Saccadic intrusions in paediatric concussion

Cochrane, Graham D.; Gould, Sara; Sheehan, Nichole; Busettini, C.; Christy, Jennifer Braswell; Weise, Katherine K.; Swanson, Mark W.

doi:10.1111/cxo.13045

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…In addition, our group has previously reported several cases of children months from their original injury becoming acutely more symptomatic and developing objective saccadic changes. 42 As we hypothesize these changes are due to maladaptive pathway remodeling, it is our belief that time since injury is not necessarily indicative of symptom severity.…”

Section: Discussionmentioning

confidence: 96%

Vestibular, Oculomotor, and Balance Functions in Children With and Without Concussion

Cochrane

Christy

Almutairi

et al. 2021

Journal of Head Trauma Rehabilitation

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Objective:The main objective of this study was to assess whether objective vestibular, oculomotor, and balance functions were impaired in children with a current diagnosis of concussion with vestibular and/or ocular symptoms. Setting: Data were collected in a vestibular/ocular clinical laboratory. Patient participants were recruited from a concussion clinic in a children's hospital. Participants: Thirty-three children aged 8 to 17 years with a current diagnosis of concussion and vestibular and/or ocular symptoms and 30 children without concussion. Design: Crosssectional single-visit study. Main Outcome Measures: Eye-tracking rotary chair oculomotor and vestibular measures, vestibular evoked potentials, and static posturography. Results: There were no statistically significant differences on any clinical measure between children with concussion and children without concussion. Younger children without concussion performed significantly worse on several rotary chair and balance measures compared with older children without concussion. Conclusions: No vestibular, oculomotor, or balance measures were significantly different between children with concussion and children without concussion, suggesting these measures may not be useful in the evaluation of a child with concussion and vestibular and/or oculomotor symptoms. Future research should investigate age effects and other vestibular and oculomotor tests to identify objective findings that better relate to vestibular and/or ocular symptoms in children with concussion.

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Section: Discussionmentioning

confidence: 96%

Vestibular, Oculomotor, and Balance Functions in Children With and Without Concussion

Cochrane

Christy

Almutairi

et al. 2021

Journal of Head Trauma Rehabilitation

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“…Our previous work in mTBI indicated that a set of 6–8 metrics extracted from oculomotor tests, e.g., saccades, antisaccades, smooth pursuit, and vestibular tests, was strongly associated with the presence of a concussion in both acute and chronic patients [ 17 , 22 ]. These tests were also able to monitor progression over time after mTBI [ 21 ] and response to treatment [ 54 ]. For example, impairments in saccades (i.e., saccadic intrusions) following mTBI can cause visual disturbances (e.g., double vision, oscillopsia) accompanied by headaches.…”

Section: Discussionmentioning

confidence: 99%

“…For example, impairments in saccades (i.e., saccadic intrusions) following mTBI can cause visual disturbances (e.g., double vision, oscillopsia) accompanied by headaches. Improvements in saccadic eye movements using vision therapy (and/or medication) mitigated clinical symptoms [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Portable eye-tracking as a reliable assessment of oculomotor, cognitive and reaction time function: Normative data for 18–45 year old

et al. 2021

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Eye movements measured by high precision eye-tracking technology represent a sensitive, objective, and non-invasive method to probe functional neural pathways. Oculomotor tests (e.g., saccades and smooth pursuit), tests that involve cognitive processing (e.g., antisaccade and predictive saccade), and reaction time tests have increasingly been showing utility in the diagnosis and monitoring of mild traumatic brain injury (mTBI) in research settings. Currently, the adoption of these tests into clinical practice is hampered by a lack of a normative data set. The goal of this study was to construct a normative database to be used as a reference for comparing patients’ results. Oculomotor, cognitive, and reaction time tests were administered to male and female volunteers, aged 18–45, who were free of any neurological, vestibular disorders, or other head injuries. Tests were delivered using either a rotatory chair equipped with video-oculography goggles (VOG) or a portable virtual reality-like VOG goggle device with incorporated infrared eye-tracking technology. Statistical analysis revealed no effects of age on test metrics when participant data were divided into pediatric (i.e.,18–21 years, following FDA criteria) and adult (i.e., 21–45 years) groups. Gender (self-reported) had an effect on auditory reaction time, with males being faster than females. Pooled data were used to construct a normative database using 95% reference intervals (RI) with 90% confidence intervals on the upper and lower limits of the RI. The availability of these RIs readily allows clinicians to identify specific metrics that are deficient, therefore aiding in rapid triage, informing and monitoring treatment and/or rehabilitation protocols, and aiding in the return to duty/activity decision. This database is FDA cleared for use in clinical practice (K192186).

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