W G Wright1,2, R T Tierney3, J McDevitt1,4. 1. Department of Physical Therapy, Neuromotor Sciences Program, Temple University, Philadelphia, PA, USA. 2. Department of Bioengineering, Temple University, Philadelphia, PA, USA. 3. Department of Kinesiology, Temple University, Philadelphia, PA, USA. 4. Department of Athletic Training, East Stroudsburg University, East Stroudsburg, PA, USA.
Abstract
BACKGROUND: The search for reliable and valid signs and symptoms of mild traumatic brain injury (mTBI), commonly synonymous with concussion, has lead to a growing body of evidence that individuals with long-lasting, unremitting impairments often experience visual and vestibular symptoms, such as dizziness, postural and gait disturbances. OBJECTIVE: Investigate the role of visual-vestibular processing deficits following concussion. METHODS: A number of clinically accepted vestibular, oculomotor, and balance assessments as well as a novel virtual reality (VR)-based balance assessment device were used to assess adults with post-acute concussion (n = 14) in comparison to a healthy age-matched cohort (n = 58). RESULTS: Significant between-group differences were found with the VR-based balance device (p = 0.001), with dynamic visual motion emerging as the most discriminating balance condition. The symptom reports collected after performing the oculomotor and vestibular tests: rapid alternating horizontal eye saccades, optokinetic stimulation, and gaze stabilization, were all sensitive to health status (p < 0.05), despite the absence of oculomotor abnormalities being observed, except for near-point convergence. The BESS, King-Devick, and Dynamic Visual Acuity tests did not detect between-group differences. CONCLUSION: Postural and visual-vestibular tasks most closely linked to spatial and self-motion perception had the greatest discriminatory outcomes. The current findings suggest that mesencephalic and parieto-occipital centers and pathways may be involved in concussion.
BACKGROUND: The search for reliable and valid signs and symptoms of mild traumatic brain injury (mTBI), commonly synonymous with concussion, has lead to a growing body of evidence that individuals with long-lasting, unremitting impairments often experience visual and vestibular symptoms, such as dizziness, postural and gait disturbances. OBJECTIVE: Investigate the role of visual-vestibular processing deficits following concussion. METHODS: A number of clinically accepted vestibular, oculomotor, and balance assessments as well as a novel virtual reality (VR)-based balance assessment device were used to assess adults with post-acute concussion (n = 14) in comparison to a healthy age-matched cohort (n = 58). RESULTS: Significant between-group differences were found with the VR-based balance device (p = 0.001), with dynamic visual motion emerging as the most discriminating balance condition. The symptom reports collected after performing the oculomotor and vestibular tests: rapid alternating horizontal eye saccades, optokinetic stimulation, and gaze stabilization, were all sensitive to health status (p < 0.05), despite the absence of oculomotor abnormalities being observed, except for near-point convergence. The BESS, King-Devick, and Dynamic Visual Acuity tests did not detect between-group differences. CONCLUSION: Postural and visual-vestibular tasks most closely linked to spatial and self-motion perception had the greatest discriminatory outcomes. The current findings suggest that mesencephalic and parieto-occipital centers and pathways may be involved in concussion.
Entities:
Keywords:
Key words: Concussion; near point convergence; optokinetic stimulation; posture; virtual reality
Authors: Taylor M Yeates; H Gerry Taylor; Erin D Bigler; Nori M Minich; Ken Tang; Daniel M Cohen; Ann Bacevice; Leslie K Mihalov; Barbara Bangert; Nicholas A Zumberge; Keith Owen Yeates Journal: J Neurotrauma Date: 2021-04-05 Impact factor: 5.269