Cochrane Graham D, Christy Jennifer B, Almutairi Anwar, Busettini Claudio, Swanson Mark W, Weise Katherine K
Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama.
Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama.
Optom Vis Sci. 2019 Apr;96(4):256-265. doi: 10.1097/OPX.0000000000001364.
Oculomotor tests in concussion commonly show impairment in smooth pursuit and saccadic function. Honing in on the systems likely to be affected by concussion will streamline use of oculomotor function as a supplemental diagnostic and prognostic tool, as well as improve our understanding of the pathophysiology of concussion.
This study investigates oculomotor function between concussed and healthy collegiate athletes and determines measurement test-retest reliability of those tools.
Eighty-seven healthy athletes were recruited from a U.S. Division 1 sports university and completed a 30-minute vestibular ocular testing battery in an enclosed rotary chair system equipped with 100-Hz eye-tracking goggles. Forty-three individuals completed the battery twice. Twenty-eight individuals with a current diagnosis of concussion also completed the battery. All participants were aged 18 to 24 years. Bivariate statistical tests examined differences in scores across groups, and intraclass coefficients were computed to test reliability.
Concussed individuals had significantly longer saccadic, visual, and dual-task reaction times and reduced saccadic accuracy. There was no difference in optokinetic reflex gain, but few concussed individuals tolerated the task. Reaction time latencies and optokinetic gain show moderate test-retest reliability. Smooth pursuit tasks and saccadic accuracies showed poor test-retest reliability.
Saccadic latency was the most sensitive oculomotor function to change after concussion and was reliable over time. Saccadic accuracy was significantly lower in the concussed group but had poor retest reliability. Optokinetic gain may warrant more investigation because of its high test-retest reliability and symptom provocation in concussion, despite not showing a significant difference between groups.
脑震荡的动眼神经测试通常显示平滑追踪和扫视功能受损。深入研究可能受脑震荡影响的系统将简化动眼神经功能作为补充诊断和预后工具的使用，并增进我们对脑震荡病理生理学的理解。
本研究调查了脑震荡的和健康的大学生运动员之间的动眼神经功能，并确定了这些工具测量的重测信度。
从一所美国一级体育大学招募了87名健康运动员，他们在配备有100赫兹眼动追踪护目镜的封闭式转椅系统中完成了一项30分钟的前庭眼动测试组套。43人完成了两次该组套测试。28名目前被诊断为脑震荡的个体也完成了该组套测试。所有参与者年龄在18至24岁之间。双变量统计测试检查了各组得分的差异，并计算了组内相关系数以测试信度。
脑震荡个体的扫视、视觉和双任务反应时间显著更长，扫视准确性降低。视动反射增益没有差异，但很少有脑震荡个体能耐受该任务。反应时间潜伏期和视动增益显示出中等的重测信度。平滑追踪任务和扫视准确性显示出较差的重测信度。
扫视潜伏期是脑震荡后最敏感的动眼神经功能变化指标，且随时间推移具有可靠性。脑震荡组的扫视准确性显著较低，但重测信度较差。视动增益尽管在两组之间未显示出显著差异，但因其高重测信度和在脑震荡中引发症状，可能值得进一步研究。
