title: Visual-vestibular processing deficits in mild traumatic brain injury.
abstract: The search for reliable and valid signs and symptoms of mild traumatic brain injury (mTBI), commonly synonymous with concussion, has lead to a growing body of evidence that individuals with long-lasting, unremitting impairments often experience visual and vestibular symptoms, such as dizziness, postural and gait disturbances.
  
  
  
  Investigate the role of visual-vestibular processing deficits following concussion.
  
  
  
  A number of clinically accepted vestibular, oculomotor, and balance assessments as well as a novel virtual reality (VR)-based balance assessment device were used to assess adults with post-acute concussion (n = 14) in comparison to a healthy age-matched cohort (n = 58).
  
  
  
  Significant between-group differences were found with the VR-based balance device (p = 0.001), with dynamic visual motion emerging as the most discriminating balance condition. The symptom reports collected after performing the oculomotor and vestibular tests: rapid alternating horizontal eye saccades, optokinetic stimulation, and gaze stabilization, were all sensitive to health status (p < 0.05), despite the absence of oculomotor abnormalities being observed, except for near-point convergence. The BESS, King-Devick, and Dynamic Visual Acuity tests did not detect between-group differences.
  
  
  
  Postural and visual-vestibular tasks most closely linked to spatial and self-motion perception had the greatest discriminatory outcomes. The current findings suggest that mesencephalic and parieto-occipital centers and pathways may be involved in concussion.
authors.affiliation: Department of Physical Therapy, Neuromotor Sciences Program, Temple University, Philadelphia, PA, USA.|Department of Bioengineering, Temple University, Philadelphia, PA, USA.
authors.forename: W G
authors.initials: WG
authors.lastname: Wright
authors.affiliation: Department of Kinesiology, Temple University, Philadelphia, PA, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Tierney
authors.affiliation: Department of Physical Therapy, Neuromotor Sciences Program, Temple University, Philadelphia, PA, USA.|Department of Athletic Training, East Stroudsburg University, East Stroudsburg, PA, USA.
authors.forename: J
authors.initials: J
authors.lastname: McDevitt
mesh_terms: D001924:Brain Concussion / Q000150:complications / Q000523:psychology; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000523:psychology*; D003290:Convergence, Ocular; D004244:Dizziness / Q000150:complications / Q000523:psychology; D005260:Female; D020233:Gait Disorders, Neurologic / Q000150:complications / Q000523:psychology; D006801:Humans; D008297:Male; D015840:Oculomotor Nerve Diseases / Q000209:etiology / Q000503:physiopathology; D004856:Postural Balance; D011698:Pursuit, Smooth; D012027:Reflex, Vestibulo-Ocular; D012438:Saccades; D015837:Vestibular Diseases / Q000209:etiology* / Q000523:psychology*; D014724:Vestibular Function Tests; D000076142:Virtual Reality; D014786:Vision Disorders / Q000209:etiology* / Q000523:psychology*; D014792:Visual Acuity; D055815:Young Adult
keywords: Key words: Concussion; near point convergence; optokinetic stimulation; posture; virtual reality