Visuo-oculomotor Function and Reaction Times in Athletes with and without Concussion
Visuo-oculomotor Function and Reaction Times in Athletes with and without Concussion
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DOI：
10.1097/opx.0000000000001364
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发表时间：
2019-04-01
影响因子：
1.4
通讯作者：
Weise, Katherine K.
中科院分区：
文献类型：
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作者：
Cochrane, Graham D.;Christy, Jennifer B.;Weise, Katherine K.
意义：脑震荡患者的眼动检查通常显示平滑追踪功能和跳眼功能受损。对可能受脑震荡影响的系统进行研究，将简化动眼肌功能作为补充诊断和预后工具的使用，并提高我们对脑震荡病理生理学的理解。目的研究脑震荡和健康大学生运动员的动眼肌功能，并确定这些工具的测量-重测信度。方法从美国一所1级体育大学招募87名健康运动员，在配有100 hz眼动追踪镜的封闭式旋转椅系统中完成30分钟的前庭眼动测试。43个人完成了两次电池测试。目前诊断为脑震荡的28人也完成了电池测试。所有参与者年龄在18至24岁之间。双变量统计检验检验各组间得分的差异，并计算类内系数以检验信度。结果脑震荡个体的跳高、视觉和双任务反应时间显著延长，跳高准确性显著降低。在光动力学反射增益方面没有差异，但很少有脑震荡个体能够耐受这项任务。反应时延迟和光动力学增益表现出中等的重测信度。平滑追踪任务和跳变精度表现出较差的重测信度。结论：跳眼潜伏期是脑震荡后最敏感的动眼肌功能变化，且随时间变化是可靠的。在脑震荡组，跳跃性准确性明显较低，但重测信度较差。光动力学增益可能值得更多的研究，因为它在脑震荡中具有较高的重测信度和症状激发，尽管没有显示出组间的显著差异。
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.