Persistent vestibular-ocular impairment following concussion in adolescents

Objectives: The current study investigated the role of persistent vestibular-ocular symptoms and impairment following sport-related concussion on recovery time and clinical outcomes among adolescents. Design: Prospective cohort. Methods: 50 (F-22/M-28) adolescents aged 12-20 years completed a vestibular-ocular motor screening, neurocognitive assessment, and the Post-Concussion Symptom Scale (PCSS) at clinical assessments conducted at 0-10 and 11-21 days after concussion. Participants were assigned to: 1) persistent vestibular-ocular (PERSIST), 2) vestibular-ocular improvement (IMPROVE), or 3) no vestibular-ocular impairment (NONE) groups based on vestibular-ocular motor screening conducted during each assessment. A 3 (GROUP) X 2 (TIME) ANOVA was performed on neurocognitive and symptom scores, and a between-subjects ANOVA was performed for recovery time. Results: 49 subjects were identified among the PERSIST (n = 17), IMPROVE (n = 12) and NONE (n= 20) groups. There were no neurocognitive performance differences between groups at 0-10 days post-concussion, but groups differed on PCSS at 11-21 days (p =.001), with the PERSIST (29.0 +/- 24.9) group reporting higher symptoms than the NONE (5.45 +/- 10.0; p = .005) group. The PERSIST group took significantly longer to recover (34.9 +/- 11.6 days) than the NONE (22.9 +/- 14.9 days) group (p =.03). All groups improved on verbal (p < .001) and visual memory (p = .028), visual motor speed (p = .005), and reaction time (p = .004) from 0-10 to 11-20 days following SRC and no significant group by time interactions for cognitive scores identified. Conclusions: Persistent post-concussion vestibular-ocular symptoms and impairment may influence neurocognitive performance and clinical recovery following sport-related concussion. (C) 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.