Department of Ophthalmology, University of Auckland, Auckland, New Zealand.
Mātai Medical Research Institute, Gisborne, New Zealand.
Brain Behav. 2022 Aug;12(8):e2714. doi: 10.1002/brb3.2714. Epub 2022 Jul 21.
Mild traumatic brain injury (mTBI), commonly known as concussion, is a complex neurobehavioral phenomenon affecting six in 1000 people globally each year. Symptoms last between days and years as microstructural damage to axons and neurometabolic changes result in brain network disruption. There is no clinically available objective biomarker to diagnose the severity of injury or monitor recovery. However, emerging evidence suggests eye movement dysfunction (e.g., saccades and smooth pursuits) in patients with mTBI. Patients with a higher symptom burden and prolonged recovery time following injury may show higher degrees of eye movement dysfunction. Likewise, recent advances in magnetic resonance imaging (MRI) have revealed both white matter tract damage and functional network alterations in mTBI patients, which involve areas responsible for the ocular motor control. This scoping review is presented in three sections: Section 1 explores the anatomical control of eye movements to aid the reader with interpreting the discussion in subsequent sections. Section 2 examines the relationship between abnormal MRI findings and eye tracking after mTBI based on the available evidence. Finally, Section 3 communicates gaps in our knowledge about MRI and eye tracking, which should be addressed in order to substantiate this emerging field.
轻度创伤性脑损伤(mTBI),通常称为脑震荡,是一种全球每年每 1000 人中就有 6 人受到影响的复杂神经行为现象。症状持续时间为数天到数年,轴突的微观结构损伤和神经代谢变化导致大脑网络中断。目前尚无临床可用的客观生物标志物来诊断损伤严重程度或监测恢复情况。然而,有证据表明,mTBI 患者存在眼球运动功能障碍(例如,眼跳和平滑追踪)。受伤后症状负担较高和恢复时间较长的患者可能表现出更高程度的眼球运动功能障碍。同样,磁共振成像(MRI)的最新进展揭示了 mTBI 患者的白质束损伤和功能网络改变,这些改变涉及负责眼球运动控制的区域。本范围综述分为三个部分:第 1 部分探讨眼球运动的解剖控制,以帮助读者理解后续部分的讨论。第 2 部分根据现有证据,检查 mTBI 后异常 MRI 发现与眼动追踪之间的关系。最后,第 3 部分传达了我们对 MRI 和眼动追踪的知识空白,为了证实这一新兴领域,这些空白需要得到解决。