Abstract
Patients with mild traumatic brain injuries (mTBI) often report difficulties in motor coordination and visuo-spatial attention. However, the consequences of mTBI on fine motor and visuo-motor coordination are still not well understood. We aimed to evaluate whether mTBI had a concomitant effect on fine motor ability and visuo-motor integration and whether this is related to visual perception and visuo-spatial attention impairments, including patients at different symptoms stage. Eleven mTBI patients (mean age 22.8 years) and ten healthy controls participated in the study. Visuo-motor integration of fine motor abilities and form recognition were measured with the Beery-Buktenica Developmental Test of Visual-Motor Integration test, motion perception was evaluated with motion coherence test, critical flicker fusion was measured with Pocket CFF tester. Visuo-spatial was assessed with the Ruff 2 & 7 Selection Attention Test. mTBI patients showed reduced visuo-motor integration, form recognition, and motor deficits as well as visuo-spatial attention impairment, while motion perception and critical flicker fusion were not impaired. These preliminary findings suggest that the temporary brain insults deriving from mTBI compromise fine motor skills, visuomotor integration, form recognition, and visuo-spatial attention. The impairment in visuo-motor coordination was associated with speed in visuo-attention and correlated with symptoms severity while motor ability was correlated with time since concussion. Given the strong correlation between visuomotor coordination and symptom severity, further investigation with a larger sample seems warranted. Since there appeared to be differences in motor skills with respect to symptom stage, further research is needed to investigate symptom profiles associated with visuomotor coordination and fine motor deficits in mTBI patients.
Highlights
Mild traumatic brain injury or concussion affects the cognitive abilities of approximately 42 million people worldwide every year [1]. mTBI is defined as a physiological disruption of brain functions, which may occur after a concussion or acceleration/deceleration
Given the results described above, this study aims to investigate whether mTBI affects diffuse motor, visual and cognitive abilities involving fine motor, visuo-motor integration, visuospatial attention, motion perception compromising both lower and higher visual and motor functions
The mTBI patients failed only in those items including the highest number of distractors
Summary
Mild traumatic brain injury (mTBI) or concussion affects the cognitive abilities of approximately 42 million people worldwide every year [1]. mTBI is defined as a physiological disruption of brain functions, which may occur after a concussion or acceleration/deceleration. The results showed that mTBI patients have lower sensitivity for orientation-defined and contrast-defined stimuli, but higher spatial frequency sensitivity both for first and second-order stimuli Based on this evidence, Spiegel et al [6] proposed that mTBI visual symptoms could be linked to altered temporal processing of visual information, in agreement with previous findings indicating visual symptoms related to flickering [11, 12]. From computational models of the morphology of white matter structures, it was observed that crucial areas, as the superior parietal lobe (SPL) and others in the PPC were more prone to damage in DAI following concussion [3] This evidence and the role of the V6 complex inside SPL as a visual-input node to the eye/hand coordination [23] hint at possible deficits in visuo-motor and fine motor ability in mTBI. We expect that having more symptoms is associated with an increased impairment in neurocognitive functions for those patients with persisting symptoms after concussion
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