Abstract Details

Title Influence of Concussion History and Age of First Concussion on Post-Concussion Visio-Vestibular Function in Adolescent Patients

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) Sports Neurology and Neuro Trauma Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 005

Objective This study sought to investigate if abnormalities in visio-vestibular examination (VVE) are associated with concussion history (first vs. recurrent) or age of first concussion (AFC) in acutely concussed adolescent patients.

Background Early concussive and subconcussive head impact exposure in adults has been linked to greater risk of subsequent concussion and long-term impairments. Research has focused on adult athletes, with little data on younger patients.

Design/Methods Data were collected prospectively from patients aged 14-18 years old presenting within 28 days of injury. The VVE consisted of 9 maneuvers: smooth pursuit, horizontal/vertical saccades and gaze stability, binocular convergence, left/right monocular accommodation, and complex tandem gait. Primary outcomes included AFC, lifetime concussions, VVE subtests (normal/abnormal), and total VVE score (abnormal=2+ abnormal subtests). Multivariable logistic regressions were employed to determine if recurrent concussion or younger AFC were associated with abnormal VVE outcomes while controlling for age, sex, and lifetime concussion (AFC analysis only).

Results One thousand fifty-two patients were included in the concussion history analysis (male=450(42.3%); age=15.6±1.2 years; lifetime concussions=2.8±1.0). Five hundred and nineteen (49.3%) presented with recurrent concussion. Controlling for age and sex, there were no significant associations between first vs. recurrent concussion and any VVE subtest or total score (all p>0.05). One hundred and ninety-one patients were included in the AFC analysis (male=67(35.1%); age=15.7±1.3 years, lifetime concussions=2.4±0.7; AFC=13.2±2.1 years). Younger AFC was significantly associated with greater odds of abnormal vertical saccades (OR=0.82; 95%CI=0.69,0.98), trending toward significance with horizontal saccades (OR=0.85; 95%CI=0.72,1.00).

Conclusions Our findings suggest that patients with a concussion history present with similar visio-vestibular function to those with no concussion history at initial visit following injury. However, among those sustaining a recurrent concussion, those with an earlier AFC present with abnormal saccadic eye movement. This study provides foundational data regarding potential cumulative clinical effects of concussion in younger athletes.

Authors/Disclosures
Patricia R. Roby, PhD (Children's Hospital of Philadelphia) PRESENTER	The institution of Dr. Roby has received research support from NIH.
	No disclosure on file
Christina Master, MD, FAAP, CAQSM (Children's Hospital of Philadelphia)	The institution of Dr. Master has received research support from NIH. The institution of Dr. Master has received research support from DoD. The institution of Dr. Master has received research support from AMSSM. The institution of Dr. Master has received research support from PA Department of Health. Dr. Master has received intellectual property interests from a discovery or technology relating to health care. Dr. Master has received intellectual property interests from a discovery or technology relating to health care. Dr. Master has received intellectual property interests from a discovery or technology relating to health care.
Kristy Arbogast	The institution of Kristy Arbogast has received research support from NIH. The institution of Kristy Arbogast has received research support from Pennsylvania Department of Health. The institution of Kristy Arbogast has received research support from Football Research Inc.

��ɫ��

��ɫ��