Changes in saccadic eye movement and memory function after mild closed head injury in children

Abstract

ABBREVIATIONS BRIEFBehavior Rating Inventory of Executive Function ImPACT Immediate post-concussion assessment and cognitive testing mCHI Mild closed head injury mTBI Mild traumatic brain injury Peabody Picture Vocabulary Test, 4th edition AIM The aim of this study was to determine whether volitional saccadic impairments are present in children with mild closed head injury (mCHI) and whether these deficits are predictive of ongoing cognitive impairment.METHOD We analysed a sample of 26 children with mCHI (20 males, 6 females; mean age 13y 1mo, SD 2y) and 29 age-matched comparison children (20 males, 9 females; mean age 12y 2mo, SD 2y). Participants completed a battery of saccadic eye movement tasks and a set of computer-based cognitive tasks at three time points: within 2 weeks of mCHI, and at 3 months and 6 months. RESULTSThe group with mCHI made fewer errors on the antisaccade task at the first time point and showed increased latencies on prosaccades, correct antisaccades, and corrected antisaccade errors at the third time point (6mo). The group with mCHI also showed poorer performance on the cognitive tasks assessing memory.INTERPRETATION Even very mild, uncomplicated mCHI in children may persistently affect aspects of executive control and visual processing.Mild closed head injury (mCHI), or mild traumatic brain injury (mTBI), occurs when a blow to the head or a forceful motion of the head leads to brief loss of consciousness (<30min) or an alteration in mental state (e.g. confusion or disorientation), or any loss of memory for events before or after the incident. 1 The use of mCHI instead of mTBI does not explicitly imply the presence of brain injury. Although information on mTBI in children is limited, a recently completed prospective population-based study of 0-to 17-year-olds in Sweden yielded an annual incidence of 468 per 100 000.2 Evidence suggests that the prognosis after mTBI is good for most children; however, recent studies have observed that a significant proportion of these children experience ongoing problems. Hawley et al. 3 reported frequent behavioural, emotional, memory, and attention problems in 10% to 18% of children with mTBI, and personality change in 21%. Adults with mTBI often demonstrate difficulties with attention and working memory, and speed of processing (see Frencham et al. 4 for a meta-analysis). Research investigating the cognitive problems experienced by children with mTBI, however, is limited, with highly variable findings between studies. Anderson et al. 5 reported intact memory capacity over the course of both short-and long-term recovery after paediatric mTBI. Ponsford et al. 6 reported no impairment on a range of measures, including memory, attention, and processing speed at 1 week and 3 months after injury. However, Levin et al. 7 identified that children with 'complicated' mTBI, whose computed tomography (CT) revealed brain pathophysiology complications, had significantly poorer episodic memory and slower cognitive processing at short-and long-term follow-u...

Memory and the hippocampal formation following pediatric traumatic brain injury

“…Historically, decreased memory function in TBI populations has been reported to reflect deficits in monitoring and control processes that result from damage sustained to PFC regions (Di Stefano et al, 2000). Considering that maturation of PFC continues into early adulthood and that PFC development mediates age-related increase in memory-related monitoring and control processes (Ofen, 2012;Ofen, Chai, Schuil, Whitfield-Gabrieli, & Gabrieli, 2012), TBI-related insult to PFC during childhood likely results in long-term deficits in memory functioning (Phillipou, Douglas, Krieser, Ayton, & Abel, 2013). However, in addition to deficits related to damage to PFC, there is growing evidence that the hippocampal formation is also adversely affected by TBI (Ariza et al, 2006;Tasker et al, 2005;Wilde et al, 2007).…”

Cerebral Visual Impairment in Children

“…Impairment of convergence can occur but commonly resolves spontaneously (Poggi et al 2000 ;Barlow et al 2005 ;Kedar et al 2006 ). Changes in volitional saccadic eye movements may be present after mild closed head injury in children, which may persistently impair visual processing (Phillipou et al 2014 ). The spectrum of severity ranges from total loss of vision, to any degree of impairment of visual acuity and visual fi eld loss, through to visual perceptual dysfunction, notably in our experience, the typical pattern of 'dorsal stream dysfunction' due to bilateral posterior parietal dysfunction, culminating in impaired visual search, which may be associated with impaired visual guidance of movement.…”

Antisaccadic Eye Movements Are Correlated with Corpus Callosum White Matter Mean Diffusivity, Stroop Performance, and Symptom Burden in Mild Traumatic Brain Injury and Concussion

“…Antisaccade latency returns to normal after 1 week post-mTBI ( 19 , 20 ), but accuracy differences have been documented up to few months postinjury ( 20 ). Some studies have shown that antisaccade accuracy appears to be impaired in the acute stages, with patients making more errors than controls ( 19 – 21 ); others indicate better performance ( 22 ). Only one study was found to relate acute antisaccade performance to neuroimaging, and the focus was mainly on functional performance ( 21 ).…”