Quantitative measurement of post-concussion syndrome Using Electrovestibulography

Abdelbaset Suleiman,Brian Lithgow,Behzad Mansouri,Zahra Moussavi,Zeinab Dastgheib

doi:10.1038/s41598-017-15487-2

Abstract

In this study, a noninvasive quantitative measure was used to identify short and long term post-concussion syndrome (PCS) both from each other and from healthy control populations. We used Electrovestibulography (EVestG) for detecting neurophysiological PCS consequent to a mild traumatic brain injury (mTBI) in both short-term (N = 8) and long-term (N = 30) (beyond the normal recovery period) symptomatic individuals. Peripheral, spontaneously evoked vestibuloacoustic signals incorporating - and modulated by - brainstem responses were recorded using EVestG, while individuals were stationary (no movement stimulus). Tested were 38 individuals with PCS in comparison to those of 33 age-and-gender-matched healthy controls. The extracted features were based on the shape of the averaged extracted field potentials (FPs) and their detected firing pattern. Linear discriminant analysis classification, incorporating a leave-one-out routine, resulted in (A) an unbiased 84% classification accuracy for separating healthy controls from a mix of long and short-term symptomatology PCS sufferers and (B) a 79% classification accuracy for separating between long and short-term symptomatology PCS sufferers. Comparatively, short-term symptomatology PCS was generally detected as more distal from controls. Based on the results, the EVestG recording shows promise as an assistive objective tool for detecting and monitoring individuals with PCS after normal recovery periods.

Highlights

In this study, a noninvasive quantitative measure was used to identify short and long term postconcussion syndrome (PCS) both from each other and from healthy control populations
All patients who presented to neuro-ophthalmology clinic and were diagnosed with PCS, met the inclusion criteria for the study and did not have the exclusion criteria, were referred to the research assistant to be included in this study
Considering this fact and the link between dizziness and the abnormal function of the vestibular apparatus, the representative results of this study support the hypothesis that vestibular activity is perturbed following mild traumatic brain injury (mTBI)

Summary

Introduction

A noninvasive quantitative measure was used to identify short and long term postconcussion syndrome (PCS) both from each other and from healthy control populations. Following an mTBI, patients usually experience one or more of the following clinical symptoms: headaches, dizziness, depression, memory loss, confusion, blurred vision and balance problems that may occur with or without loss of consciousness[3,4] The persistence of these symptoms for more than one week is usually referred to as post-concussion syndrome (PCS)[5]. Persistent PCS has been reported in 20–30% of concussed individuals and comprise incomplete recovery[9] which include somatic (e.g. headaches, dizziness), cognitive (e.g. poor concentration), mood (e.g. depression), visual (e.g. convergence insufficiency, poor accommodation) and behavioral (e.g. irritability) problems[9,10] These symptoms can be dominant in the first few hours or days right after the impact but may persist for weeks, months or even years[10]. Such disagreement between the imaging finding and the existence of cognitive impairments in PCS group might be due to a damage in the neural network rather than a focal lesion site likely to be detected by imaging techniques

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Conclusion