Abstract
(1) Background: The King-Devick (KD) rapid number naming test is sensitive for concussion diagnosis, with increased test time from baseline as the outcome measure. Eye tracking during KD performance in concussed individuals shows an association between inter-saccadic interval (ISI) (the time between saccades) prolongation and prolonged testing time. This pilot study retrospectively assesses the relation between ISI prolongation during KD testing and cognitive performance in persistently-symptomatic individuals post-concussion. (2) Results: Fourteen participants (median age 34 years; 6 women) with prior neuropsychological assessment and KD testing with eye tracking were included. KD test times (72.6 ± 20.7 s) and median ISI (379.1 ± 199.1 msec) were prolonged compared to published normative values. Greater ISI prolongation was associated with lower scores for processing speed (WAIS-IV Coding, r = 0.72, p = 0.0017), attention/working memory (Trails Making A, r = −0.65, p = 0.006) (Digit Span Forward, r = 0.57, p = −0.017) (Digit Span Backward, r= −0.55, p = 0.021) (Digit Span Total, r = −0.74, p = 0.001), and executive function (Stroop Color Word Interference, r = −0.8, p = 0.0003). (3) Conclusions: This pilot study provides preliminary evidence suggesting that cognitive dysfunction may be associated with prolonged ISI and KD test times in concussion.
Highlights
IntroductionA concussion is a form of mild traumatic brain injury in which biomechanical forces to the head or body result in neurological symptoms such as headaches, dizziness, blurred vision, emotional lability, difficulty concentrating, or slowed information processing [1]
A concussion is a form of mild traumatic brain injury in which biomechanical forces to the head or body result in neurological symptoms such as headaches, dizziness, blurred vision, emotional lability, difficulty concentrating, or slowed information processing [1].In most individuals, symptoms resolve spontaneously within days to weeks following injury
KD test times were substantially prolonged in this cohort of participants with a history of concussion and persistent symptoms to 72.6 (±20.7) sec relative to previously published KD test times in healthy individuals with no history of concussion (51.24 (±9.7) sec [29]— 53.4 (±14.04) sec) [26]
Summary
A concussion is a form of mild traumatic brain injury in which biomechanical forces to the head or body result in neurological symptoms such as headaches, dizziness, blurred vision, emotional lability, difficulty concentrating, or slowed information processing [1]. Symptoms resolve spontaneously within days to weeks following injury. Prolonged recovery with persistent symptoms occurs in 10–25% of individuals [2,3,4]. Given the lack of symptom specificity and clarity with regard to the timing of biological concussion resolution, protracted recovery with persistent symptoms may overlap with the development of other disorders such as depression and psychosocial maladjustment. Sensitive sideline and outpatient diagnostic tests are needed
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