Near Point of Convergence after Concussion in Children

Storey, Eileen; Master, Stephen R.; Lockyer, Julia; Podolak, Olivia E.; Grady, Matthew F.; Master, Christina L.

doi:10.1097/opx.0000000000000910

Cited by 58 publications

(36 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The current study examined the effect of previous concussion history on ocular near point of convergence (NPC) The key findings from the current study indicate that the number of previous concussions, time since last concussion, total symptom score, and total symptom severity do not appear to impact ocular NPC. This measurement was chosen because several recent studies have demonstrated that NPC increases following acute concussion [6,39,43,48], a season of high magnitude impacts in football [32], or through subconcussive head impacts induced by an acute bout of soccer heading [33]. Measurement of NPC for concussion evaluation is appealing because it is simple and quick to measure and is an indirect probe of neurological function [43].…”

Section: Discussionmentioning

confidence: 99%

“…Recent research has revealed that NPC is altered following concussion or subconcussive impacts. In particular, both blast-induced concussions in soldiers and sport-related concussions in young adults and children lead to an increased NPC during the acute and subacute post-injury stages relative to uninjured controls [6,39,43,48]. Furthermore, Kawata and colleagues [30] have demonstrated that a short period of subconcussive head impacts from 10 soccer headers leads to an increase in NPC.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A History of Concussion Does Not Lead to an Increase in Ocular Near Point of Convergence

et al. 2018

View full text Add to dashboard Cite

Ocular near point of convergence (NPC) has been shown to be sensitive to the effects of concussion and subconcussive impacts. To determine if NPC is also sensitive to a previous history of concussion, male contact-sport athletes either with (n=26) or without (n=16) a history of at least one previous concussion had their NPC assessed. The results showed that participants with a history of concussion displayed NPC values (9.4±1.6 cm) indistinguishable from those with no history of concussion (8.4±2.1 cm, t-test, p=0.09). This was the case regardless of whether 1, 2, or 3 or more concussions had occurred and despite the fact participants with concussion (mean time since last concussion: 1136 days) suffered from an increased number and severity of symptoms as assessed with the SCAT 3 (3.6±2.2 vs. 2.13±1.89 symptoms, 6.1±4.1 vs. 3.19±2.99 severity, t-test, p<0.05). Taken together, these results imply that NPC may not be a suitable tool to assess the potential long-term effects of one or more concussions over a longer time frame.: Future research using larger sample sizes is warranted to evaluate the potential dose-response relationship between number of prior concussions and NPC.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A History of Concussion Does Not Lead to an Increase in Ocular Near Point of Convergence

et al. 2018

View full text Add to dashboard Cite

show abstract

“…To the best of our knowledge, there is one study series examining fMRI activation during a oculomotor sensorimotor task ( Johnson et al, 2015a , Johnson et al, 2015b ). We chose to examine eye movement behavior due to the solid body of literature showing ocular motor performance to be one of the most robust indicators of concussion ( Balaban et al, 2016 ; Brahm et al, 2009 ; Capó-Aponte et al, 2012a , Capó-Aponte et al, 2012b ; Cifu et al, 2015 ; DeHaan et al, 2007 ; Drew et al, 2007 ; Heitger et al, 2009 , Heitger et al, 2007a , Heitger et al, 2007b , Heitger et al, 2006 , Heitger et al, 2004 ; Hoffer et al, 2017 ; Kraus et al, 2007 ; Liston et al, 2017 ; Maruta et al, 2017 ; Master et al, 2016 ; Mucha et al, 2014 ; Pearce et al, 2015 ; Samadani et al, 2015 ; Storey et al, 2017 ; Thiagarajan et al, 2011 ). Oculomotor control has been strongly linked to neural integrity ( John Leigh and Zee, 2015 ; Pierrot-Deseilligny et al, 2004 ) and tasks that assess oculomotor function are linked to a number of cognitive functions including attention, visuospatial processing, working memory, processing speed and predictive behavior ( Barnes, 2008 ; Hutton, 2008 ; John Leigh and Zee, 2015 ; Pierrot-Deseilligny et al, 2004 ; Schütz et al, 2011 ).…”

Section: Introductionmentioning

confidence: 99%

Comparing fMRI activation during smooth pursuit eye movements among contact sport athletes, non-contact sport athletes, and non-athletes

