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The Collaborative Assessment of Neurocognition and Vision in Adolescents with Sports-related Concussion - The CANVAS Concussion Study

Peiffer, Adam J
http://rave.ohiolink.edu/etdc/view?acc_num=osu1523962375501181

Abstract Details

2018, Master of Science, Ohio State University, Vision Science.
BACKGROUND: Vision related diagnoses are common following concussion in both adults and children. These vision diagnoses are associated with similar symptoms that are classically considered present following a concussion. Symptom surveys are utilized after an individual suffers a concussion, but they often inadequately assess vision related symptoms. The Convergence Insufficiency Symptoms Survey has been shown to correlate to other surveys specifically designed for concussion evaluation and may be a useful tool in the evaluation of concussion due to the high prevalence of vision related symptoms. Children with a concussion and binocular vision disorders (BVD) have been shown to score lower on some individual areas of a neurocognitive computer-based testing programs. Therefore, BVDs may complicate neurocognitive assessment following a concussion. METHODS: The primary objective for this study is to test the hypothesis that the presence of a binocular vision disorder (BVD) affects adolescents' scores on a computerized neurocognitive test that is commonly used in the assessment of sports-related concussion (SRC). 54 adolescent subjects (35 concussion, 19 control) ages 9 to less than 18 competed both the CogState Brief Battery and a sensorimotor evaluation assessing vergence, accommodation, ocular motility, and symptoms. Each group was further separated into those with or without BVD, and differences between the groups were assessed using statistical analyses. RESULTS: 80% of the SRCs and 57% of Controls were found to have a BVD. There were no significant differences in the mean DEM ratios and DEM errors for SRCs versus Controls (P=0.958 and P=0.382). Mean CISS for SRCs and Controls was 19.74 and 14.79 respectively (P=0.073). Mean CISS was 22.21 for SRCs with BVD and 9.86 for SRCs without BVD (P=0.003). Mean CISS was 18.55 for Controls with BVD and 9.63 for Controls without BVD (P=0.012). The mean CogState standard score for SRCs were Processing (86.10), Attention (86.41), Learning (96.74), and Working Memory (92.87). The mean CogState standard score for Controls were Processing (97.96), Attention (99.79), Learning (100.11), and Working Memory (95.38). Processing (P=0.019) and Attention (P=0.004) were statistically different between these two groups. Learning (P=0.025) was lower in the SRC with BVD compared to without BVD. Attention (P=0.031) was lower in the SRC without BVD compared to Controls without BVD. All other mean CogState standard scores were statistically similar between groups. CONCLUSION: BVDs are prevalent in adolescents with SRC. The DEM may provide utility in vision evaluations following a concussion by accounting for automaticity deficits. The CISS is an adequate tool to assess vision related concussion symptoms. The presence of BVDs alone is not significantly associated with reduced scores on the CogState Brief Battery. However, their effect on the CogState scores does appear to be additive to effects due to the presence of a concussion. Vision assessment could play an important role in concussion evaluation. Academic accommodations, with respect to vision performance, should be considered following a concussion.
Catherine McDaniel, OD, MS (Advisor)
Andrew Hartwick, OD, PhD (Advisor)
James MacDonald, MD, MPH (Committee Member)
Nicklaus Fogt, OD, PhD (Committee Member)
127 p.
Cognitive Psychology; Ophthalmology; Sports Medicine
Concussion, Convergence Insufficiency, Oculomotor, CogState, Pediatric, Developmental Eye Movement Test, Vergence Facility, Binocular Vision

Recommended Citations

Citations

  • Peiffer, A. J. (2018). The Collaborative Assessment of Neurocognition and Vision in Adolescents with Sports-related Concussion - The CANVAS Concussion Study [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523962375501181

    APA Style (7th edition)

  • Peiffer, Adam. The Collaborative Assessment of Neurocognition and Vision in Adolescents with Sports-related Concussion - The CANVAS Concussion Study. 2018. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1523962375501181.

    MLA Style (8th edition)

  • Peiffer, Adam. "The Collaborative Assessment of Neurocognition and Vision in Adolescents with Sports-related Concussion - The CANVAS Concussion Study." Master's thesis, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523962375501181

    Chicago Manual of Style (17th edition)

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This open access ETD is published by The Ohio State University and OhioLINK.