SeeMe: An Automated Tool to Detect Early Recovery After Brain Injury

Stony Brook University200 enrolled

Overview

Early prediction of outcomes after acute brain injury (ABI) remains a major unsolved problem. Presently, physicians make predictions using clinical examination, traditional scoring systems, and statistical models. In this study, we will use a novel technique, "SeeMe," to objectively assess the level of consciousness in patients suffering from comas following ABI. SeeMe is a program that quantifies total facial motion over time and compares the response after a spoken command (i.e. "open your eyes") to a pre-stimulus baseline.

Acute brain injury (ABI) recovers at a variable rate. While some progress has been made in predicting long-term outcomes in traumatic brain injury (TBI) and intracranial hemorrhage, there is a critical need for short-term prediction of outcomes, in the first days and weeks after injury. With advances in machine learning and artificial intelligence, there is a growing interest in facial analysis and its application in neurological and psychiatric disorders. Here we describe "SeeMe," a novel automated objective measure of consciousness based on microexpression analyses in response to auditory commands. In measuring the smallest muscular movements undetectable by clinical observation, this technique has the high spatial resolution needed to detect hidden signs of recovery and the high temporal resolution needed to study neural circuits.

Study Type

OBSERVATIONAL

Enrollment

200

Conditions

Disorder of Consciousness Consciousness, Loss of Trauma, Brain Traumatic Brain Injury

Interventions

SeeMeDIAGNOSTIC_TEST

A video-recorded SeeMe command following assessment by a trained professional once a day Each session involves three command sets that are played from an audio recording 10 times over the course of 8 minutes. These commands are "Stick out your tongue", "Open your eyes", and "Show me a smile" Each command set is recorded separately for a total of 3 videos per session. These videos are then analyzed by SeeMe to detect if subjects are responding to commands.

Coma Recovery Scale-Revised (CRS-R)DIAGNOSTIC_TEST

A video-recorded CRS-R score assessment by a trained professional once a day. A score of 10 or greater, an auditory score \>2, or an arousal score \> 0 means that a subject is responding to commands

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * 18 years old or older * Healthy Volunteers * Comatose patients (patients with a GCS \< 9) due to an acute brain injury (traumatic brain injury, spontaneous subarachnoid hemorrhage, severe meningoencephalitis, etc.) Exclusion Criteria: * A history of a neurologically debilitating disease (i.e., dementia, glioblastoma, Alzheimer's, multiple sclerosis, major vessel stroke, previous severe TBI, etc.) * Any other medical condition that, in the judgment of the investigator, makes participation in the study unsafe. * Pregnant subjects * Comatose patients without a legal authorized representative (LAR) * Prisoners or wards of the state * Persons who have not attained the legal age for consent to treatments or procedures

Outcomes

Primary Outcomes

Detection of Command Following

Length of time until an intervention is able to detect that a subject is following commands

Time frame: Measured Daily from enrollment until subject is following commands or date of death of any cause, whichever comes first, up to 60 days.