Assessment of Anti-Saccades Within 24 to 48 Hours Post-Concussion

Georgia Southern University

Digital Commons@Georgia Southern

Georgia Southern University Research Symposium

Apr 16th, 9:30 AM - 10:30 AM

Assessment of Anti-Saccades Within 24 to 48

Hours Post-Concussion

Nathan D'Amico

Georgia Southern University, [email protected]

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Recommended Citation

D'Amico, Nathan, "Assessment of Anti-Saccades Within 24 to 48 Hours Post-Concussion" (2016). Georgia Southern University Research

Symposium. 47.

Assessment of Anti-Saccades

Within 24 to 48 Hours

Post-Concussion

Nathan D’Amico, ATC

Introduction

•

~90% of concussions involve oculomotor

dysfunction

• ~ 30 areas of the brain and 8 of the 12 cranial nerves are responsible for vision

•

Saccade deficits (anti-saccades)

are the most common type of

Saccadic Eye Movements

Saccades

• Rapid eye movements

that bring a fixed point or area of interest (AOI) into the center of sight (Johnson, 2014)

• Important for navigating

safely through the environment

Anti-Saccades

• Reflexive saccade away

from the fixed point or area of interest (AOI) (DeHaan, 2007)

• Inhibitory signal

consistently present as a cognitive rule that the participant must apply

Accessing Saccades

•

Saccadic eye movements are readily recorded,

quantifiable, and neural substrates are understood

(Phillipou, 2013)

•

Anti-saccades may provide a fast, accurate, and

reliable way to screen for concussion

• May provide important information regarding the health

and integrity of the brain post-concussion

Purpose

•

To investigate anti-saccades (involuntary gaze

deviations) between athletes post-concussion (PC)

and matched controls (MC) during a dynamic,

environmentally relevant task

1) Anti-saccades

2) Duration of anti-saccades

Subjects

•

10 collegiate Division I athletes with a diagnosed

concussion (PC)

• PC tested within 24 to 48 hours of diagnosis • PC matched with healthy controls (MC)

• MC matched based on position, gender, height, and

Participation Criteria

Inclusion Criteria

• Ages 18-30

• NCAA Division I athletes and

cheerleaders • No musculoskeletal injury • No history of psychiatric illness or seizures • Documented concussion (PC)

Exclusion Criteria

• Documented head injury

within past 12 months

• LOC within past 6 months • Diagnosis of learning

disorders or ADHD

• Involved in NCAA sporting

Design

•

Exploratory research

•

Prospective cohort

•

Testing at one time point

• 24 to 48 hours post-concussion

• WiiFit Soccer Heading game using ASL Eye Tracker

•

3 trials (1 practice and 2 collection)

Procedures

•

WiiFit Soccer Heading game

• Dynamic, environmentally relevant task

• Athletes sway their body in a ML direction to head soccer

ball coming down center, left, and right of the screen

*NOT ACTUALLY HEADING SOCCER BALLS*

• Athletes instructed to look at the center of the screen

where the soccer balls are being kicked from (AOI)

• Each gaze deviation away from where the balls are

Procedures Cont.

•

Applied Science Laboratories (ASL) Eye Tracker

• Applied Science Laboratory Desktop 7 Eye Tracking

System (240 Hz)

• Communicates with Vicon Nexus 1.8.5 8-camera motion

capture system (Eye-Head Integration)

Creates the 3 AOIs (center, left, and right)

• Worn by athletes while playing the WiiFit Soccer Heading

Concussed Healthy

Statistical Analyses

•

One-Way ANOVA

• Creates the 3 AOIs (center, left, and right) • PC vs MC

•

N = 10 per group (PC and MC)

• G*Power: 8-10

One-Way ANOVA

Group N Mean P-Value

Anti-Saccades PC 10 11.85 <.001

MC 10 2.00

Anti-Saccade Duration PC 10 8.90 .003

MC 10 0.45

Average Anti-Saccade Duration PC 10 0.83 .002

2 4 6 8 10 12 14 Nu mber of An ti-Saccades (# )

Anti-Saccades

0 1 2 3 4 5 6 7 8 9 10 Tot al D ur ati on o f An ti-Saccade s (s )

Anti-Saccade Duration

0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Av g. D ur at ion of An ti-Saccades (s )

Average Anti-Saccade Duration

Conclusion

•

Anti-Saccades are more prevalent in PC than MC

• Anti-Saccades (p=.022)

• Duration of Anti-Saccades (p=.020)

• Average Duration of Anti-Saccades (p=.000)

•

PC are unable to appropriately control their gaze

during an environmentally relevant dynamic task

• Potential oculomotor impairment 24-48 hours post injury

References

1) Thiagarajan P, Ciuffreda KJ, Ludlam DP. Vergence dysfunction in mild traumatic brain injury (mTBI): a review.

Ophthalmic & Physiological Optics: The Journal Of The British College Of Ophthalmic Opticians (Optometrists). 2011;31(5):456-468.

2) Ciuffreda KJ, Kapoor N, Rutner D, et al. Occurrence of oculomotor dysfunctions in acquired brain injury: a

retrospective analysis. Optometry. 2007; 78: 155-161.

3) Cifu DX, Wares JR, Hoke KW, et al. Differential eye movements in mild traumatic brain injury versus normal controls. J Head trauma Rehabil. 2015; 30: 21-28.

4) Johnson B, Zhang K, Hallett M, Slobounov S. Functional neuroimaging of acute oculomotor deficits in concussed athletes. Brain Imaging And Behavior. 2014.

5) Ciuffreda KJ, Ludham D, Thiagarajan P. Oculomotor diagnostic protocol of mTBI population. Am Optom Ass. 2011; 1-3

6) DeHaan A, Halterman C, Langan J, et al. Cancelling Planned actions following mild traumatic brain injury.

Neuropsychologia. 2007; 406-411.

7) Mullen SJ, Yucel YH, Cusimano M, et al. Saccadic eye movements in mild traumatic brain injury: a pilot study.

Can J Neurol Sci. 2014; 41: 58-65.

8) Maruta J, Ghajar J. Detecting eye movement abnormalities from concussion. Progress In Neurological

Surgery. 2014;28:226-233.

9) Phillipou AA, Douglas J, Krieser D, et al. Changes in saccadic eye movement and memory function after mild

closed head injury in children. Develop Med Child Neuro. 2013; 337-345

10) Heitger MH, Jones RD, Anderson TJ. A new approach to predicting postconcussion syndrome after mild