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John-Ross Rizzo, Todd E Hudson, Weiwei Dai, Joel Birkemeier, Rosa M Pasculli, Ivan Selesnick, Laura J Balcer, Steven L Galetta, Janet C Rucker
OBJECTIVE: The King-Devick (KD) test, which is based on rapid number naming speed, is a performance measure that adds vision and eye movement assessments to sideline concussion testing. We performed a laboratory-based study to characterize ocular motor behavior during the KD test in a patient cohort with chronic concussion to identify features associated with prolonged KD reading times. METHODS: Twenty-five patients with a concussion history (mean age: 31) were compared to control participants with no concussion history (n = 42, mean age: 32)...
October 2016: Annals of Clinical and Translational Neurology
David V Walsh, José E Capó-Aponte, Thomas Beltran, Wesley R Cole, Ashley Ballard, Joseph Y Dumayas
OBJECTIVES: The Department of Defense reported that 344,030 cases of traumatic brain injury (TBI) were clinically confirmed from 2000 to 2015, with mild TBI (mTBI) accounting for 82.3% of all cases. Unfortunately, warfighters with TBI are often identified only when moderate or severe head injuries have occurred, leaving more subtle mTBI cases undiagnosed. This study aims to identify and validate an eye-movement visual test for screening acute mTBI. METHODS: Two-hundred active duty military personnel were recruited to perform the King-Devick® (KD) test...
September 11, 2016: Journal of the Neurological Sciences
James Patrick MacDonald, Iris Petersen, Douglas Kyrouac
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Katherine K Weise, Mark W Swanson, Kimberly Penix, Matthew Heath Hale, Drew Ferguson
PURPOSE: The King-Devick test (KD) has been studied as a remove-from-play sideline test in college-age athletes and older; however, studies in younger athletes are limited. A cross-sectional study of the KD and other vision correlates was completed on school-aged athletes during pre-season physicals for a variety of sports to determine the repeatability of the KD. The study also evaluated how convergence, alignment, or pupil function contributed to a slower King-Devick baseline reading...
July 23, 2016: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Eric W Slattery, Kelsey Logan, Paul Gubanich
No abstract text is available yet for this article.
May 2016: Medicine and Science in Sports and Exercise
Kristin M Galetta, Kimberly R Chapman, Maritza D Essis, Michael L Alosco, Danielle Gillard, Eric Steinberg, Diane Dixon, Brett Martin, Christine E Chaisson, Neil W Kowall, Yorghos Tripodis, Laura J Balcer, Robert A Stern
The King-Devick (K-D) test is a 1 to 2 minute, rapid number naming test, often used to assist with detection of concussion, but also has clinical utility in other neurological conditions (eg, Parkinson disease). The K-D involves saccadic eye and other eye movements, and abnormalities thereof may be an early indicator of Alzheimer disease (AD)-associated cognitive impairment. No study has tested the utility of the K-D in AD and we sought to do so. The sample included 206 [135 controls, 39 mild cognitive impairment (MCI), and 32 AD dementia] consecutive subjects from the Boston University Alzheimer's Disease Center registry undergoing their initial annual evaluation between March 2013 and July 2015...
June 13, 2016: Alzheimer Disease and Associated Disorders
John-Ross Rizzo, Todd E Hudson, Weiwei Dai, Ninad Desai, Arash Yousefi, Dhaval Palsana, Ivan Selesnick, Laura J Balcer, Steven L Galetta, Janet C Rucker
OBJECTIVE: Concussion is a major public health problem and considerable efforts are focused on sideline-based diagnostic testing to guide return-to-play decision-making and clinical care. The King-Devick (K-D) test, a sensitive sideline performance measure for concussion detection, reveals slowed reading times in acutely concussed subjects, as compared to healthy controls; however, the normal behavior of eye movements during the task and deficits underlying the slowing have not been defined...
