Peripheral Vestibular and Balance Function in Athletes With and Without Concussion

Abstract

Participants were tested in a Neuro Kinetics Inc. I-Portal® Neuro Otologic Test Center system (NOTC) by an experienced trained examiner. The I-Portal® NOTC is a chair attached to a high-torque motor driven by a computer and contained inside a lightproof enclosure. The testing protocol took approximately 30 minutes. Participants sat in the NOTC, were secured for safety, and the head was restrained. A binocular infrared

The use of continuous spectral analysis for the assessment of postural stability changes after sports-related concussion

“…The greatest effect size and the largest frequency range over which a difference was detected was for the increase in AP spectral content in DL stance. Changes were identified across the investigated frequency range, suggesting potential vestibular and cerebellar integration as well as proprioceptive control system effects of SRC, in concordance with existing literature (Christy et al, 2019;Guskiewicz, 2003;Mallinson and Longridge, 1998;Nowak, 2018;Wright et al, 2017). As all trials were performed with vision obscured, for consistency with M-BESS, identification of any post-SRC effects on visual system integration was outside the scope of the study.…”

Alterations in Resting‐State Functional Brain Connectivity and Correlations with Vestibular/Ocular‐Motor Screening Measures in Postconcussion Vestibular Dysfunction

“…Studies have previously demonstrated the utility of VOMS in the clinical evaluation of concussion to differentiate patients with concussion from healthy controls; 6,10,12 however, the pathophysiologic mechanisms underlying these differences remain unknown. Recent studies assessing peripheral vestibular function postconcussion using a variety of objective measures have concluded that postconcussive vestibular impairments are likely centrally derived 6,7 . We identified several patterns of rs‐fMRI brain connectivity with significant correlations with VOMS derivative scores.…”

“…Recent studies assessing peripheral vestibular function postconcussion using a variety of objective measures have concluded that postconcussive vestibular impairments are likely centrally derived. 6,7 We identified several patterns of rs-fMRI brain connectivity with significant correlations with VOMS derivative scores. In particular, we identified a core connectivity network across all seven VOMS testing conditions--right and left multisensory orientation area.…”

“…[3][4][5] While postconcussion vestibular dysfunction (PCVD) may result from peripheral vestibular end organ or central injuries, recent evidence favors central injury as the predominant mechanism. [6][7][8] Regardless of etiology, the pathophysiologic mechanisms underlying PCVD symptomatology remain unknown. This knowledge gap has important clinical relevance, including limited understanding of the mechanisms underlying symptom persistence, hindered development of targeted therapeutic strategies, 9 and inability to prospectively identify subsets of patients who will benefit from therapy.…”

“…Balance and vestibular dysfunction at the time of concussion are associated with protracted recovery and rehabilitation intervention may improve outcomes 3–5 . While postconcussion vestibular dysfunction (PCVD) may result from peripheral vestibular end organ or central injuries, recent evidence favors central injury as the predominant mechanism 6–8 . Regardless of etiology, the pathophysiologic mechanisms underlying PCVD symptomatology remain unknown.…”