Examining Postconcussion Symptoms of Dizziness and Imbalance on Neurocognitive Performance in Collegiate Football Players

Honaker, Julie A.; Lester, Houston F.; Patterson, Jessie N.; Jones, Sherri M.

doi:10.1097/mao.0000000000000432

Cited by 5 publications

(6 citation statements)

References 34 publications

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“…Although the assessment of memory function is typically included in CNPs (to varying degrees) and frequently was used in our study samples, information on the detailed assessment of other potentially relevant symptoms such as headache, fogginess or dizziness was very limited. Only two studies added symptom-specific questionnaires,41 48 although it is well known that specific symptoms such as headache,67 dizziness54 or fogginess42 influence some neurocognitive components and symptoms impact on recovery 19 57. Greater emphasis is needed using symptom-specific diagnostic approaches for the evaluation of these frequently occurring symptoms, particularly in cases of prolonged or atypical recovery 2 45 67–69…”

Section: Discussionmentioning

confidence: 99%

What domains of clinical function should be assessed after sport-related concussion? A systematic review

Feddermann-Demont¹,

Echemendía²,

Schneider³

et al. 2017

Br J Sports Med

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The overall quality of the studies was considered low. The absence of an objective, gold standard criterion makes the accurate diagnosis of SRC challenging. Current approaches tend to emphasise cognition, symptom assessment and postural stability with less of a focus on other domains of functioning. We propose that the clinical assessment of SRC should be symptom based and interdisciplinary. Whenever possible, the SRC assessment should incorporate neurological, vestibular, ocular motor, visual, neurocognitive, psychological and cervical aspects.

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Section: Discussionmentioning

confidence: 99%

What domains of clinical function should be assessed after sport-related concussion? A systematic review

Feddermann-Demont¹,

Echemendía²,

Schneider³

et al. 2017

Br J Sports Med

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“…7,8 ImPACT is commonly used in the context of sports to assess athletes after a head impact and was approved by the Food and Drug Administration in August 2016 as the first medical device to evaluate cognitive function after a suspected head injury. 9,10 In pre-clinical modeling of mTBI, animal models seek to mimic the clinical condition not only in terms of the pathophysiology but also replicating functional or behavioral alterations. Consequently, there are myriad behavioral assessments that pre-clinical researchers employ to evaluate cognitive functioning after mTBI (for review, see 11 ).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Touchscreen Chambers To Assess Cognition in Adult Mice: Effect of Training and Mild Traumatic Brain Injury

Nichols

Hagan

Floyd

2017

Journal of Neurotrauma

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Cognitive impairments are often experienced after a mild traumatic brain injury (mTBI). In the clinical arena, neuropsychological assessments are used frequently to detect cognitive deficits. Animal models of mTBI, however, rely on an assortment of behavioral tasks to assess cognitive outcome. Computer-based touchscreen systems have been developed for rodents and are hypothesized to offer a translational approach to evaluate cognitive function because of the similarities of tasks performed in rodents to those implemented in humans. While these touchscreen systems have been used in pre-clinical models of neurodegenerative diseases and psychiatric disorders, their use in assessing cognitive impairment after mTBI has not been investigated. We hypothesized that mTBI would result in impaired cognitive performance on touchscreen tasks, particularly those with hippocampal-based learning components, including the paired associate learning (PAL) task and the location discrimination (LD) task. Adult male, C57BL/6 mice received a single impact-acceleration mTBI. We found that training mice before injury to perform to criteria is arduous and that performance is sensitive to many environmental variables. Despite extensive optimization and training, mice failed to perform better than chance in the PAL paradigm. Alternatively, mice demonstrated some capacity to learn in the LD paradigm, but only with the easier stages of the task. The mTBI did not affect performance in the LD paradigm, however. Thus, we concluded that under the conditions presented here, the PAL and LD touchscreen tasks are not robust outcome measures for the evaluation of cognitive performance in C57BL/6 mice after a single impact-acceleration mTBI.

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“…Our patient's extreme but nonsustained multi-directional sway exhibited during stance suggested a functional (psychogenic) balance disorder [5,9]. Whilst many patients with mTBI (and also those with functional balance disorders) will volunteer troublesome symptoms of imbalance in the absence of objective neurological deficits [10], our patient with severe TBI was unaware of his postural impairment.…”

Section: Discussionmentioning

confidence: 94%

Targeted rehabilitation reduces visual dependency and improves balance in severe traumatic brain injury: a case study

Kaski

Buttell

Greenwood

2017

Disability and Rehabilitation

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Purpose: To further understand the mechanisms underlying gait impairment following traumatic brain injury. Case report: A 58-year-old man presented with marked unsteadiness and motion sensitivity following a severe traumatic brain injury. He underwent a 6-week inpatient rehabilitation program focused on reweighting and subsequently re-integrating ascending interoceptive information, by gradual reduction of maladaptive visual fixation techniques. We report clinical neurological outcomes and measures of functional outcome, as well as an objective assessment of visual dependency (the rod and disk test) at baseline and after the rehabilitation. Results: Clinically, the patient had gait unsteadiness exacerbated by visual motion. A significant reduction in visual dependency occurred with tailored multi-disciplinary rehabilitation via gradual removal of visual fixation strategies that the patient had developed to maintain balance (t-test; p < 0.01), as well as clinical improvements in gait, balance, and functional outcome. Conclusions: We highlight the importance of visual dependency in the generation of maladaptive gait strategies following brain injury. Our data suggest assessing and treating visual dependency to be an important component of gait rehabilitation after traumatic brain injury. ä IMPLICATIONS FOR REHABILITATIONWhilst gait disturbance in TBI is multifactorial, abnormal visual dependency may be important but under-recognised component of the disorder. Visual dependency can be easily and objectively assessed by the bedside in patients using a dynamic rod and disc test. Tailored rehabilitation with gradual reduction of maladaptive visual fixation can reduce visual dependency and contribute to improved gait and balance following TBI. ARTICLE HISTORY

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Examining Postconcussion Symptoms of Dizziness and Imbalance on Neurocognitive Performance in Collegiate Football Players

Cited by 5 publications

References 34 publications

What domains of clinical function should be assessed after sport-related concussion? A systematic review

What domains of clinical function should be assessed after sport-related concussion? A systematic review

Evaluation of Touchscreen Chambers To Assess Cognition in Adult Mice: Effect of Training and Mild Traumatic Brain Injury

Targeted rehabilitation reduces visual dependency and improves balance in severe traumatic brain injury: a case study

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