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Eye movement and white matter integrity in patients with post-concussion syndrome
  1. Foad Taghdiri1,
  2. Samantha Irwin2,
  3. Namita Multani1,
  4. Apameh Tarazi3,
  5. Ahmed Ebraheem3,
  6. Jonathan Chung4,
  7. Mozghan Khodadadi3,
  8. Ruma Goswami3,
  9. Richard Wennberg3,
  10. Robin Green3,
  11. Dave Mikulis3,
  12. Charles Tator3,
  13. Moshe Eizenman4,
  14. Maria Carmela Tartaglia1,3
  1. 1Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, 60 Leonard avenue, Toronto, Canada
  2. 2Department of Neurology, Hospital for Sick Children, Toronto, Canada
  3. 3Devision of Neurology, University Health Network, Toronto Western Hospital, Canada
  4. 4Department of Ophthalmology, Department of Electrical and Computer Engineering, Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, Canada

Abstract

Objective To assess eye movements in patients with post-concussion syndrome (PCS) and use diffusion tensor imaging (DTI) to determine relationship between eye movements and white matter integrity.

Design cross-sectional study.

Intervention Attention and executive function were tested using Visual Attention Scanning Technology (VAST) [EL-MAR Inc., Toronto, Ontario, Canada]. In a matching task, the normalised number of transitions (NNT) to a master image before making the first selection was used as a surrogate of working memory. During this task, subjects view a set of slides, each slide includes a master image and six variants, and they have to select a variant that is similar to the master (only one variant is an exact replica of the master).

Outcome measures We related performance on VAST to white matter integrity using Tract-Based Spatial Statistics of DTI metrics such as fractional anisotropy (FA) for whole brain analyses as well as seed-based probabilistic tractography analysis of the superior longitudinal fasciculus (SLF), Cingulum tract, and Uncinate fasciculus (UF).

Main results 60 participants (mean age 34.3 years, SD 13.8) had a mean of 4 concussions. There were negative correlations between whole brain FA and NNT (r=−0.501, p<0.001). In addition, when we performed probabilistic tractography analyses, we found a negative correlation between the FA of right SLF and NNT (r=−0.332, p=0.009).

Conclusions Impaired performance on eye tracking measures of attention and executive function may reflect alterations in white matter tracts.

Competing interests None.

Moshe Eizenman is a director in EL-MAR Inc.

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