Stuart Samuel, Parrington Lucy, Martini Douglas, Peterka Robert, Chesnutt James, King Laurie
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom.
Department of Neurology, Oregon Health and Science University, Portland, OR, United States.
Front Sports Act Living. 2020 Jan 28;2:5. doi: 10.3389/fspor.2020.00005. eCollection 2020.
Mild traumatic brain injury (mTBI), or concussion, occurs following a direct or indirect force to the head that causes a change in brain function. Many neurological signs and symptoms of mTBI can be subtle and transient, and some can persist beyond the usual recovery timeframe, such as balance, cognitive or sensory disturbance that may pre-dispose to further injury in the future. There is currently no accepted definition or diagnostic criteria for mTBI and therefore no single assessment has been developed or accepted as being able to identify those with an mTBI. Eye-movement assessment may be useful, as specific eye-movements and their metrics can be attributed to specific brain regions or functions, and eye-movement involves a multitude of brain regions. Recently, research has focused on quantitative eye-movement assessments using eye-tracking technology for diagnosis and monitoring symptoms of an mTBI. However, the approaches taken to objectively measure eye-movements varies with respect to instrumentation, protocols and recognition of factors that may influence results, such as cognitive function or basic visual function. This review aimed to examine previous work that has measured eye-movements within those with mTBI to inform the development of robust or standardized testing protocols. Medline/PubMed, CINAHL, PsychInfo and Scopus databases were searched. Twenty-two articles met inclusion/exclusion criteria and were reviewed, which examined saccades, smooth pursuits, fixations and nystagmus in mTBI compared to controls. Current methodologies for data collection, analysis and interpretation from eye-tracking technology in individuals following an mTBI are discussed. In brief, a wide range of eye-movement instruments and outcome measures were reported, but validity and reliability of devices and metrics were insufficiently reported across studies. Interpretation of outcomes was complicated by poor study reporting of demographics, mTBI-related features (e.g., time since injury), and few studies considered the influence that cognitive or visual functions may have on eye-movements. The reviewed evidence suggests that eye-movements are impaired in mTBI, but future research is required to accurately and robustly establish findings. Standardization and reporting of eye-movement instruments, data collection procedures, processing algorithms and analysis methods are required. Recommendations also include comprehensive reporting of demographics, mTBI-related features, and confounding variables.
轻度创伤性脑损伤（mTBI），即脑震荡，是头部受到直接或间接外力作用后发生的，会导致脑功能改变。mTBI的许多神经体征和症状可能很细微且短暂，有些症状可能会持续超过正常恢复时间范围，比如平衡、认知或感觉障碍，这些可能会增加未来进一步受伤的风险。目前对于mTBI尚无公认的定义或诊断标准，因此也没有一种单一的评估方法被开发或认可能够识别出患有mTBI的人。眼球运动评估可能有用，因为特定的眼球运动及其指标可归因于特定的脑区或功能，并且眼球运动涉及多个脑区。最近，研究集中在使用眼动追踪技术进行定量眼球运动评估，以诊断和监测mTBI的症状。然而，客观测量眼球运动所采用的方法在仪器设备、方案以及对可能影响结果的因素（如认知功能或基本视觉功能）的认识方面存在差异。本综述旨在审视之前对mTBI患者眼球运动进行测量的研究工作，以为制定可靠或标准化的测试方案提供参考。检索了Medline/PubMed、CINAHL、PsychInfo和Scopus数据库。22篇文章符合纳入/排除标准并进行了综述，这些文章比较了mTBI患者与对照组在扫视、平稳跟踪、注视和眼球震颤方面的情况。讨论了当前在mTBI患者中使用眼动追踪技术进行数据收集、分析和解释的方法。简而言之，研究报告了广泛的眼球运动仪器和结果测量指标，但各项研究对设备和指标的有效性及可靠性报告不足。研究报告中关于人口统计学、mTBI相关特征（如受伤后的时间）的报告较差，这使得结果的解释变得复杂，而且很少有研究考虑认知或视觉功能可能对眼球运动产生的影响。综述证据表明mTBI患者的眼球运动存在受损情况，但未来需要开展研究以准确且可靠地确定研究结果。需要对眼球运动仪器、数据收集程序、处理算法和分析方法进行标准化和报告。建议还包括全面报告人口统计学、mTBI相关特征和混杂变量。
