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青少年脑震荡后症状与眼球运动障碍的相关性。

Association between post-concussion symptoms and oculomotor deficits among adolescents.

机构信息

Department of Ophthalmology, Boston Children's Hospital, Boston, Massachusetts, USA.

Department of Ophthalmology, Massachusetts Eye and Ear, Boston, Massachusetts, USA.

出版信息

Brain Inj. 2021 Aug 24;35(10):1218-1228. doi: 10.1080/02699052.2021.1959065. Epub 2021 Aug 12.

Abstract

PURPOSE

To examine the association between Post-Concussion Symptom Scale (PCSS) scores, Convergence Insufficiency Symptom Survey (CISS) scores, and oculomotor deficits post-concussion.

METHODS

Records of adolescent patients examined in a multidisciplinary concussion clinic between July 2014 and May 2019 were reviewed. PCSS and CISS scores, results of eye examination and oculomotor assessment, concussion history, and demographics were abstracted.

RESULTS

One hundred and forty patient records (median age, 15.3 years; 52 males, presented 109 days (median) from their most recent concussion) met inclusion criteria. Mean total scores on PCSS and CISS were 46.67 ± 25.89 and 27.13 ± 13.22, respectively, and were moderately correlated with each other (r = 0.53, < .001). Oculomotor deficits were observed in 123 (88%) patients. Step-wise linear regression identified increased PCSS total score to be significantly associated with decreased amplitude of accommodation ( < .001). Increased CISS total score was significantly associated with receded near point of convergence, developmental eye movement test error scores, and cause of concussion.

CONCLUSION

High PCSS scores may indicate an accommodation deficit and thus prompt an oculomotor assessment in patients following a concussion. Using the CISS and a detailed oculomotor assessment may reveal underlying oculomotor deficits, which may benefit from treatment.

摘要

目的

研究脑震荡后患者的脑震荡后症状量表(PCSS)评分、集合不足症状调查(CISS)评分和眼动缺陷之间的关系。

方法

回顾了 2014 年 7 月至 2019 年 5 月在多学科脑震荡诊所接受检查的青少年患者的记录。提取了 PCSS 和 CISS 评分、眼部检查和眼动评估结果、脑震荡病史和人口统计学资料。

结果

140 份患者记录(中位数年龄 15.3 岁;52 名男性,最近一次脑震荡后 109 天(中位数)就诊)符合纳入标准。PCSS 和 CISS 的总分分别为 46.67±25.89 和 27.13±13.22,彼此中度相关(r=0.53,<0.001)。123 名(88%)患者存在眼动缺陷。逐步线性回归显示,PCSS 总分增加与调节幅度降低显著相关(<0.001)。CISS 总分增加与集合近点退缩、发育性眼运动试验错误评分和脑震荡原因显著相关。

结论

PCSS 评分高可能表明存在调节缺陷,从而提示脑震荡后患者需要进行眼动评估。使用 CISS 和详细的眼动评估可能会发现潜在的眼动缺陷,这些缺陷可能受益于治疗。

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