Category: Brain Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Neuroplasticity (includes neuroscience)
To examine if gaze stability deficits persist for at least one year after a concussion. A secondary objective was to examine the relationship between gaze stability, sleep, and psychological symptoms.
Design : Cross-sectional comparison study
Participants (or Animals, Specimens, Cadavers) :
Seventeen students (mean age 23.35 ± 1.3 years) with a history of 1-9 concussions (mean duration since last concussion 4.4 ± 1.9 years) and 17 age and sex-matched controls.
Main Outcome Measure(s) :
1. Gaze stability: Loss of visual acuity with head movements determined by the Dynamic Visual Acuity (DVA) test, and maximum velocity of head movement while maintaining a stable gaze measured by the Gaze stabilization test (GST) (in the yaw and pitch planes), 2. Pittsburgh Sleep Quality Index (PSQI), 3. Epworth Sleepiness Scale (ESS), 4. Depression and Anxiety Stress Scale-21 (DASS-21).
Individuals with concussion showed more DVA loss in the pitch plane (p=0.04) compared to controls. PSQI (p = 0.01), ESS (p = 0.01), and DASS-21 (p = 0.02) scores were higher in concussed compared to controls. Greater loss of DVA in the pitch plane was correlated with the PSQI (r = 0.43, p = 0.01) and the ESS (r = 0.41, p = 0.02), DVA loss in the yaw plane correlated with number of concussions (r = 0.4, p = 0.019). Decreased velocity on the GST in the yaw plane was correlated with the PSQI (r = -0.4, p = 0.01) and the ESS (r = -0.49, p = 0.003), GST in the pitch plane was correlated with the ESS (r= - 0.5, p = 0.02).
Gaze instability, impaired sleep quality, and increased daytime sleepiness persist long term after concussion injury. Number of concussions sustained may affect continued symptoms.
Linda D'Silva– Clinical Assistant Professor, Director of the Vestibular and Balance Rehabilitation Lab, University of Kansas Medical Center, Kansas City, Kansas
Catherine Siengsukon– Associate Professor, Director of Sleep, Health & Wellness Lab, Physical Therapy & Rehab Science Dept , University of Kansas Medical Center, Kansas City, Kansas
Hannes Devos– Assistant Professor, University of Kansas Medical Center, Kansas City, Kansas