抄録集

BackgroundMild traumatic brain injury (mTBI) is an increasingly common global health issue that affects 50-60 Million people worldwide.Thirty to forty percent of those who experience mTBI have subacute or chronic effects of the injury.Optimized diagnosis and treatment modalities for this disorder are urgently needed.Unfortunately, questions remain including how best to diagnose the condition, how to determine the prognosis of the condition, and how to treat the condition to prevent short-and long-term consequences.The aim of this talk is to discuss novel diagnostic and treatment paradigms in mTBI as they have developed over the years, as they currently stand, and what novel approaches we will be utilizing in the future. Materials and MethodsA combination of oculomotor, vestibular and reaction time (OVRT) tests were performed in a virtual reality google (Synopsis, Inc, Pittsburgh, PA, USA).The test included pursuit tests, saccade tests, oculomotor control tests, reaction time testes and vergence tests.In a series of several experiments this battery of tests was used to examine performance differences between the following: 1) Controls and mTBI subjects, 2) mTBI subjects and other vestibular disorders, and 3) acute mTBI subjects and more chronic mTBI subjects.Objective test outcomes of each of the 14 tests were compared between groups using standard statical methods to determine differences.In addition, patterns of pupil and eye motion response were evaluated for the vergence tests and compared in controls, acute mTBI, chronic mTBI, and other vestibular conditions. ResultsThe experiments in total included over 500 controls, 450 mTBI subjects, and 100 other vestibular condition subjects.Each experiment was had properly matched comparison groups and the power to determine differences between the groups.The results are as follows: 1) A series of six tests could determine the presence of mTBI when comparing acute mTBI to control, (AUC 0.966, Sensitivity 0.929, and Specificity 0.90) Using these tests and the analysis of vergencies acute mTBI could be distinguished from other vestibular disorders and 3) Using vergence alone the state of mTBI (acute (0-7 days), subacute (10-30 days), and chronic (90 days and over) could be determined.Furthermore, using a combination of the tests and vergence results prognosis of the state of mTBI recovery could be determined. ConclusionsMild traumatic brain injury is a major public health problem.Despite a great deal of study accurate diagnosis, prognostic information, and optimal treatment have not been defined.In this word we discuss the use of a portable device to study mTBI.Using a combination of test the device can determine the presence of mTBI.The weight of the evidence in this area is so strong that the device has US FDA approval for determining the presence of mTBI.Moreover, using different combinations of tests, the device can determine the difference between mTBI and other vestibular disorders and can determine the status of recovery of an individual with mTBI.We also will discuss how the device guides treatment and novel new treatment paradigms. 297 Equilibrium Res Vol.84(5) -- (vestibular migraine) 4 -72 3 (ICHD-3) NSAIDs QOL