{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T14:45:13Z","timestamp":1790779513203,"version":"4.1.0"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T00:00:00Z","timestamp":1637539200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH-13-C-0008"],"award-info":[{"award-number":["W81XWH-13-C-0008"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000005","name":"U.S. Department of Defense","doi-asserted-by":"publisher","award":["W81XWH-12-C020"],"award-info":[{"award-number":["W81XWH-12-C020"]}],"id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R43DC014611"],"award-info":[{"award-number":["R43DC014611"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R44HD100247"],"award-info":[{"award-number":["R44HD100247"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Eye movements measured by high precision eye-tracking technology represent a sensitive, objective, and non-invasive method to probe functional neural pathways. Oculomotor tests (e.g., saccades and smooth pursuit), tests that involve cognitive processing (e.g., antisaccade and predictive saccade), and reaction time tests have increasingly been showing utility in the diagnosis and monitoring of mild traumatic brain injury (mTBI) in research settings. Currently, the adoption of these tests into clinical practice is hampered by a lack of a normative data set. The goal of this study was to construct a normative database to be used as a reference for comparing patients\u2019 results. Oculomotor, cognitive, and reaction time tests were administered to male and female volunteers, aged 18\u201345, who were free of any neurological, vestibular disorders, or other head injuries. Tests were delivered using either a rotatory chair equipped with video-oculography goggles (VOG) or a portable virtual reality-like VOG goggle device with incorporated infrared eye-tracking technology. Statistical analysis revealed no effects of age on test metrics when participant data were divided into pediatric (i.e.,18\u201321 years, following FDA criteria) and adult (i.e., 21\u201345 years) groups. Gender (self-reported) had an effect on auditory reaction time, with males being faster than females. Pooled data were used to construct a normative database using 95% reference intervals (RI) with 90% confidence intervals on the upper and lower limits of the RI. The availability of these RIs readily allows clinicians to identify specific metrics that are deficient, therefore aiding in rapid triage, informing and monitoring treatment and\/or rehabilitation protocols, and aiding in the return to duty\/activity decision. This database is FDA cleared for use in clinical practice (K192186).<\/jats:p>","DOI":"10.1371\/journal.pone.0260351","type":"journal-article","created":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T18:26:44Z","timestamp":1637605604000},"page":"e0260351","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":30,"title":["Portable eye-tracking as a reliable assessment of oculomotor, cognitive and reaction time function: Normative data for 18\u201345 year old"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6625-2946","authenticated-orcid":true,"given":"Aura","family":"Kullmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin C.","family":"Ashmore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandr","family":"Braverman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Mazur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary","family":"Snapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikhaylo","family":"Szczupak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Murphy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Marshall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carey D.","family":"Balaban","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hoffer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Kiderman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,11,22]]},"reference":[{"key":"pone.0260351.ref001","first-page":"66","article-title":"Frontal eye field, where art thou? Anatomy, function, and non-invasive manipulation of frontal regions involved in eye movements and associated cognitive operations.","volume":"8","author":"M Vernet","year":"2014","journal-title":"Front Integr Neurosci"},{"key":"pone.0260351.ref002","volume-title":"The Neurology of Eye Movement.","author":"RJ Leigh","year":"2006"},{"key":"pone.0260351.ref003","doi-asserted-by":"crossref","first-page":"563","DOI":"10.3389\/fnhum.2017.00563","article-title":"Eye Gaze and Aging: Selective and Combined Effects of Working Memory and Inhibitory Control.","volume":"11","author":"TJ Crawford","year":"2017","journal-title":"Front Hum Neurosci."