Head And Eye Movement Deficits In Sport-related Concussion During The Voms In Vr

Sport-related concussions (SRC) impair5 vestibular and ocular motor function. The Vestibular/Ocular-Motor Screening (VOMS) is a diagnostic tool that is used to assess vestibular and ocular motor deficits post-SRC. This test relies on self-symptom reporting, which may lack reliability. Virtual Reality (VR) offers a more objective approach by quantifying head and eye movements. PURPOSE: Evaluate eye and head movements in individuals with SRC using a VR-based VOMS assessment and explore the relationship between these movements and symptom provocation. METHODS: Fourteen Division-I athletes with a physician-diagnosed SRC (female = 11, male = 3; avg. age = 20 ± 2 years) and 14 Division-I healthy athletes (female = 6, male = 8; avg. age = 20 ± 2 years) performed the VOMS in VR. Eye and head movements were tracked with a head-mounted display equipped with eye tracking, alongside symptoms. We calculated eye azimuth and elevation, and head angular movement. We then applied a Savitzky-Golay filter. Saccades were classified based on onset-offset velocity thresholds, and smooth pursuits were classified as anything that was not a saccade. Smooth pursuits, saccades, vestibular-ocular reflex (VOR) movement, and visual motion sensitivity (VMS) movement data were then used in the final statistical analysis. SRC and control were compared with a paired t-test, while correlations between the eye and head data and symptom provocation were analyzed using Spearman-Rank correlation. RESULTS: The SRC group had significantly lower smooth pursuit gain (0.66 ± 0.09 vs. 0.75 ± 0.04, p = 0.002) than controls. VOR gain was also significantly lower in the SRC group for both azimuth (0.79 ± 0.19 vs. 0.89 ± 0.05, p = 0.03) and elevation (0.78 ± 0.20 vs. 0.93 ± 0.06, p = 0.01). Azimuth VOR gain positively correlated with total VOMS change score (ρ = 0.58, p = 0.038), while VMS velocity asymmetry negatively correlated with total VOMS change score (ρ = -0.61, p = 0.027). Smooth pursuit error correlated with the smooth pursuit subtest change score (ρ = -0.51, p = 0.023). CONCLUSION: Smooth pursuit and the VOR are negatively affected following an SRC, as well as correlate with symptom provocation. The VOMS in VR assessment provides a more objective method of evaluating SRC, which potentially overcomes the limitation that is associated with self-reported symptoms. Supported by: Editing process assisted by Perplexity AI. This research was supported by the Neuroscience COBRE (PG30GM145646) and CTR-IN COBRE (1U54GM104944)