Journal of Ophthalmic and Vision Research

ISSN: 2008-322X

The latest research in clinical ophthalmology and the science of vision.

Elevated Smooth Pursuit Gain in Collegiate Athletes with Sport-related Concussion Immediately Following Injury

Published date: Jun 21 2024

Journal Title: Journal of Ophthalmic and Vision Research

Issue title: Apr–Jun 2024, Volume 19, Issue 2

Pages: 227–234

DOI: 10.18502/jovr.v19i2.12348

Authors:

Madison Taylormadisontaylor@nevada.unr.eduSchool of Public Health, University of Nevada, Reno, NV, USA

Marian Berryhillmberryhill@unr.eduDepartment of Psychology, University of Nevada, Reno, NV, USA

Dennis Mathewdennismathew@unr.eduDepartment of Biology, University of Nevada, Reno, NV, USA

Nicholas G Murraynicholasmurray@unr.eduSchool of Public Health, University of Nevada, Reno, NV, USA

Abstract:

Purpose: Although there is evidence that sport-related concussion (SRC) affects oculomotor function and perceptual ability, experiments are often poorly controlled and are not replicable. This study aims to test the hypothesis that there are decreased values when assessing oculomotor impairment indicating poorer performance in SRC patients.

Methods: Fifteen DI athletes presenting with SRC (7 females, 8 males) and 15 student volunteers (CON) (12 females, 3 males) completed a dynamic visual acuity (DVA) task that involved answering the direction of a moving stimulus (Landolt C) while wearing a head-mounted binocular eye tracker. There were 120 trials total with 60 trials presenting at 30º per second and 60 presenting at 90º per second. Various eye movement measurements, including horizontal smooth pursuit eye movements (SPEM) gain and saccadic peak velocity, were analyzed between groups using univariate ANOVAs. Saccade count in SPEM trials, accuracy, and vision were analyzed using Kruskal–Wallis tests.

Results: There was no statistical difference in saccadic peak velocity: SRC = 414.7 ± 42º/s, CON = 406.6 ± 40.6º/s. A significant difference was found between SRC patients and healthy controls in horizontal SPEM gain (SRC = 0.9 ± 0.04, CON = 0.86 ± 0.03, F(1,28) = 7.243, P = 0.012) indicating that patients demonstrated compensatory eye movements when tracking the target. There were significantly more saccades in all SPEM trials (P = 0.001).

Conclusion: SRC oculomotor deficits manifest as elevated horizontal SPEM gain when assessed within 48 hours of injury and compared to healthy controls within the same age range. SRC demonstrates altered oculomotor ability. While accurate in tracking a stimulus, SRC patients may conduct less controlled eye movements.

Keywords: Concussion, mTBI, Oculomotor Control, Visual Acuity

References:

1. Theadom A, Starkey NJ, Dowell T, Hume PA, Kahan M, McPherson K, et al.; BIONIC Research Group. Sports-related brain injury in the general population: an epidemiological study. J Sci Med Sport 2014;17:591–596.

2. McInnes K, Friesen CL, MacKenzie DE, Westwood DA, Boe SG. Mild traumatic brain injury (mTBI) and chronic cognitive impairment: A scoping review. PLoS One 2017;12:e0174847.

3. Sharp DJ, Jenkins PO. Concussion is confusing us all. Pract Neurol 2015;15:172–186.

4. Corwin DJ, Wiebe DJ, Zonfrillo MR, Grady MF, Robinson RL, Goodman AM, et al. Vestibular deficits following youth concussion. J Pediatr 2015;166:1221–1225.

5. Eagle SR, Ferris LM, Mucha A, Sinnott A, Marchetti G, Trbovich A, et al. Minimum detectable change and false positive rates of the vestibular/ocular motor screening (VOMS) tool: An NCAA-DoD care consortium analysis. Brain Inj 2021;35:1563–1568.

6. Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman- Enseki C, DeWolf RM, et al. A brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med 2014;42:2479–2486.

7. Kneavel M, Ernst W, Brandsma L. Collegiate athletes’ perceptions of the culture of concussion reporting. J Am Coll Health 2021;69:435–443.

8. Hirad A, Bazarian J, Merchant-Borna K, Garcea F, Heilbronner S, Paul D, et al. A common neural signature of brain injury in concussion and subconcussion. Sci Adv 2019;5:8.

9. Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: A retrospective analysis. Optometry 2007;78:155–161.

10. Hunt AW, Mah K, Reed N, Engel L, Keightley M, Reed N, et al. Oculomotor-based vision assessment in mild traumatic brain injury: A systematic review. J Head Trauma Rehabil 2016;31:252–261.