},{"issue":"1","key":"pone.0260351.ref004","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/WCO.0000000000000274","article-title":"Eye movements in neurodegenerative diseases.","volume":"29","author":"MR MacAskill","year":"2016","journal-title":"Curr Opin Neurol"},{"key":"pone.0260351.ref005","doi-asserted-by":"crossref","first-page":"31","DOI":"10.3389\/fneur.2018.00031","article-title":"Eye Movement Abnormalities in Multiple Sclerosis: Pathogenesis, Modeling, and Treatment.","volume":"9","author":"A Serra","year":"2018","journal-title":"Front Neurol"},{"issue":"1","key":"pone.0260351.ref006","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3233\/JAD-141173","article-title":"Eye movements in Alzheimer\u2019s disease","volume":"44","author":"RJ Molitor","year":"2015","journal-title":"J Alzheimers Dis"},{"key":"pone.0260351.ref007","doi-asserted-by":"crossref","first-page":"592","DOI":"10.3389\/fneur.2017.00592","article-title":"Eye Movements in Parkinson\u2019s Disease and Inherited Parkinsonian Syndromes.","volume":"8","author":"E Pretegiani","year":"2017","journal-title":"Front Neurol."},{"issue":"4\u20135","key":"pone.0260351.ref008","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1159\/000454880","article-title":"Patterns of Eye Movement Impairment Correlate with Regional Brain Atrophy in Neurodegenerative Parkinsonism.","volume":"17","author":"O Vintonyak","year":"2017","journal-title":"Neurodegener Dis"},{"key":"pone.0260351.ref009","doi-asserted-by":"crossref","first-page":"e5442","DOI":"10.7717\/peerj.5442","article-title":"Eye movement control during visual pursuit in Parkinson\u2019s disease.","volume":"6","author":"CC Wu","year":"2018","journal-title":"PeerJ"},{"key":"pone.0260351.ref010","first-page":"103","article-title":"Value of otoneurological tests in the staging of multiple sclerosis","volume":"6","author":"D Alpini","year":"1987","journal-title":"Ital J Neurol Sci"},{"issue":"1","key":"pone.0260351.ref011","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s10072-010-0395-1","article-title":"Pursuit ocular movements in multiple sclerosis: a video-based eye-tracking study.","volume":"32","author":"L De Santi","year":"2011","journal-title":"Neurol Sci"},{"key":"pone.0260351.ref012","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.visres.2020.01.003","article-title":"Saccadic delay in multiple sclerosis: A quantitative description","volume":"168","author":"JA Nij Bijvank","year":"2020","journal-title":"Vision Res"},{"issue":"3","key":"pone.0260351.ref013","doi-asserted-by":"crossref","first-page":"359","DOI":"10.1016\/j.bandc.2008.08.023","article-title":"Smooth pursuit in schizophrenia: a meta-analytic review of research since 1993","volume":"68","author":"GA O\u2019Driscoll","year":"2008","journal-title":"Brain Cogn"},{"key":"pone.0260351.ref014","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3389\/fspor.2020.00005","article-title":"The Measurement of Eye Movements in Mild Traumatic Brain Injury: A Structured Review of an Emerging Area.","volume":"2","author":"S Stuart","year":"2020","journal-title":"Front Sports Act Living"},{"issue":"3","key":"pone.0260351.ref015","doi-asserted-by":"crossref","first-page":"e210599","DOI":"10.1001\/jamanetworkopen.2021.0599","article-title":"Classification of Comprehensive Neuro-Ophthalmologic Measures of Postacute Concussion","volume":"4","author":"CN Feller","year":"2021","journal-title":"JAMA Netw Open"},{"key":"pone.0260351.ref016","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/B978-0-444-63954-7.00008-2","article-title":"Sideline assessment of concussion.","volume":"158","author":"Z Schepart","year":"2018","journal-title":"Handb Clin Neurol"},{"issue":"9","key":"pone.0260351.ref017","doi-asserted-by":"crossref","first-page":"e0162168","DOI":"10.1371\/journal.pone.0162168","article-title":"Oculomotor, Vestibular, and Reaction Time Tests in Mild Traumatic Brain Injury.","volume":"11","author":"C Balaban","year":"2016","journal-title":"PLoS One"},{"issue":"4","key":"pone.0260351.ref018","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.optm.2006.11.011","article-title":"Occurrence of oculomotor dysfunctions in acquired brain injury: a retrospective analysis","volume":"78","author":"KJ Ciuffreda","year":"2007","journal-title":"Optometry"},{"issue":"4","key":"pone.0260351.ref019","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1097\/OPX.0000000000001364","article-title":"Visuo-oculomotor Function and Reaction Times in Athletes with and without Concussion","volume":"96","author":"GD Cochrane","year":"2019","journal-title":"Optometry and vision science: official publication of the American Academy of Optometry"},{"issue":"1","key":"pone.0260351.ref020","doi-asserted-by":"crossref","first-page":"4583","DOI":"10.1038\/s41598-018-22825-5","article-title":"Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli","volume":"8","author":"A Danna-Dos-Santos","year":"2018","journal-title":"Sci Rep"},{"issue":"4","key":"pone.0260351.ref021","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/lio2.74","article-title":"The use of oculomotor, vestibular, and reaction time tests to assess mild traumatic brain injury (mTBI) over time.","volume":"2","author":"ME Hoffer","year":"2017","journal-title":"Laryngoscope Investig Otolaryngol."