Evaluating the Vestibulo-Ocular Reflex Following Traumatic Brain Injury: A Scoping Review

Brain Inj. 2021 Nov 10;35(12-13):1496-1509. doi: 10.1080/02699052.2021.1972450. Epub 2021 Sep 8.

Abstract

Purpose:To identify the tests and tools used to evaluate vestibulo-ocular reflex (VOR) function after traumatic brain injury (TBI) in all age groups and across TBI severity.Methods: An electronic search was conducted to include relevant peer-reviewed literature published up to November 2019. Studies included those done with humans, of all ages, and had assessments of oculomotor and/or vestibulo-ocular function in TBI.Results: Of the articles selected (N = 48), 50% were published in 2018/2019. A majority targeted mild TBI, with equal focus on non-computerized versus computerized measures of VOR. Computerized assessment tools used were videonystagmography, dynamic visual acuity/gaze stability, rotary chair, and caloric irrigation. Non-computerized tests included the head thrust, dynamic visual acuity, gaze stability, head shaking nystagmus, rotary chair tests and the vestibular/oculomotor screening tool. High variability in administration protocols were identified. Namely: testing environment, distances/positioning/equipment used, active/passive state, procedures, rotation frequencies, and variables observed.Conclusions: There is a rapid growth of literature incorporating VOR tests in mild TBI but moderate and severe TBI continues to be under-represented. Determining how to pair a clinical test with a computerized tool and developing standardized protocols when administering tests will help in developing an optimal battery assessing the VOR in TBI.

Keywords: Traumatic brain injury; concussion; measurement; vestibulo-ocular reflex; vision.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Brain Concussion*
  • Brain Injuries, Traumatic* / complications
  • Brain Injuries, Traumatic* / diagnosis
  • Eye Movements
  • Humans
  • Reflex, Vestibulo-Ocular
  • Visual Acuity

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