11. Hunfalvay M, Murray NP, Mani R, Carrick FR. Smooth pursuit eye movements as a biomarker for mild concussion within 7-days of injury. Brain Inj 2021;35:1682–1689.

12. Murray NG, Szekely B, Islas A, Munkasy B, Gore R, Berryhill M, et al. Smooth pursuit and saccades after sport-related concussion. J Neurotrauma 2020;37:340– 346.

13. Tyuma I. [Interaction of hemoglobin with red cell membrane]. Tanpakushitsu Kakusan Koso 1987;32:537– 541.

14. Maruta J, Jaw E, Modera P, Rajashekar U, Spielman LA, Ghajar J. Frequency responses to visual tracking stimuli may be affected by concussion. Mil Med 2017;182 S1:120–123.

15. Suh M, Kolster R, Sarkar R, McCandliss B, Ghajar J; Cognitive and Neurobiological Research Consortium. Deficits in predictive smooth pursuit after mild traumatic brain injury. Neurosci Lett 2006;401:108–113.

16. Murray NG, D’Amico NR, Powell D, Mormile ME, Grimes KE, Munkasy BA, et al. ASB clinical biomechanics award winner 2016: Assessment of gaze stability within 24-48 hours post-concussion. Clin Biomech 2017;44:21–27.

17. Murray NG, Ambati VN, Contreras MM, Salvatore AP, Reed-Jones RJ. Assessment of oculomotor control and balance post-concussion: A preliminary study for a novel approach to concussion management. Brain Inj 2014;28:496–503.

18. Johnson B, Hallett M, Slobounov S. Follow-up evaluation of oculomotor performance with fMRI in the subacute phase of concussion. Neurology 2015;85:1163–1166.

19. Danna-Dos-Santos A, Mohapatra S, Santos M, Degani AM. Long-term effects of mild traumatic brain injuries to oculomotor tracking performances and reaction times to simple environmental stimuli. Sci Rep 2018;8:4583.

20. Heitger MH, Jones RD, Macleod AD, Snell DL, Frampton CM, Anderson TJ. Impaired eye movements in postconcussion syndrome indicate suboptimal brain function beyond the influence of depression, malingering or intellectual ability. Brain 2009;132:2850–2870.

21. DiCesare CA, Kiefer AW, Nalepka P, Myer GD. Quantification and analysis of saccadic and smooth pursuit eye movements and fixations to detect oculomotor deficits. Behav Res Methods 2017;49:258– 266.

22. Cifu DX, Wares JR, Hoke KW, Wetzel PA, Gitchel G, Carne W. Differential eye movements in mild traumatic brain injury versus normal controls. J Head Trauma Rehabil 2015;30:21–28.

23. Nicholas G. Murray, Ryan Moran, Arthur Islas, Phillip Pavilionis, Brian Szekely, Sushma Alphonsa, et al. Sportrelated concussion adopt a more conservative approach to straight path walking and turning during tandem gait. J Clin Transl Res 2021;7:4.

24. Pavilionis P, Adhanom IB, Moran R, Taylor MR, Murray NG. Virtual reality application for vestibular/ocular motor screening: Current clinical protocol versus a novel prototype. Sports Health 2024;16:407–413. https://doi. org/10.1177/19417381231163158

25. Bach M. The Freiburg Visual Acuity Test-variability unchanged by post-hoc re-analysis. Graefes Arch Clin Exp Ophthalmol 2007;245:965–971.

26. Holmqvist K, Andersson R. Eye tracking: A comprehensive guide to methods, paradigms, and measures. 2nd ed. CreateSpace Independent Publishing Platform; 2017.

27. Otero-Millan J, Troncoso XG, Macknik SL, Serrano- Pedraza I, Martinez-Conde S. Saccades and microsaccades during visual fixation, exploration, and search: Foundations for a common saccadic generator. J Vis 2008;8:21.1–18.

28. Blower DJ. Determining visual acuity thresholds: A simulation study of stimulus presentation strategies. Naval Aerospace Medical Research Lab Pensacola FL; 1981. https://apps.dtic.mil/sti/citations/ADA111821

29. Giza CC, Hovda DA. The new neurometabolic cascade of concussion. Neurosurgery 2014;75:S24–33.

30. Heitger MH, Anderson TJ, Jones RD, Dalrymple-Alford JC, Frampton CM, Ardagh MW. Eye movement and visuomotor arm movement deficits following mild closed head injury. Brain 2004;127:575–590.

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