},{"issue":"3","key":"pone.0260351.ref022","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/HTR.0000000000000437","article-title":"Oculomotor, Vestibular, and Reaction Time Effects of Sports-Related Concussion: Video-Oculography in Assessing Sports-Related Concussion.","volume":"34","author":"KM Kelly","year":"2019","journal-title":"The Journal of head trauma rehabilitation"},{"issue":"6","key":"pone.0260351.ref023","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1136\/jnnp.52.6.742","article-title":"Reaction time after head injury: fatigue, divided and focused attention, and consistency of performance","volume":"52","author":"DT Stuss","year":"1989","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"suppl_1","key":"pone.0260351.ref024","first-page":"237","article-title":"Vestibular Test Patterns in the NICoE Intensive Outpatient Program Patient Population.","volume":"183","author":"JE King","year":"2018"},{"issue":"2017","key":"pone.0260351.ref025","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.proeng.2017.04.393","article-title":"Case Study: Reaction Time of Children According to Age.","volume":"187","author":"K Bucsuh\u00e1zy","year":"2017","journal-title":"Procedia Engineering"},{"issue":"9","key":"pone.0260351.ref026","doi-asserted-by":"crossref","first-page":"e0204008","DOI":"10.1371\/journal.pone.0204008","article-title":"Age dependent normative data of vertical and horizontal reflexive saccades.","volume":"13","author":"S Hopf","year":"2018","journal-title":"PLoS One"},{"issue":"2","key":"pone.0260351.ref027","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3233\/VES-150548","article-title":"Age related changes in ocular motor testing in healthy subjects.","volume":"25","author":"F Seferlis","year":"2015","journal-title":"J Vestib Res"},{"issue":"5","key":"pone.0260351.ref028","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1037\/0022-006X.68.5.767","article-title":"Normative data for normative comparisons.","volume":"68","author":"PC Kendall","year":"2000","journal-title":"J Consult Clin Psychol"},{"issue":"1","key":"pone.0260351.ref029","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1002\/lio2.231","article-title":"Acute findings in an acquired neurosensory dysfunction","volume":"4","author":"ME Hoffer","year":"2019","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"pone.0260351.ref030","article-title":"Eye Tracking as a Biomarker for Concussion in Children.","author":"A Bin Zahid","year":"2018","journal-title":"Clin J Sport Med"},{"issue":"Pt 3","key":"pone.0260351.ref031","first-page":"575","article-title":"Eye movement and visuomotor arm movement deficits following mild closed head injury","volume":"127","author":"MH Heitger","year":"2004","journal-title":"Brain"},{"issue":"5","key":"pone.0260351.ref032","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1002\/lio2.632","article-title":"Normative data for ages 18\u201345 for ocular motor and vestibular testing using eye tracking","volume":"6","author":"A Kullmann","year":"2021","journal-title":"Laryngoscope Investig Otolaryngol"},{"key":"pone.0260351.ref033","article-title":"Test-retest Repeatability and Reproducibility of Oculomotor, Vestibular, and Reaction Time Testing in 3D Head Mounted Display (HMD) with Integrated Eye Tracking.","author":"A Kiderman","year":"2015","journal-title":"National Neurotrauma Societ;"},{"key":"pone.0260351.ref034","volume-title":"Reference Intervals: A User\u2019s Guide","author":"Washington DAP","year":"2005"},{"key":"pone.0260351.ref035","article-title":"Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory, Approved Guideline.","author":"GL Horowitz","journal-title":"Defining, Establishing, and Verifying Reference Intervals in the Clinical Laboratory"},{"key":"pone.0260351.ref036","doi-asserted-by":"crossref","first-page":"46","DOI":"10.3389\/fnhum.2015.00046","article-title":"Effects of aging on eye movements in the real world.","volume":"9","author":"S Dowiasch","year":"2015","journal-title":"Front Hum Neurosci"},{"issue":"6","key":"pone.0260351.ref037","doi-asserted-by":"crossref","first-page":"2478","DOI":"10.1167\/iovs.05-1311","article-title":"Horizontal saccade dynamics across the human life span","volume":"47","author":"EL Irving","year":"2006","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"pone.0260351.ref038","doi-asserted-by":"crossref","first-page":"640","DOI":"10.3389\/fneur.2017.00640","article-title":"Visual Tracking in Development and Aging.","volume":"8","author":"J Maruta","year":"2017","journal-title":"Front Neurol"},{"key":"pone.0260351.ref039","doi-asserted-by":"crossref","first-page":"131","DOI":"10.3109\/00016489409128316","article-title":"Effect