Crampton Adrienne, Teel Elizabeth, Chevignard Mathilde, Gagnon Isabelle
School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.
School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.
Neurochirurgie. 2021 May;67(3):231-237. doi: 10.1016/j.neuchi.2021.01.002. Epub 2021 Jan 19.
Mild traumatic brain injury (mTBI) is a prevalent injury which occurs across many populations, including children and adolescents, athletes, military personnel, and the elderly. mTBI can result in various subjective symptoms and clinical deficits, such as abnormalities to the vestibulo-ocular reflex (VOR). Over 50% of individuals with mTBI are reported to have VOR abnormalities, which strongly contribute to feelings of dizziness and unsteadiness. Dizziness is a strong predictor for prolonged recovery following mTBI and is additionally linked with mental health difficulties and functional limitations affecting likelihood of return to work. Early diagnosis, and subsequent treatment, of VOR deficits following mTBI may greatly improve recovery outcomes and a patient's quality of life, but a thorough comprehension of the related pathophysiology is necessary to understand the assessments used to diagnose VOR abnormalities. Therefore, the purpose of this article is i) provide readers with an introduction on the VOR physiology to facilitate understanding about mTBI-related abnormalities, and ii) to discuss current assessments that are commonly used to measure VOR function following mTBI. As the VOR and oculomotor (OM) systems are heavily linked and often work in tandem, discussion of the relevant aspects of the OM system is also provided.
轻度创伤性脑损伤（mTBI）是一种常见的损伤，发生于许多人群，包括儿童、青少年、运动员、军事人员和老年人。mTBI可导致各种主观症状和临床缺陷，如前庭眼反射（VOR）异常。据报道，超过50%的mTBI患者存在VOR异常，这是导致头晕和不稳感的主要原因。头晕是mTBI后恢复时间延长的一个重要预测指标，还与心理健康问题以及影响重返工作可能性的功能受限有关。mTBI后VOR缺陷的早期诊断及后续治疗可能会极大地改善恢复结果和患者的生活质量，但要理解用于诊断VOR异常的评估方法，就必须全面了解相关的病理生理学。因此，本文的目的是：i）向读者介绍VOR生理学，以促进对mTBI相关异常的理解；ii）讨论目前常用于测量mTBI后VOR功能的评估方法。由于VOR和眼球运动（OM）系统紧密相连且常常协同工作，因此本文也将讨论OM系统的相关方面。
