Oculomotor and vestibulo-ocular function post-concussion in children and adolescents
Bibliographic record
Abstract
Objective: The objectives of this study were (1) to document oculomotor (OM) and vestibulo-ocular (VO) function in children who sustained a concussion and were symptomatic at the time of assessment, and to compare them to that of children with prior concussion who were clinically recovered (asymptomatic) and of uninjured children, and (2) to document the extent to which OM and VO function relate to post-concussion symptom severity in children with symptomatic and asymptomatic concussion. Study Design: A prospective cross-sectional study that included 108 symptomatic/clinically recovered pediatric patients with concussion and 79 healthy youth, between 9 and 18 years of age. Setting: Participants with concussion were recruited from a speciality concussion clinic at the Montreal Children’s Hospital, McGill University Health Center. Methods: OM (smooth pursuit, saccades, anti-saccades and vergence) and VO (average vestibulo-ocular reflex gain) function were acquired with a commercial VR eye-tracking system (Saccade Analytics, InSight software). Post-concussion symptoms were scored with the Post-Concussion Symptom Inventory (PCSI) and were obtained from the patient’s concussion clinic electronic medical records, as were number of previous concussions and premorbid conditions. A series of one-way ANOVA tests and Pearson r correlations were used to address the two objectives. Results: There was a significant main effect at the p<.05 level for vergence during smooth pursuit [ F (2,176) =10.90, p<.05], mean latency during saccades [F (2, 171) = 5.99, p=.003] and mean response delay during anti-saccades [F (2,177=9.07, p.<05]. For VO, there was a significant main effect for average vestibular ocular reflex gain in the horizontal leftward [F (2,168) = 7, p=.001] and rightward directions [W (2,163) = 13.08, p <.05] and vertical upward [F (2,147) = 7.60, p=.001] and downward directions [W (2,144) = 13.70, p <.05]. Significant group differences in OM and VO function highlighted that children with symptomatic concussion showed poorer performance when compared to clinically recovered and healthy children. The Pearson correlation test indicated a significant strong positive correlation between mean saccade error and total PCSI scores for the younger (8-12-year-olds) clinically recovered children. Additionally, children with greater symptom scores on the PCSI tended to preform worse on the OM/VO eye tracking tasks than children who reported lower symptom scores. Conclusion: Our results lead us to conclude that children with symptomatic concussion do indeed present with clinical oculomotor and vestibulo-ocular function impairments and tend to report more severe post- concussion symptoms when compared to healthy and recovered children. The significant group differences between the symptomatic children, recovered and healthy children suggests that VR eye tracking may be an effective tool for identifying OM and VO deficits in the acute phase of concussion. Although more investigation is needed, VR eye tracking of OM and VO function has the potential to provide clinicians with a measurement tool that is both objective and developmentally appropriate for use with children
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".