Clinical evaluation of concussion: the evolving role of oculomotor assessments

Abstract

Sports-related concussion is a change in brain function following a direct or an indirect force to the head, identified in awake individuals and accounting for a considerable proportion of mild traumatic brain injury. Although the neurological signs and symptoms of concussion can be subtle and transient, there can be persistent sequelae, such as impaired attention and balance, that make affected patients particularly vulnerable to further injury. Currently, there is no accepted definition or diagnostic criteria for concussion, and there is no single assessment that is accepted as capable of identifying all patients with concussion. In this paper, the authors review the available screening tools for concussion, with particular emphasis on the role of visual function testing. In particular, they discuss the oculomotor assessment tools that are being investigated in the setting of concussion screening.

Keywords: BESS = Balance Error Scoring System; DVS = dynamic visuo-motor synchronization; KDT = King-Devick Test; SAC = Standardized Assessment of Concussion; SCAT-3 = Sport Concussion Assessment Tool, 3rd Edition; TBI = traumatic brain injury; TGT = tandem gait test; concussion diagnosis; concussion screening; eye tracking; mTBI = mild traumatic brain injury; oculomotor tracking; traumatic brain injury; vision tracking.