Balance-Attention Interference Following Concussion

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DESCRIPTION (provided by applicant): Anthony P. Kontos, PhD, is Associate Professor and Assistant Director for Research in the UPMC Sports Medicine Concussion Program in the Department of Orthopaedic Surgery at the University of Pittsburgh. His academic background is in psychology and kinesiology. He has a Master of Science degree in exercise science, a Master of Arts in counseling psychology, and a PhD in kinesiology/sport psychology. His goal is to transition into the role of an independent investigator with the qualifications and experience necessary to design and implement translational investigations on vestibular and neuropsychological dysfunction and treatments in patients with concussion. During this K01 award, Dr. Kontos will gain experience and skills in vestibular and clinical neuropsychological testing methods. Dr. Kontos will be mentored in vestibular research methods by Dr. Furman from the Departments of Otolaryngology and Physical Therapy, and in neuropsychological research methods by Dr. Collins from the Department of Orthopaedic Surgery. Dr. Kontos will complete didactic coursework at the University of Pittsburgh in Neurobiology Systems with Dr. Simon and in the Clinical Translational Science Institute's Clinical Research certificate program. Dr. Kontos will also be mentored in directed study and consult with Dr. Carey Balaban, Professor of Otolaryngology, Neurobiology, Communication Sciences & Disorders and Bioengineering Director, Center for National Preparedness on vestibular anatomy and physiology; Dr. Neeraj Ghandi, Associate Professor of Otolaryngology on experimental and computational ocular-motor and sensory integration related vestibular function; Dr. Bill Yates, Professor of Otolaryngology on the role of the vestibular system in autonomic control; Dr. Redfern from the Departments of Bioengineering, Physical Therapy, and Otolaryngology regarding the use of attention-balance dual-task paradigms; and with Dr. Sparto regarding the acquisition and translation of balance data. During the award period, Dr. Kontos will gain the skills necessary to successfully complete the proposed research plan through a combination of coursework, directed research and clinical training, participation in professional organizations and symposia, and collaborations with his mentor and consultants. Specifically, Dr. Kontos will gain skills in assessing post-concussion vestibular dysfunction through the use of vestibular and neuropsychological assessment tools, and a novel dual-task visual reaction time/balance test paradigm. The Primary Aim of the proposed research plan is to investigate vestibular and neuropsychological dysfunction using a balance-attention dual-task paradigm among three well-defined groups of participants aged 13-20 years: 1) patients with concussion without vestibular dysfunction, 2) patients with concussion with vestibular dysfunction, and 3) healthy controls. Groups will be compared using a balance- attention dual-task paradigm that involves participants performing a visual reaction time task while standing on the ground and on a compliant foam pad. The extensive research environments and resources in both the Departments of Orthopaedic Surgery and Otolaryngology at the University of Pittsburgh will contribute significantly to the development of Dr. Kontos's career as an independent investigator focused on clinical/translational research of vestibular dysfunction in patients with concussion. The coursework in the CTSI certificate program will further enhance Dr. Kontos's ability to successfully conduct clinical/translational research involving patients with concussion and compete successfully for NIH-funding for his research. RELEVANCE The proposed study represents the first empirical investigation of a balance-attention dual-task paradigm to detect vestibular dysfunction in patients following concussion. The information from the proposed study will help inform concussion assessment and management strategies for clinicians working with this population.