Abstract
Vestibular impairment following concussion is associated with higher symptom burden, worse cognitive performance, and longer recovery. However, the role of persistent vestibular symptoms and impairment on these outcomes among adolescents is unknown. PURPOSE: Determine the role of persistent vestibular symptoms and impairment following concussion on recovery time and clinical outcomes among adolescents. METHODS: 50 (F-22/M-28) adolescents aged 12-20 years completed the Vestibular/Ocular Motor Screening tool (VOMS), Immediate Post-concussion Assessment and Cognitive Testing (ImPACT), and Post-concussion Symptom Scale (PCSS) at 0-10 and 11-21 days after concussion. Participants were grouped into: 1) persistent vestibular (PV), 2) vestibular improvement (VI), and 3) no vestibular (NoV). A 3 (group) X 2 (time) ANOVA with Bonferroni correction was performed for cognitive and symptom scores, and one-way ANOVA was performed for recovery time. RESULTS: Participants included 17 (35%) PV, 12 (25%) VI, and 20 (40%) NoV with one being excluded based on outlier analyses. Results supported group differences on PCSS at 11-21 days (p=.004), with PV (29.0±24.9) reporting higher symptoms than VI (13.0±15.5; p=.045) and NoV (5.45±10.0; p=.005). The VP group took longer to recover (34.9±11.6 days, p=.03) than the NoV (22.9±14.9 days) group. There were no significant group by time interactions for cognitive scores. However, all groups improved on verbal (p=.007) and visual (p=.03) memory, visual motor speed (p=.02), and reaction time (p=.03) from 0-10 to 11-20 days. Females were 5.7x more likely than males to be in the PV versus NoV group (p=.02, 95% CI=1.3-24.6). CONCLUSION: Persistent vestibular symptoms and impairment following concussion may play a role in higher symptom burden and prolonged recovery that warrants attention from clinicians. Females may be more likely to experience these persistent vestibular symptoms and impairment. Funding This research was supported in part by a grant to the University of Pittsburgh from the National Institute on Deafness and Other Communication Disorders (1K01DC012332-01A1) to Dr Kontos.
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