Presentation at the American Academy of Neurology 2017 Annual Meeting

Sensorimotor Vision Screening in a Random Sample of Recently Deployed Soldiers With and Without a History of Mild TBI

Authors: Chang A, Finkel A, Schwab K, Brenner L, Klimp S, McMillan H, Scher A
Publication: Presentation at the American Academy of Neurology 2017 Annual Meeting
Date: April 27, 2017
Tags: Soldiers,

Objective: To determine if simple screening tests of visual function are sensitive to a history of mTBI in recently deployed soldiers.

Background: Mild traumatic brain injury (mTBI=concussion) can result in persistent neurological symptoms such as dizziness, headaches, behavioral changes, and sleep disturbances. Vision problems can also stem from these injuries, including difficulty with reading, double vision, and eye strain. Such symptoms are often overlooked in the standard evaluation of mTBI. We evaluated the performance of three simple tests of visual function in a non-clinical cohort of recently deployed soldiers in order to determine whether these tests distinguished between soldiers with and without a history of mTBI.

Design/Methods: Participants were a random subset of recently deployed soldiers returning to Fort Bragg, NC. We evaluated near point of convergence break, amplitude of accommodation, and saccadic eye movement (King Devick) during a structured clinical examination. Mean test values / proportions with clinically significant results were compared between soldiers with (cases) and without (controls) a history of mTBI sustained during this last deployment.

Results: Participants (n=406; 122 mTBI cases; 284 controls) were primarily male (89%) and young (28 years of age). Compared to controls, those with a history of mTBI did worse on all visual tests and had approximately doubled odds of having clinically relevant results. Sub-group analysis showed that mTBI with reported loss of consciousness was particularly associated with poor performance on these tests.

Conclusions: Three simple tests of visual function are sensitive to a history of mTBI in this non-clinical sample of recently deployed soldiers. Since these tests are quick, inexpensive, and easy to administer, they may be useful as screening instruments or prognostic biomarkers in studies of non-clinical populations. Study Supported by: Primary funding was provided by the Center for Neuroscience and Regenerative Medicine (CNRM) and the Defense Medical Research and Development Program (DMRDP).

 

Summary Points:

  • K-D Test is sensitive to a history of mTBI in this sample of recently deployed soldiers who underwent a structured clinical examination.
  • K-D Test has utility as a screening and prognostic instrument for deployed soldiers.
Read More