By Leila Uginčius
University Public Affairs
The absolute best thing about the research being conducted by a team of Virginia Commonwealth University collaborators is also the absolute worst thing: it is very simple.
“I can explain it to anyone in less than two minutes,” said George Gitchel, Ph.D., an associate professor in the VCU Department of Physical Medicine and Rehabilitation and director of clinical research for Hunter Holmes McGuire VA Medical Center’s Parkinson’s Disease Research, Education and Clinical Center. “But medical professionals are very skeptical because of that. They want [it] to be hard.”
“It” is a noninvasive eye-tracking system that can screen for and distinguish among Parkinson’s disease, essential tremor, traumatic brain injury and several other neurological conditions.
Thanks to the dozen cranial nerves that carry motor and sensory information directly to the human brain, eyes are windows to diagnosing more than 20 neurological disorders. The diagnostic test uses cameras and an advanced software platform to track the natural movements of the eye. A patient looks at a dot on a computer screen. Healthy patients watching the screen have regular, well-defined movements. Patients experiencing neurological problems have irregular movements that, thanks to the technology invented at VCU, can assist a physician in diagnosing disease.
Paul Wetzel, Ph.D., associate professor of biomedical engineering in the VCU College of Engineering, began working on the diagnostic test more than two decades ago as an offshoot of work he had done to improve the ergonomics of Air Force cockpits by tracking pilots’ eye movements.
“I walked into this [project] as already conceived, but what I did was play a major part in recognizing the need to continue and escalate our efforts toward, not just a research interest ... but for the clinical value as well,” Baron said.
Rounding out the team is Gitchel, who initially heard about the project as an undergraduate student of Wetzel’s. At the time, the data collection was still in its infancy, but the eye-tracking technology fascinated Gitchel. When he was accepted into the Ph.D. program at VCU, Wetzel offered him the opportunity to work on the project at the VA and use the research for his dissertation.
“I am personally invested as well,” Gitchel said. “My grandfather was a World War II veteran who was misdiagnosed with Alzheimer’s.” The family only found out the mistake when the autopsy showed a different disease.
Gitchel’s grandmother experienced a similar misdiagnosis. She was diagnosed with Parkinson’s disease in her mid-60s.
“She was slowing down a bit, and her gerontologist said, ‘Let me see your shoes. Look — the heels are worn down a bit. You must have Parkinson’s,’” Gitchel said. “That is how she was diagnosed.” She carried that diagnosis for almost 20 years before passing away. Knowing what he knows now, Gitchel is convinced she did not have Parkinson’s.
Last week, VCU honored the trio with the university’s 2019 Billy R. Martin Award for Innovation, named for the innovator who served as chair of the Department of Pharmacology and Toxicology until his death in 2008. A world-renowned neuropharmacologist and educator, Martin conducted groundbreaking translational research in substance abuse.
“As a nationally premier research university, we work to advance the human condition everywhere,” said VCU President Michael Rao, Ph.D. “I appreciate the innovative breakthroughs that happen every day at VCU — from our faculty and our students. The pioneering work of Mark Baron, Paul Wetzel and George Gitchel is a perfect example of this. Their research, discovery and innovation will make a difference in the lives of countless people, which is the ultimate mission of our university.”
Rao himself took the test at the event and was found to have healthy, well-defined eye movement.
Compared to traditional diagnostics such as PET or MR scans, this test takes much less time (about five minutes) and costs far less. The ability to treat patients at very early stages of neurodegenerative diseases could potentially lead to better outcomes.
In 2016, the Michael J. Fox Foundation for Parkinson’s Research awarded the researchers a $1 million grant to test the device. More recently, the team has licensed the technology — through VCU Innovation Gateway's tech transfer — to RightEye LLC, a Bethesda, Maryland-based startup.
“It is at a state in which it will provide invaluable objective advantage to clinical assessment alone and will continue to be refined to improve gradually to be more and more accurate,” Baron said.
The collaboration between the VA and VCU cannot be overstated, Gitchel said, as the access to patients and funding on one side with academic support and data analysis on the other is invaluable. After licensing the technology, the three-way collaboration among the VA, VCU and RightEye surprises him every day, he said.
“We’ve achieved that holy grail of translational research, and actually jumped that wide chasm from laboratory, bench-type research into something that is easily used at the bedside,” he said. “We’ve taken something that is inherently difficult, and made it as simple as possible.”
A.J. Hostetler in the VCU Office of the Vice President of Research and Innovation contributed to this article.