Concussion and Vestibular-Ocular Testing

At Your Brain Health, we include detailed testing of vestibular-ocular motor function in our baseline screening and follow-up concussion assessments.

Vestibular-ocular motor dysfunction is common after concussion and therefore helps confirm diagnosis, but more importantly, vestibular-ocular motor dysfunction is associated with persistent symptoms and prolonged recovery. However, the good news is that vestibular-ocular treatments are some of the very best early interventions that improve outcomes. Currently, Your Brain Health uses both the Vestibular-Ocular Motor Screen (Symptom provocation) and NeuroFlex® (Objective measures) to help assess and monitor brain health and recovery.

Here are some facts about vestibular-ocular motor dysfunction you should know…..

Vestibular-Ocular tests involve many brain functions [1].

Vestibular-Ocular motor dysfunction is common after concussion, occurring in more than half of sports related concussion [2].

Vestibular-Ocular motor function can be tested with the Vestibular-Ocular Motor Screen (VOMS) and modified VOMS [3].

Vestibular-Ocular motor function can be tested objectively with Eye Tracking Software [4].

Objective head and eye-tracking technology provides quick objective information previously only available in research laboratories. Eye tracking technology is common in vestibular practice but in sporting practice it is just emerging [5].

Vestibular-Ocular motor signs and symptoms are associated with persistent symptoms and prolonged recovery [6,7].

Vestibular Rehabilitation combined with cervical and ocular training improves outcomes following concussion [8].

Early Vestibular Rehabilitation is better [9].

 

Associate Professor James McLoughlin, Co-Director, Your Brain Health

References

  1. Crampton A, Teel E, Chevignard M, Gagnon I. Vestibular-ocular reflex dysfunction following mild traumatic brain injury: A narrative review. Neurochirurgie. 2021;67: 231–237.
  2. Kaae C, Cadigan K, Lai K, Theis J. Vestibulo-ocular dysfunction in mTBI: Utility of the VOMS for evaluation and management – A review. NeuroRehabilitation. 2022;50: 279–296.
  3. Mucha A, Collins MW, Elbin RJ, Furman JM, Troutman-Enseki C, DeWolf RM, et al. A Brief Vestibular/Ocular Motor Screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42: 2479–2486.
  4. Snegireva N, Derman W, Patricios J, Welman KE. Eye tracking technology in sports-related concussion: a systematic review and meta-analysis. Physiol Meas. 2018;39: 12TR01.
  5. Snegireva N, Derman W, Patricios J, Welman KE. Awareness and Perceived Value of Eye Tracking Technology for Concussion Assessment among Sports Medicine Clinicians: A Multinational Study. Phys Sportsmed. 2020;48: 165–172.
  6. Lau BC, Kontos AP, Collins MW, Mucha A, Lovell MR. Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? Am J Sports Med. 2011;39: 2311–2318.
  7. Whitney SL, Eagle SR, Marchetti G, Mucha A, Collins MW, Kontos AP, et al. Association of acute vestibular/ocular motor screening scores to prolonged recovery in collegiate athletes following sport-related concussion. Brain Inj. 2020;34: 840–845.
  8. Reid SA, Farbenblum J, McLeod S. Do physical interventions improve outcomes following concussion: a systematic review and meta-analysis? Br J Sports Med. 2022;56: 292–298.
  9. Ferry B, Means G, Green C, Risoli T, Martinez C, Vomer RP 2nd, et al. Early Initiation of Vestibular Therapy Following Sports-Related Concussions: A Retrospective Cohort Study. Cureus. 2023;15: e39764.