Wright W G, Tierney R T, McDevitt J
Department of Physical Therapy, Neuromotor Sciences Program, Temple University, Philadelphia, PA, USA.
Department of Bioengineering, Temple University, Philadelphia, PA, USA.
J Vestib Res. 2017;27(1):27-37. doi: 10.3233/VES-170607.
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.
Investigate the role of visual-vestibular processing deficits following concussion.
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).
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.
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.
寻找轻度创伤性脑损伤（mTBI，通常与脑震荡同义）可靠且有效的体征和症状，已产生越来越多的证据表明，长期存在、持续不缓解的损伤个体常出现视觉和前庭症状，如头晕、姿势和步态障碍。
研究脑震荡后视觉-前庭加工缺陷的作用。
使用一些临床认可的前庭、动眼和平衡评估方法，以及一种新型的基于虚拟现实（VR）的平衡评估设备，对急性脑震荡后的成年人（n = 14）与年龄匹配的健康队列（n = 58）进行评估。
基于VR的平衡设备发现组间存在显著差异（p = 0.001），动态视觉运动成为最具区分性的平衡条件。在进行动眼和前庭测试（快速交替水平眼扫视、视动刺激和注视稳定）后收集的症状报告，尽管除了近点集合外未观察到动眼异常，但对健康状况均敏感（p < 0.05）。BESS、King-Devick和动态视力测试未检测到组间差异。
与空间和自我运动感知最密切相关的姿势和视觉-前庭任务具有最大的区分结果。目前的研究结果表明，中脑和顶枕中心及通路可能参与脑震荡。
