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Vision as a piece of the head trauma puzzle

Eye volume 37, pages 2385–2390 (2023)Cite this article

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Abstract

Approximately half of the brain’s circuits are involved in vision and control of eye movements. Therefore, visual dysfunction is a common symptom of concussion, the mildest form of traumatic brain injury (TBI). Photosensitivity, vergence dysfunction, saccadic abnormalities, and distortions in visual perception have been reported as vision-related symptoms following concussion. Impaired visual function has also been reported in populations with a lifetime history of TBI. Consequently, vision-based tools have been developed to detect and diagnose concussion in the acute setting, and characterize visual and cognitive function in those with a lifetime history of TBI. Rapid automatized naming (RAN) tasks have provided widely accessible and quantitative measures of visual-cognitive function. Laboratory-based eye tracking approaches demonstrate promise in measuring visual function and validating results from RAN tasks in patients with concussion. Optical coherence tomography (OCT) has detected neurodegeneration in patients with Alzheimer’s disease and multiple sclerosis and may provide critical insight into chronic conditions related to TBI, such as traumatic encephalopathy syndrome. Here, we review the literature and discuss the future directions of vision-based assessments of concussion and conditions related to TBI.

摘要

将近一半的大脑回路参与视觉及眼球运动的控制。因此, 视觉障碍是脑震荡的常见症状, 是最轻微的脑部创伤 (TBI) ——。光敏度下降、辐辏功能失调、扫视运动异常和视物变形已被报道为脑震荡后的视觉相关体征。在有TBI终生病史的人群中, 也有视觉功能受损的报道。因此, 用于检测和诊断急性环境中的脑震荡的视觉工具已研发出来, 用以检测有TBI终生病史的患者的视觉和认知功能。快速自动命名 (RAN) 任务提供了视觉认知功能的广泛可及的定量测量。基于实验室的眼动追踪方法在测量脑震荡患者的视觉功能和验证RAN任务的结果方面大有前景。相干光断层扫描技术 (OCT) 已检测到阿尔茨海默病和多发性硬化症患者的神经元退行性变, 并可能提供与TBI相关的慢性疾病之间的关键性证据, 如创伤性脑病综合征。本文我们对文献进行了回顾性分析, 讨论了基于视觉的脑震荡评估和TBI相关研究的未来方向。

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Fig. 1: Major cortical and subcortical pathways involved in saccadic generation.
Fig. 2: Screenshots of the Mobile Integrated Cognitive Kit (MICK) app.
Fig. 3: Box plot showing MULES and SUN time scores with learning effects (n = 59).

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Funding

This study was supported in part by the NYU Grossman School of Medicine.

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Authors and Affiliations

  1. Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA

    Carter A. Bell, Scott N. Grossman, Laura J. Balcer & Steven L. Galetta

  2. Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA

    Laura J. Balcer & Steven L. Galetta

  3. Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA

    Laura J. Balcer

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The authors confirm contribution to the paper as follows: study conception and design: SLG; literature review: CAB; draft manuscript preparation: CAB; LJB, SLG, SNG, MB. All authors reviewed and approved the final version or the manuscript.

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Correspondence to Steven L. Galetta.

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Bell, C.A., Grossman, S.N., Balcer, L.J. et al. Vision as a piece of the head trauma puzzle. Eye 37, 2385–2390 (2023). https://doi.org/10.1038/s41433-023-02437-8

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