of aging on smooth pursuit eye movement.","volume":"511","author":"R Kanayama","year":"1994","journal-title":"Acta Otolaryngol Suppl"},{"issue":"11","key":"pone.0260351.ref040","doi-asserted-by":"crossref","first-page":"1950","DOI":"10.1589\/jpts.29.1950","article-title":"The effects of aging on the subjective vertical in the frontal plane in healthy adults","volume":"29","author":"K Fukata","year":"2017","journal-title":"J Phys Ther Sci"},{"issue":"12","key":"pone.0260351.ref041","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1136\/bjo.2004.044222","article-title":"Age related change of optokinetic nystagmus in healthy subjects: a study from infancy to senescence","volume":"88","author":"C Valmaggia","year":"2004","journal-title":"Br J Ophthalmol"},{"issue":"3","key":"pone.0260351.ref042","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.bandc.2008.08.019","article-title":"Development of eye-movement control","volume":"68","author":"B Luna","year":"2008","journal-title":"Brain Cogn"},{"key":"pone.0260351.ref043","first-page":"140","article-title":"Age Limit of Pediatrics.","author":"AP Hardin","year":"2017","journal-title":"Pediatrics"},{"key":"pone.0260351.ref044","article-title":"Oculomotor, Vestibular, and Reaction Time Effects of Sports-Related Concussion: Video-Oculography in Assessing Sports-Related Concussion.","author":"KM Kelly","year":"2018","journal-title":"The Journal of head trauma rehabilitation"},{"key":"pone.0260351.ref045","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1159\/000358786","article-title":"Detecting eye movement abnormalities from concussion.","volume":"28","author":"J Maruta","year":"2014","journal-title":"Prog Neurol Surg"},{"issue":"3","key":"pone.0260351.ref046","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1212\/WNL.57.3.524","article-title":"Persistent prolongation of simple reaction time in sports concussion","volume":"57","author":"DL Warden","year":"2001","journal-title":"Neurology"},{"issue":"2","key":"pone.0260351.ref047","doi-asserted-by":"crossref","first-page":"P101","DOI":"10.1093\/geronb\/57.2.P101","article-title":"Variability in reaction time performance of younger and older adults","volume":"57","author":"DF Hultsch","year":"2002","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"2","key":"pone.0260351.ref048","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.neuroimage.2004.02.006","article-title":"A shared neural network for simple reaction time.","volume":"22","author":"K Kansaku","year":"2004","journal-title":"Neuroimage"},{"issue":"9","key":"pone.0260351.ref049","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1212\/01.WNL.0000142990.44979.5A","article-title":"Neural substrate of antisaccades: role of subcortical structures","volume":"63","author":"C Condy","year":"2004","journal-title":"Neurology"},{"issue":"4","key":"pone.0260351.ref050","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1007\/s11940-002-0027-z","article-title":"Vision Disturbances Following Traumatic Brain Injury.","volume":"4","author":"N Kapoor","year":"2002","journal-title":"Curr Treat Options Neurol"},{"issue":"8","key":"pone.0260351.ref051","doi-asserted-by":"crossref","first-page":"2129","DOI":"10.1152\/jn.00906.2011","article-title":"Delay activity of saccade-related neurons in the caudal dentate nucleus of the macaque cerebellum","volume":"109","author":"RC Ashmore","year":"2013","journal-title":"J Neurophysiol"},{"issue":"7","key":"pone.0260351.ref052","doi-asserted-by":"crossref","first-page":"804","DOI":"10.7205\/MILMED-D-12-00061","article-title":"Visual dysfunctions and symptoms during the subacute stage of blast-induced mild traumatic brain injury","volume":"177","author":"JE Capo-Aponte","year":"2012","journal-title":"Mil Med"},{"issue":"8","key":"pone.0260351.ref053","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.4103\/1673-5374.162752","article-title":"A new tool for monitoring brain function: eye tracking goes beyond assessing attention to measuring central nervous system physiology","volume":"10","author":"U. Samadani","year":"2015","journal-title":"Neural Regen Res"},{"key":"pone.0260351.ref054","article-title":"Saccadic intrusions in paediatric concussion.","author":"GD Cochrane","year":"2020","journal-title":"Clinical & experimental optometry."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260351","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,22]],"date-time":"2021-11-22T18:27:36Z","timestamp":1637605656000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0260351"}},"subtitle":[],"editor":[{"given":"Stefan","family":"Glasauer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,11,22]]},"references-count":54,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,11,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0260351","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,22]]}}}