Advanced Neurologic Testing
Advanced Testing of Nervous System Function
We are expertly trained in the use of advanced neurologic instruments that aid in objectively evaluating your nervous system function and measuring progress.
Fast, Objective, Repeatable Tests that Improve Care and Outcomes.
With our specialized computerized eye tracking testing we screen for concussions and monitor recovery, issue comprehensive core vision tests, or improve athletic performance by identifying vision strengths and weaknesses. We can detect autism, diagnose early stages of Parkinson’s disease, or identify vision issues in children that impede reading and provide training for improvement. These are just a few of an expanding list of applications we use in our cutting edge neurological assessment.
Eye movement tracking/vision performance results, reports, and recommendations are generated within minutes and give us an objective, measurable way to view the quality of a person’s health, vision, or performance and then track improvement from recommended training. There is no other system in the world using eye tracking in this manner.
Eye Movement Tracking/vision performance is used in aiding the assessment of the oculomotor system (nervous system control of moving your eyes) and the function of those areas of your brain controlling those movements.
Certain areas and pathways of the brain are activated during different types of eye movements, such as quick eye movements (saccades), pursuits (slow eye movements) and steady gaze (holding eyes still).
Invaluable neurologic information concerning specific areas of your brain is obtained by observing movements of your eyes.
The Eye Movement Tracking/Vision Performance testing is comfortably performed in our office. We simply place special glasses on your head to record and measure your eye movements in a variety of conditions.
During the test computer software is recording and graphing your precise eye movements as you follow the visual target with your eyes. By measuring your recorded eye movements and displaying them on the computer screen you can see your own eye movements and how they compare to normal measurements.
Sway Balance System Assessment of Postural Stability
We use Sway Balance System testing performed in our office for assessing how well your brain is perceiving your body position in space.
An FDA cleared mobile software application that revolutionizes the way athletes and patients are monitored for signs of neurological, vestibular and musculoskeletal dysfunction. We can quickly evaluate postural stability by instructing the patient to press the mobile device against their chest while performing the different balance tests.
Your perception of your body position in space is what your brain uses to build brain maps of where your body parts are in relation each other and to your environment. Your brain map is built on the information it receives from all of the nervous system receptors (sight, touch, hearing, inner ear balance organs) and the map is continuously updated.
By evaluating the information from the Sway Balance test we get additional critical information about the functioning of your brain and nervous system.
RightEye Neuro Vision Tests are an objective assessment of eye movement after stroke, concussion or any other acquired brain injury. Fast, objective, and repeatable tests that replace subjective, manual tests in an office setting.
RightEye Neuro Vision consists of 9 individual tests: The following nine tests provide a rapid, objective functional assessment of critical areas of the brain. Additional tests are available as indicated by this assessment.
- Circular smooth pursuit (with video playback)
- Horizontal smooth pursuit (with video playback)
- Vertical smooth pursuit (with video playback)
- Horizontal volitional saccades (with video playback)
- Vertical volitional saccades (with video playback)
- Simple Reaction Time (minimal processing)
- Choice Reaction (decision-making)
- Discriminate Reaction (impulsivity)
- Cardinal Gaze Position (directional)
Saccade Measurement Testing
What are saccades and why are they important?
Saccades are quick, simultaneous movements of both eyes in the same direction. Saccades allow you to voluntarily move your eyes quickly from one interesting spot to another, or react by moving your eyes to a suddenly appearing danger as a reflex.
You do not look at the world with your eyes fixed in one position. Your eyes move around, rapidly locating interesting parts of your world and building up a mental, three-dimensional “brain map” corresponding to your environment. When reading these words right now, your eyes make jerky saccadic movements and your eyes stop several times, moving very quickly between each stop.
You cannot consciously control the speed of your eye movement during each saccade; your eyes move as fast as they can. The purpose of your saccadic eye movement is to aim the part of your eye with the best vision (fovea) at the thing you want to see the best, and then hold your eye there as you examine it.
The brain areas you use in controlling saccades involves three separate cortical areas: the frontal eye fields, the parietal eye fields, and the supplementary eye fields; and several subcortical areas in the basal ganglia, thalamus and brainstem.
What do measurements of saccades tell us about your brain?
Your saccadic eye movements may be abnormal in a number of ways indicating the areas of your brain that are functioning abnormally. Without the use of objective measurement techniques, it may be very difficult to distinguish between these brain areas and monitor your response to treatment.
The measurement may be divided into two main types, saccadic velocity (how fast your eyes move during your saccade) and saccadic latency (how long it takes for you to start your saccade).
Saccadic velocity is a very sensitive indicator of even slight disturbances within your neuromuscular system because this level of saccadic control is a highly evolved one. Saccades are some of the fastest movement that your body makes, often less than 25ms in duration and with your eye reaching velocities of up to 800deg/s. Very precise timed patterns of firing have to be created by your brainstem to achieve these precise movements so quickly.
Your saccadic latency is being controlled at a completely different, higher level in your brain. It is not enough to be able to move your eyes rapidly and precisely, you need to be able to aim them at the important things you want to see. There are several areas in your brain pathway that can slow down how quickly you start your saccade in response to an impulse to look at something you want to see.
These two measures of saccade eye movements – latency and velocity – together provide us information about the functional status of two entirely distinct levels of your brain. This is why impairment of saccadic eye movements is one of the very first signs of nearly every neuromuscular pathology right at its onset, observable long before the appearance of symptoms in other parts of your neuromuscular system!
Measuring saccadic eye movements for neurological assessment was previously restricted by very limited access to the most advanced clinical eye movement laboratories; now measurements can be made at our facility. We believe that this opens up exciting new possibilities for helping you by providing an instrument for precise measurements of your brain function in our clinic!
Quantitative EEG Brain Map
Quantitative electroencephalography (QEEG) has been shown to be a sensitive indicator of the presence of brain injury after mild head injury. QEEG can be used to distinguish normal controls from patients with mild head injury (mTBI), and patients with mild head injury from those with severe head injury. MRI or CAT scans, can detect anatomical changes that may be associated with more severe brain injury. However, concussions don’t usually cause those kinds of changes. A test for concussion needs to be able to detect changes in brain function, and quantitative EEG, when done correctly, can provide an objective measure of brain activity.
Current evidence suggests that electrophysiological abnormalities reflecting functional changes in the brain may emerge earlier than structural changes and may better detect mTBI than conventional neuroimaging techniques.
Computerized Performance Testing for attention, memory, cognitive processing.
Establishes a baseline measurement of reaction time, attention, inhibition, impulsivity, memory, information processing efficiency, and executive function as a cross correlation to the other testing measures.
Interactive Self Inventory and Cognitive Emotional Checklist
These tests assess mood, anxiety, stress and emotionality, a major distinguishing factor from all other sports concussion tools currently on the market. The results are then compared with the normative database for all these measures.