The Influence of Vestibular Ocular Motor Dysfunction on Neurocognition Following Mild Traumatic Brain Injury
Article Sidebar
Main Article Content
Abstract
Background: Individuals with traumatic brain injury (TBI) are at risk of developing a number of complications, among which vestibular impairments are common. Persistent vestibular ocular motor dysfunction (VOMD) leads to impaired neurocognition and is a prognostic factor for worse symptoms and delayed recovery.
Objective: To determine the influence of vestibular ocular motor dysfunction on neurocognition following mild traumatic brain injury (mTBI).
Methods: A descriptive cross-sectional study was conducted at Lahore General Hospital. Eighty diagnosed cases of mild traumatic brain injury were recruited based on specific inclusion criteria, including a Glasgow Coma Scale score of 13-15, post-traumatic amnesia of less than 24 hours, loss of consciousness for less than 30 minutes, and a positive Vestibular Ocular Motor Screening (VOMS) Score. Exclusion criteria included patients with open head injuries, fractures, or other medical conditions such as epilepsy and cerebrovascular diseases. Neurocognition was assessed using the Montreal Cognitive Assessment (MoCA). Data were analyzed using SPSS version 25, with descriptive statistics calculated for demographic variables and inferential statistics used to examine the relationship between VOMD and neurocognitive impairment.
Results: The mean age of the patients was 21.21 ± 2.103 years. Out of the 80 participants, 52 (65%) had impaired neurocognition, while 28 (35%) had normal neurocognition. The MoCA subscales of visuospatial abilities, attention, and abstraction were significantly related to impaired neurocognition. The VOMS subscales, including VOR-Vertical, VOR-Horizontal, and Visual Motion Sensitivity Test, showed significant associations with neurocognitive impairment.
Conclusion: The majority of patients with mild traumatic brain injury exhibited poor neurocognition when the vestibular-ocular motor system was compromised. These findings highlight the importance of incorporating comprehensive vestibular therapy in the treatment of mTBI patients to prevent long-term complications and ensure early recovery.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Savitsky B, Givon A, Rozenfeld M, Radomislensky I, Peleg K. Traumatic Brain Injury: It Is All About Definition. Brain Inj. 2016;30(10):1194-200.
DeRight J. Mild Traumatic Brain Injury. Essential Neuropsychology: A Concise Handbook for Adult Practitioners. 2022. p. 185-92.
Voormolen DC, Polinder S, Von Steinbuechel N, Vos PE, Cnossen MC, Haagsma JA. The Association Between Post-Concussion Symptoms and Health-Related Quality of Life in Patients with Mild Traumatic Brain Injury. Inj. 2019;50(5):1068-74.
Langlois JA, Rutland-Brown W, Wald MM. The Epidemiology and Impact of Traumatic Brain Injury: A Brief Overview. J Head Trauma Rehabil. 2006;21(5):375-8.
Wright DW, O'Brien NP, Mullen MT, et al. Predicting Neurocognitive and Functional Recovery Following Mild Traumatic Brain Injury. Brain Inj. 2017;31(1):1-10.
Dean PJ, O'Neill D, Sterr A. Post-Concussion Syndrome: Prevalence After Mild Traumatic Brain Injury in Comparison with a Sample Without Head Injury. Brain Inj. 2012;26(1):14-26.
Schneider KJ. Concussion-Part I: The Need for a Multifaceted Assessment. Musculoskelet Sci Pract. 2019;42:140-50.
Wallace B, Lifshitz J. Traumatic Brain Injury and Vestibulo-Ocular Function: Current Challenges and Future Prospects. Eye Brain. 2016;8:153-9.
Glendon K, Blenkinsop G, Belli A, Pain M. Does Vestibular-Ocular-Motor (VOM) Impairment Affect Time to Return to Play, Symptom Severity, Neurocognition and Academic Ability in Student-Athletes Following Acute Concussion? Brain Inj. 2021:1-10.
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(4)
Hitier M, Besnard S, Smith PF. Vestibular Pathways Involved in Cognition. Front Integr Neurosci. 2014;8:59.
Yorke AM, Smith L, Babcock M, Alsalaheen B. Validity and Reliability of the Vestibular/Ocular Motor Screening and Associations with Common Concussion Screening Tools. Sports Health. 2017;9(2):174-80.
Kontos AP, Monti K, Eagle SR, Thomasma E, Holland CL, Thomas D, et al. Test-Retest Reliability of the Vestibular Ocular Motor Screening (VOMS) Tool and Modified Balance Error Scoring System (mBESS) in US Military Personnel. J Sci Med Sport. 2021;24(3):264-8.
Debert CT, Stilling J, Wang M, Sajobi T, Kowalski K, Benson BW, et al. The Montreal Cognitive Assessment as a Cognitive Screening Tool in Athletes. Can J Neurol Sci. 2019;46(3):311-8.
Freitas S, Simoes MR, Marôco J, Alves L, Santana I. Construct Validity of the Montreal Cognitive Assessment (MoCA). J Int Neuropsychol Soc. 2012;18(2):242-50.
Sinnott AM, Elbin R, Collins MW, Reeves VL, Holland CL, Kontos AP. Persistent Vestibular-Ocular Impairment Following Concussion in Adolescents. J Sci Med Sport. 2019;22(12):1292-7.
Corwin DJ, Wiebe DJ, Zonfrillo MR, Grady MF, Robinson RL, Goodman AM, et al. Vestibular Deficits Following Youth Concussion. Pediatrics. 2015;166(5):1221-5.
Frenette L, Tinawi S, Correa J, Alturki A, LeBlanc J, Feyz M, et al. Early Detection of Cognitive Impairments with the Montreal Cognitive Assessment in Patients with Uncomplicated and Complicated Mild Traumatic Brain Injury. Brain Inj. 2019;33(2):189-97.
Brown CN, Guskiewicz KM, Bleiberg J. Athlete Characteristics and Outcome Scores for Computerized Neuropsychological Assessment: A Preliminary Analysis. J Athl Train. 2007;42(4):515-23.
Bruce JM, Echemendia RJ. History of Multiple Self-Reported Concussions Is Not Associated with Reduced Cognitive Abilities. J Clin Exp Neuropsychol. 2009;64(1):100-6.