A new computer vision-based system to help clinicians objectively assess visual pursuit with the moving mirror stimulus for the diagnosis of minimally conscious state

Minimally conscious state (MCS) is a neurological syndrome in which the patient shows signs of partial consciousness after having emerged from unresponsive wakefulness syndrome (UWS), which itself follows a state of coma. Distinguishing between MCS and UWS is complex and has major impact on the clinical management and prognosis of affected patients. Research on disorders of consciousness (DoC) has revealed that (1) visual pursuit, i.e. the ability of a patient to track a moving stimulus, is one of the most decisive clinical signs for establishing the MCS/UWS distinction, and that (2) the most effective moving stimulus for visual pursuit assessment is a mirror where the patient can see his/her own face. In clinical practice, while this guidance is widely followed, the visual pursuit ability is typically assessed on the basis of the clinician's opinion only, i.e. in a subjective thus biased manner. In this paper, we present a new system using cameras and computer vision techniques, which helps clinicians to objectify the assessment of visual pursuit. Our system is specifically designed to work with the moving mirror stimulus in order to follow the recommended, well-established clinical setup. We validate our system on healthy control subjects and give preliminary results obtained with DoC patients.