March 15, 2016: Journal of the Neurological Sciences
Rachel E Ventura, Laura J Balcer, Steven L Galetta, Janet C Rucker
Mild head injury such as concussions and subconcussive repetitive impact may lead to subtle changes in brain function and it is imperative to find sensitive and reliable tests to detect such changes. Tests involving the visual system, in particular eye movements, can incorporate higher cortical functioning and involve diffuse pathways in the brain, including many areas susceptible to head impact. With concussions, the clinical neuro-ophthalmic exam is important for detecting abnormalities in vergence, saccades, pursuit, and visual fixation...
February 15, 2016: Journal of the Neurological Sciences
B Alsalaheen, J Haines, A Yorke, J Diebold
The King-Devick test appears to be a promising tool in screening for concussions. However, limited evidence exists on the baseline associations between the K-D test and age and baseline screening tools used after concussion. Additionally, there are no published reference values for the K-D test in high school football players. The K-D test, the Balance Error Scoring System, and the Limits of Stability (LOS) test were administered to 157 high school football players. Additionally, a subsample of 62 participants completed the test twice to examine the reliability of K-D test...
February 2016: Scandinavian Journal of Medicine & Science in Sports
Rachel E Ventura, Laura J Balcer, Steven L Galetta
Concussion may lead to subtle changes in brain function, and tests involving the visual system probe higher cortical functioning and increase our sensitivity in detecting these changes. Concussions are acutely and sometimes more persistently associated with abnormalities in balance, cognition, and vision. The visual system involves roughly half of the brain's circuits, including many regions susceptible to head impacts. After a concussion, the neuro-ophthalmologic exam commonly detects abnormalities in convergence, accommodation, the vestibulo-ocular reflex, ocular muscle balance, saccades, and pursuit...
October 2015: Seminars in Neurology
Anne W Hunt, Katherine Mah, Nick Reed, Lisa Engel, Michelle Keightley
OBJECTIVE: The purpose of this article is to synthesize and appraise the evidence regarding the use of oculomotor-based vision assessment to identify and monitor recovery from mild traumatic brain injury (mTBI). Specific objectives are to (1) identify changes in oculomotor-based vision following mTBI; (2) distinguish methods of assessment; (3) appraise the level and quality of evidence; and, if warranted, (4) determine clinical recommendations for assessment. METHODS: A systematic review was undertaken to identify and appraise relevant literature...
July 2016: Journal of Head Trauma Rehabilitation
D King, P Hume, C Gissane, T Clark
AIM: To determine whether the King-Devick (K-D) test used as a sideline test in junior rugby league players over 12 matches in a domestic competition season could identify witnessed and incidentally identified episodes of concussion. METHODS: A prospective observational cohort study of a club level junior rugby league team (n=19) during the 2014 New Zealand competition season involved every player completing two pre-competition season baseline trials of the K-D test...
October 15, 2015: Journal of the Neurological Sciences
Daniel H Seidman, Jennifer Burlingame, Lina R Yousif, Xinh P Donahue, Joshua Krier, Lydia J Rayes, Rachel Young, Muareen Lilla, Rochelle Mazurek, Kristie Hittle, Charles McCloskey, Saroj Misra, Michael K Shaw
OBJECTIVE: Concussion is the most common type of traumatic brain injury, and results from impact or impulsive forces to the head, neck or face. Due to the variability and subtlety of symptoms, concussions may go unrecognized or be ignored, especially with the pressure placed on athletes to return to competition. The King-Devick (KD) test, an oculomotor test originally designed for reading evaluation, was recently validated as a concussion screening tool in collegiate athletes. A prospective study was performed using high school football players in an attempt to study the KD as a concussion screening tool in this younger population...
September 15, 2015: Journal of the Neurological Sciences
Peter A Benedict, Natali V Baner, G Kyle Harrold, Nicholas Moehringer, Lisena Hasanaj, Liliana P Serrano, Mara Sproul, Geraldine Pagnotta, Dennis A Cardone, Steven R Flanagan, Janet Rucker, Steven L Galetta, Laura J Balcer
OBJECTIVE: This study examined components of the Sports Concussion Assessment Tool, 3rd Edition (SCAT3) and a vision-based test of rapid number naming (King-Devick [K-D]) to evaluate sports and non-sports concussion patients in an outpatient, multidisciplinary concussion center. While the Symptom Evaluation, Standardized Assessment of Concussion (SAC), modified Balance Error Scoring System (BESS), and K-D are used typically for sideline assessment, their use in an outpatient clinical setting following concussion has not been widely investigated...
