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Visual-vestibular processing deficits in mild traumatic brain injury.

W G Wright^1,2, R T Tierney³, J McDevitt^1,4

¹Department of Physical Therapy, Neuromotor Sciences Program, Temple University, Philadelphia, PA, USA.

Journal of Vestibular Research : Equilibrium & Orientation

|April 8, 2017

Summary

Virtual reality balance assessments effectively identified visual-vestibular deficits in individuals with concussion. These findings highlight the role of spatial perception in post-concussion recovery and potential brain centers involved.

Keywords:

Key words: Concussion near point convergence optokinetic stimulation posture virtual reality

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Area of Science:

Neuroscience
Rehabilitation Medicine
Sports Medicine

Background:

Mild traumatic brain injury (mTBI), or concussion, often results in persistent impairments.
Visual and vestibular symptoms, including dizziness and balance disturbances, are common in individuals with long-lasting concussion symptoms.

Purpose of the Study:

To investigate the role of visual-vestibular processing deficits following concussion.
To identify reliable markers for assessing concussion-related impairments.

Main Methods:

Adults with post-acute concussion (n=14) and a healthy cohort (n=58) underwent clinical vestibular, oculomotor, and balance assessments.
A novel virtual reality (VR)-based balance assessment device was utilized.
Symptom reports and performance on various tests were analyzed.

Main Results:

The VR-based balance device showed significant between-group differences (p=0.001), with dynamic visual motion being the most discriminating factor.
Symptom reports from oculomotor and vestibular tests were sensitive to health status (p<0.05), despite few observed oculomotor abnormalities.
Standard tests like BESS, King-Devick, and Dynamic Visual Acuity did not detect significant differences between groups.

Conclusions:

Postural and visual-vestibular tasks related to spatial and self-motion perception demonstrated the greatest discriminatory power.
Findings suggest potential involvement of mesencephalic and parieto-occipital brain centers and pathways in concussion.
VR-based assessments may offer a more sensitive approach to identifying concussion-related deficits.