The use of oculomotor, vestibular, and reaction time tests to assess mild traumatic brain injury (mTBI) over time.

OBJECTIVES: The objective of this work is to examine the outcomes of a set of objective measures for evaluating individuals with minor traumatic brain injury (mTBI) over the sub-acute time period. These methods involve tests of oculomotor, vestibular, and reaction time functions. This work expands upon published work examining these test results at the time of presentation.

STUDY DESIGN: This study is a prospective age- and sex-matched controlled study.

MATERIALS AND METHODS: The subject group was composed of 106 individuals with mTBI and 300 age- and sex-matched controls without a history of mTBI. All individuals agreeing to participate in the study underwent a battery of oculomotor, vestibular, and reaction time tests (OVRT). Those subjects with mTBI underwent these tests at presentation (within 6 days of injury) and 1 and 2weeks post injury. These outcomes were compared to each other over time as well as to results from the controls that underwent 1 test session.

RESULTS: Six measures from 5 tests can classify the control and mTBI during Session 1 with a true positive rate (sensitivity) of 84.9% and true negative rate (specificity) of 97.0%. Patterns of abnormalities changed over time in the mTBI group and overall normalized in a subset of individuals at the third (final) testing session.

CONCLUSIONS: We describe an objective and effective second generation testing algorithm for diagnosing and following the prognosis of mTBI/concussion. This testing paradigm will allow investigators to institute better treatments and provide more accurate return to activity advice.

LEVEL OF EVIDENCE: 3.