Affiliations: [a] Department of Physical Therapy, Neuromotor Sciences Program, Temple University, Philadelphia, PA, USA
| [b] Department of Bioengineering, Temple University, Philadelphia, PA, USA
| [c] Department of Kinesiology, Temple University, Philadelphia, PA, USA
| [d] Department of Athletic Training, East Stroudsburg University, East Stroudsburg, PA, USA
Correspondence:
[*]
Corresponding author: W. Geoffrey Wright, PhD, Department of PT, College of Public Health, 3307N. Broad St.
Philadelphia, 215.204.5152 (lab – Main Campus), PA 19140, USA. Tel.: +215 204 5152; Fax: +215 707 4800;
E-mail: wrightw@temple.edu.
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.
Keywords: Key words: Concussion, near point convergence, optokinetic stimulation, virtual reality, posture
