SeeMe: Using Automated Facial Tracking to Detect Voluntary Behavior in Brain Injury

Group 1: Traumatic Brain Injury (TBI) Cohort Inclusion Criteria: * Adults (22+) with a history of acute traumatic brain injury * Documented loss of consciousness with a Glasgow Coma Scale (GCS) score less than or equal to 8 upon hospitalization * Clinically stable as determined by the primary neurosurgery or ICU team * Intact auditory pathways as confirmed by BAERs * Family consent for study participation Exclusion Criteria: * Hearing Impairment confirmed via absence of Brainstem Auditory Evoked Responses (BAERs) that would prevent the patient from hearing the auditory commands * No legal authorized representative (LAR) available to provide informed consent for the patients in a comatose state * Any other medical condition that, in the judgment of the investigator, makes participation in the study unsafe. * Pregnant women * Any previous history of traumatic brain injury * Any neurodegenerative disease such as dementia Group 2: Healthy Control Cohort Inclusion Criteria: * Adults 22+ with no history of neurological or psychiatric disorders * Normal baseline neurological examination * Intact auditory pathways * Ability to provide informed consent * Ability to follow simple auditory commands in English Exclusion Criteria: * Hearing Impairment that would prevent the participant from hearing the auditory commands * Any previous history of severe traumatic brain injury (TBI) * Any neurodegenerative disease (e.g., dementia) * Any motor impairment (e.g., facial palsy, carpal tunnel syndrome) that would interfere with facial or hand movement tracking * Any other medical condition that, in the judgment of the investigator, makes participation in the study unsafe * Pregnant women Group 3: Sedated/Anesthetized Cohort Inclusion Criteria: * Adults (22+) undergoing elective spine surgery * Requirement of general anesthesia and pharmacological paralysis (neuromuscular blockade) as part of the standard surgical procedure * Clinically stable for study procedures as determined by the anesthesia and surgical teams. * Intact auditory pathways * Ability to provide informed pre-operative consent Exclusion Criteria: * Hearing Impairment that would prevent the patient from hearing the auditory commands * Any previous history of severe traumatic brain injury * Any neurodegenerative disease such as dementia * Significant baseline facial or hand motor deficits prior to the administration of anesthesia * Any other medical condition that, in the judgment of the investigator, makes participation in the study unsafe * Pregnant women