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Summary of November Topic: Concussion

The November topic for abstract of the week was Concussion. The first article looked to examine the reasoning behind why there is a difference in outcome measures between women and men after a mild TBI. It was seen that women had worse functional outcome measures 6 months after injury and wanted to investigate if this was due to psychiatric history, gender related sociodemographic variables, or by care pathways. There were 1842 men and 1022 women that were included where natural effects models were used to look at the effect of gender on the outcomes. It was shown that the worse outcomes that were seen in women were partly due to psychiatric history and not explained by the other mentioned outcomes. (1)

The next article looked to determine the discriminative validity of Vestibular/ Ocular Motor Screening (VOMS) item scores and overall VOMS score for identifying college athletes in the first few days following a sports-related concussion. 285 athletes who were concussed and 285 healthy controls completed the VOMS within 3 days of injury. It was shown that if the vertical saccades score is greater than or equal to 1 and if the horizontal vestibular/ ocular reflex is greater than or equal to 2 that these were the best discriminates to determine concussion from control. Near point of convergence did not significantly show concussion from control group. This shows that individual VOMS items and overall VOMS scores are useful in revealing concussion in collegiate athletes within 3 days of injury and can be used by clinicians to help identify concussion. (2)

The next article looked to examine the effectiveness of near point of convergence testing following concussion compared to previous measures before concussion and to look at the effectiveness of vision therapy on correcting near point of convergence. There was moderate evidence found that patients do have impaired near point convergence up to several months post-concussion, and there was low level evidence shown that the impairments can be treated with vision therapy. (3)

The last article looked to examine the relationship between risk factors and vestibular-oculomotor outcomes after sport-related concussion and to see if there was any association between the two. 85 athletes were assessed where they completed a clinical interview, history questionnaire, symptom inventory, and a VOMS screening. It was found that female sex, on-field dizziness, fogginess, and post-traumatic migraine symptoms including headache, nausea, light sensitivity, and noise sensitivity were predictive of experiencing vestibular-oculomotor symptoms or impairment after a sport- related concussion. (4)

1. Mikolic A, Oude Groeniger J, Zeldovich M, Wilson L, Roeters van Lennep JE, van Klaveren D, Polinder S. Explaining outcome differences between men and women following mild traumatic brain injury. J Neurotrauma. 2021 Oct 7. doi: 10.1089/neu.2021.0116. Epub ahead of print. PMID: 34617454.

2. Anthony P Kontos 1 2, Shawn R Eagle 1 2, Gregory Marchetti 3 2, . Discriminative Validity of Vestibular Ocular Motor Screening in Identifying Concussion Among Collegiate Athletes: A National Collegiate Athletic Association-Department of Defense Concussion Assessment, Research, and Education Consortium Study. Am J Sports Med. 2021 Jul;49(8):2211-2217.

3. Santo AL, Race ML, Teel EF. Near Point of Convergence Deficits and Treatment Following Concussion: A Systematic Review. J Sport Rehabil. 2020 Nov 1;29(8):1179-1193. doi: 10.1123/jsr.2019-0428. Epub 2020 Mar 4

4. Womble MN, McAllister-Deitrick J, Marchetti GF, Reynolds E, Collins MW, Elbin RJ, Kontos AP. Risk Factors for Vestibular and Oculomotor Outcomes After Sport-Related Concussion. Clin J Sport Med. 2021 Jul 1;31(4):e193-e199. doi: 10.1097/JSM.0000000000000761.

Click HERE for the Archived Monthly Summaries of Abstract of the week!

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