2015: Journal of the Neurological Sciences
D King, C Gissane, P A Hume, M Flaws
AIM: To use the King-Devick (K-D) test in senior amateur rugby union and rugby league players over a domestic competition season to see if it could identify witnessed and unwitnessed episodes of concussion that occurred from participation in competition matches over three years. METHODS: A prospective observational cohort study was conducted on a club level senior amateur rugby union team (n=36 players in 2012 and 35 players in 2013) and a rugby league team (n=33 players in 2014) during competition seasons in New Zealand...
April 15, 2015: Journal of the Neurological Sciences
Kristin M Galetta, Jennifer Morganroth, Nicholas Moehringer, Bridget Mueller, Lisena Hasanaj, Nikki Webb, Courtney Civitano, Dennis A Cardone, Arlene Silverio, Steven L Galetta, Laura J Balcer
BACKGROUND: Sports-related concussion commonly affects the visual pathways. Current sideline protocols test cognition and balance but do not include assessments of visual performance. We investigated how adding a vision-based test of rapid number naming could increase our ability to identify concussed athletes on the sideline at youth and collegiate levels. METHODS: Participants in this prospective study included members of a youth ice hockey and lacrosse league and collegiate athletes from New York University and Long Island University...
September 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Rachel E Ventura, Jeffrey M Jancuska, Laura J Balcer, Steven L Galetta
BACKGROUND: Concussion, particularly in relation to sports and combat activities, is increasingly recognized as a potential cause of both short- and long-term neurologic sequelae. This review will focus on the neuro-ophthalmologic findings associated with concussion, the current tests for concussion, and the potential for visual performance measures to improve our detection and assessment of concussions. EVIDENCE ACQUISITION: A PubMed search using the specific key words "concussion," "mild traumatic brain injury," "neuro-ophthalmological findings," and "diagnostic and management tests" was performed...
March 2015: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
Brian T Vernau, Matthew F Grady, Arlene Goodman, Douglas J Wiebe, Luke Basta, Yong Park, Kristy B Arbogast, Christina L Master
Baseline scores on the King-Devick (K-D) Test, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Sport Concussion Assessment Tool 3 (SCAT3), and convergence were evaluated in youth hockey players. Worse K-D times were associated with worse ImPACT visual motor speed and reaction time. Eleven concussed athletes were retested, and there was a trend toward improved ImPACT and K-D times compared to baseline.
January 2015: Developmental Neuropsychology
Danielle F Leong, Laura J Balcer, Steven L Galetta, Greg Evans, Matthew Gimre, David Watt
PURPOSE: Sports-related concussion has received increasing attention as a result of neurologic sequelae seen among athletes, highlighting the need for a validated, rapid screening tool. The King-Devick (K-D) test requires vision, eye movements, language function and attention in order to perform and has been proposed as a promising tool for assessment of concussion. We investigated the K-D test as a sideline screening tool in a collegiate cohort to determine the effect of concussion. METHODS: Athletes (n=127, mean age 19...
April 2015: Journal of Optometry
Rachel E Ventura, Laura J Balcer, Steven L Galetta
Traumatic brain injury (TBI) is a major cause of morbidity and mortality. Concussion, a form of mild TBI, might be associated with long-term neurological symptoms. The effects of TBI and concussion are not restricted to cognition and balance. TBI can also affect multiple aspects of vision; mild TBI frequently leads to disruptions in visual functioning, while moderate or severe TBI often causes structural lesions. In patients with mild TBI, there might be abnormalities in saccades, pursuit, convergence, accommodation, and vestibulo-ocular reflex...
October 2014: Lancet Neurology
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