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.

摘要

目的：确定用于评估所有年龄组和 TBI 严重程度的外伤性脑损伤 (TBI) 后前庭眼反射 (VOR) 功能的测试和工具。

方法：进行了电子搜索以纳入截至 2019 年 11 月发表的相关同行评审文献。研究包括对所有年龄段的人类进行的研究，并对 TBI 中的动眼和/或前庭眼功能进行了评估。

结果：在所选文章（N = 48）中，50% 发表于 2018/2019 年。大多数针对轻度 TBI，同样关注非计算机化与计算机化的 VOR 测量。使用的计算机化评估工具是视频眼球震颤图、动态视力/凝视稳定性、旋转椅和热量灌溉。非计算机化测试包括头部推力、动态视力、凝视稳定性、摇头性眼球震颤、旋转椅测试和前庭/动眼神经筛查工具。确定了给药方案的高度可变性。即：测试环境、使用的距离/定位/设备、主动/被动状态、程序、旋转频率和观察到的变量。

结论：在轻度 TBI 中纳入 VOR 测试的文献迅速增长，但中度和重度 TBI 的代表性仍然不足。确定如何将临床测试与计算机化工具配对并在管理测试时制定标准化协议将有助于开发评估 TBI 中 VOR 的最佳组合。