Oculomotor Disturbances Persist in Patients With Mild Brain Injury

Persistent sensorimotor impairment and disturbed oculomotor functioning were identified among adults post mild traumatic brain injury (mTBI), according to findings published in the Archives of Physical Medicine and Rehabilitation.

Researchers conducted an observational cohort study to determine if adults 4 weeks to 6 months following mTBI have sensorimotor impairments compared with healthy controls. It also aimed to establish whether impairments were evident, irrespective of participant-perceived absence of symptoms. Study participants included individuals aged 18 to 60 years (N=113). Groups consisted of participants 4 weeks to 6 months post mTBI who considered themselves asymptomatic (asymp, n=35), post-mTBI patients who considered themselves symptomatic (symp, n=37), and healthy controls (n=39). Outcome measures included assessments of oculomotor functioning, vestibulo-ocular reflex (VOR) control, balance, single and dual task tandem walk (TTW-S, TTW-D), and vestibular positional testing.

Poorer balance and tandem walk performance, and a higher frequency of positive oculomotor, VOR, and vestibular positional tests were evident in the mTBI group compared with the control group. In 53.7% of the mTBI group, ≥2 positive oculomotor findings were observed, compared with 10.8% of controls. Anterior posterior sway increased significantly (mean difference (MD) 9.73, 95% CI 0.94, 18.52), along with time to complete single tandem and dual tandem walks (MD 1.29 CI -0.30, 2.88, and MD 6.33 CI 6.34, 6.36, respectively). 

Researchers observed sensorimotor disturbances in all mTBI participants, regardless of reported ongoing symptoms. Both symptomatic and asymptomatic subgroups demonstrated more positive OKN and VORS findings and had a higher proportion of participants with ≥ 2 positive oculomotor findings.

Study limitations include a possibility of type I error due to the number of tests, and the fact that the data collecting investigator was not blind to participants’ conditions.

Reference

Galea O, O’Leary S, Williams K, Phty M, Treleaven J. An investigation of sensorimotor impairments in individuals 4 weeks to 6 months following mild traumatic brain injury. Arch Phys Med Rehabil. Published online November 30, 2021 doi:10.1016/j.apmr.2021.10.029