A - 136 Association of Pre-Injury Anxiety and Oculomotor Symptoms Following Concussion among Adolescents.

OBJECTIVE: To investigate the utility of demographic risk factors and post-concussion oculomotor symptoms to identify adolescents with anxiety panic disorder symptoms.

METHOD: Participants included 124 patients (63 male) aged 10 to 18 (M = 14.4, SD = 2.3) within 2-30 days of injury (M = 9.3, SD = 6.3) who presented to a concussion specialty clinic between 2017-2018. All participants completed the Screening for Child Anxiety Related Disorders (SCARED-C) to evaluate pre-injury anxiety as well as the Vestibular/Ocular Motor Screening (VOMS) as part of standard clinical care. A backward logistic regression (LR) was employed to determine the utility of symptom provocation on oculomotor components of the VOMS (i.e., smooth pursuits, horizontal saccades, vertical saccades, and near point of convergence) and demographic risk factors (i.e., history of anxiety or depression and gender) to identify adolescents with panic disorder symptoms on the SCARED-C.

RESULTS: The LR model was statistically significant (χ2 (6) = 26.8, p < 0.001) and explained 32.0% of the variance. The model correctly classified 84.7% of cases with high specificity = 0.97 but low sensitivity = 0.27. Variables retained in the model included provocation of dizziness during vertical saccades (OR = 1.85, p = 0.016), self-reported history of depression (OR = 7.34, p = 0.032), and sex (i.e., female; OR = 5.45, p = 0.009).

CONCLUSION: The results indicate that symptom provocation on oculomotor components of the VOMS (i.e., dizziness during vertical saccades), sex, and self-reported history of depression diagnosis are modest predictors of panic disorder symptoms in adolescents. Clinicians should consider these symptoms when interpreting symptoms post-injury.