE 3.
FIGURE 3.
Location of the upper right (red dot) and left (blue dot) eyelids are located in each image acquired during a blink.
FIGURE 4.
FIGURE 4.
Eyelid excursions of the right (red trace) and left (blue trace) eyelids during a single stimulated blink. An air puff stimulus was delivered to the right eye (ipsilateral), which begins closing before the left (contralateral) eye.
FIGURE 5.
FIGURE 5.
Representative right (red) and left (blue) eyelid excursion graph for one subject during one twenty-second test. Green lines indicate stimulus delivery.

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