Kellar

Newman

Pestilli

et al. 2018

NeuroImage: Clinical

View full text Add to dashboard Cite

ObjectivesThough sub-concussive impacts are common during contact sports, there is little consensus whether repeat blows affect brain function. Using a “lifetime exposure” rather than acute exposure approach, we examined oculomotor performance and brain activation among collegiate football players and two control groups. Our analysis examined whether there are group differences in eye movement behavioral performance and in brain activation during smooth pursuit.MethodsData from 21 off-season Division I football “starters” were compared with a) 19 collegiate cross-country runners, and b) 11 non-athlete college students who were SES matched to the football player group (total N = 51). Visual smooth pursuit was performed while undergoing fMRI imaging via a 3 Tesla scanner. Smooth pursuit eye movements to three stimulus difficulty levels were measured with regard to RMS error, gain, and lag.ResultsNo meaningful differences were found for any of the standard analyses used to assess smooth pursuit eye movements. For fMRI, greater activation was seen in the oculomotor region of the cerebellar vermis and areas of the FEF for football players as compared to either control group, who did not differ on any measure.ConclusionGreater cerebellar activity among football players while performing an oculomotor task could indicate that they are working harder to compensate for some subtle, long-term subconcussive deficits. Alternatively, top athletes in a sport requiring high visual motor skill could have more of their cerebellum and FEF devoted to oculomotor task performance regardless of subconcussive history. Overall, these results provide little firm support for an effect of accumulated subconcussion exposure on brain function.

show abstract

“…16 The symptoms and combination of visual and cognitive deficits caused by receded NPC can result in difficulty returning to school or working, especially when completing tasks that require reading and writing. 47 Clinicians should monitor NPC throughout the recovery process. Patients with impaired NPC may particularly benefit from academic or cognitive accommodations.…”

Section: Discussionmentioning

confidence: 99%

Near Point of Convergence Deficits and Treatment Following Concussion: A Systematic Review

Santo¹,

Race²,

Teel³

2020

Journal of Sport Rehabilitation

View full text Add to dashboard Cite

Context: Convergence dysfunction following concussion is common. Near point of convergence (NPC) is a quick and easy assessment that may detect oculomotor dysfunction such as convergence insufficiency (CI), but NPC measurements are rarely reported. Convergence dysfunction is treatable in otherwise healthy patients; the effectiveness of oculomotor therapy following concussion is unclear. Objectives: The purpose of this article was to systematically review the literature and answer the following clinical questions: (1) Is performance on NPC negatively affected in patients diagnosed with a concussion compared with pre-injury levels or healthy controls? (2) In patients diagnosed with concussion, what is the effect of oculomotor/vision therapy on NPC break measurements? Evidence Acquisition: The search was conducted in CINAHL, SPORTDiscus, MEDLINE, and PubMed using terms related to concussion, mild traumatic brain injury, convergence, vision, and rehabilitation. Literature considered for review included original research publications that collected measures of NPC break in concussion patients, with a pretest–posttest comparison or comparison with a healthy control group. A literature review was completed; 242 relevant articles were reviewed, with 18 articles meeting criteria for inclusion in the review. Evidence Synthesis: Articles were categorized according to the clinical question they addressed. The patient or participant sample (number, sex, age, and health status), study design, instrumentation, or intervention used, and main results were extracted from each article. Conclusions: The authors' main findings suggest that there is a moderate level of evidence that patients have impaired NPC up to several months postconcussion, and a low level of evidence that impairments can be successfully treated with oculomotor therapy. These findings should be cautiously evaluated; the studies are limited by weak/moderate quality, small sample sizes, varied methodology, and nonrandomized treatment groups. Future research should explore factors affecting convergence postconcussion and include randomized, controlled studies to determine if performing vision therapy improves visual measures and promotes recovery.

show abstract

Near Point of Convergence after Concussion in Children

Cited by 58 publications

References 18 publications

A History of Concussion Does Not Lead to an Increase in Ocular Near Point of Convergence

A History of Concussion Does Not Lead to an Increase in Ocular Near Point of Convergence

Comparing fMRI activation during smooth pursuit eye movements among contact sport athletes, non-contact sport athletes, and non-athletes

Near Point of Convergence Deficits and Treatment Following Concussion: A Systematic Review

Contact Info

Product

Resources

About