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Visuo-oculomotor Function and Reaction Times in Athletes with and without Concussion

Cochrane, Graham D., BA1*; Christy, Jennifer B., PT, PhD1; Almutairi, Anwar, PT, MS1; Busettini, Claudio, PhD2,3; Swanson, Mark W., OD, MSPH, FAAO2; Weise, Katherine K., OD, MBA, FAAO2

doi: 10.1097/OPX.0000000000001364

SIGNIFICANCE Oculomotor tests in concussion commonly show impairment in smooth pursuit and saccadic function. Honing in on the systems likely to be affected by concussion will streamline use of oculomotor function as a supplemental diagnostic and prognostic tool, as well as improve our understanding of the pathophysiology of concussion.

PURPOSE This study investigates oculomotor function between concussed and healthy collegiate athletes and determines measurement test-retest reliability of those tools.

METHODS Eighty-seven healthy athletes were recruited from a U.S. Division 1 sports university and completed a 30-minute vestibular ocular testing battery in an enclosed rotary chair system equipped with 100-Hz eye-tracking goggles. Forty-three individuals completed the battery twice. Twenty-eight individuals with a current diagnosis of concussion also completed the battery. All participants were aged 18 to 24 years. Bivariate statistical tests examined differences in scores across groups, and intraclass coefficients were computed to test reliability.

RESULTS Concussed individuals had significantly longer saccadic, visual, and dual-task reaction times and reduced saccadic accuracy. There was no difference in optokinetic reflex gain, but few concussed individuals tolerated the task. Reaction time latencies and optokinetic gain show moderate test-retest reliability. Smooth pursuit tasks and saccadic accuracies showed poor test-retest reliability.

CONCLUSIONS Saccadic latency was the most sensitive oculomotor function to change after concussion and was reliable over time. Saccadic accuracy was significantly lower in the concussed group but had poor retest reliability. Optokinetic gain may warrant more investigation because of its high test-retest reliability and symptom provocation in concussion, despite not showing a significant difference between groups.

1Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama

2Department of Optometry and Vision Science, University of Alabama at Birmingham, Birmingham, Alabama

3Vision Science Research Center, University of Alabama at Birmingham, Birmingham, Alabama


Submitted: August 10, 2018

Accepted: December 26, 2018

Funding/Support: This research was funded by a grant from the National Institutes of Health–National Eye Institute (P30 EY-03039 Vision Science Research Center Core grant).

Conflict of Interest Disclosure: Authors report no conflicts of interest.

Author Contributions and Acknowledgments: Conceptualization: JBC, CB, MWS, KKW; Data Curation: GDC, JBC, CB, MWS; Formal Analysis: GDC, JBC, CB, MWS; Funding Acquisition: JBC, CB, MWS, KKW; Investigation: GDC, JBC, AA, CB, KKW; Methodology: GDC, CB, MWS; Project Administration: GDC, JBC, AA, CB, KKW; Resources: GDC, CB; Software: GDC, CB; Supervision: GDC, JBC, AA, CB, MWS, KKW; Validation: GDC, JBC, AA, CB, MWS; Visualization: GDC, JBC, AA, CB; Writing – Original Draft: GDC, JBC; Writing – Review & Editing: GDC, JBC, CB, MWS, KKW.

The preliminary data for this work were presented as two-poster presentations at the American Physical Therapy Association's Combined Sections Meeting in February 2017 in San Antonio, Texas.

© 2019 American Academy of Optometry