Application of electrovestibulography on post-concussion syndrome: diagnosis and monitoring
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Date
2019-02-14
Authors
Suleiman, Abdelbaset
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Abstract
Following a mild Traumatic Brain Injury (mTBI), there can be neuropathological changes in the brain resulting in permanent or transient neurological symptoms and signs of a functional disturbance. The persistence of these symptoms for more than one month is usually referred to as Post-Concussion Syndrome (PCS). PCS severity usually increases when comorbid depression exists. Moreover, the diagnosis of PCS might be overlooked in favour of a diagnosis of depression due to the overlap in the symptoms of the two pathologies. This study, for the first time, presents staged research to evaluate a novel technology, called Electrovestibulography (EVestG), that holds the potential to objectively and cost-effectively be utilized as an assistive tool to diagnose PCS, its comorbid depression and quantitatively measure the recovery from PCS and its sequelae following a treatment.
In the first stage of this research, two EVestG features were extracted from the recorded signals to distinguish PCS from age and gender-matched healthy controls. These two features resulted in an unbiased classification accuracy of 84% and 79% for separating healthy controls from PCS sufferers and for separating long (>3 months) and short-term (<3 months) PCS sufferers, respectively.
Secondly, it was shown that the calculated accuracy for separating PCS from healthy controls can be affected when comorbid depression exists. By adding an EVestG depression-specific feature from a previous study, the calculated accuracy was improved from 83% to >90% for those with moderate/severe depression.
Then, it was shown EVestG features could monitor recovery following repetitive Transcranial Magnetic Stimulation (rTMS) treatment for PCS with and without comorbid depression. Additionally, the EVestG features used have shown the potential to robustly detect and monitor changes, relatively independently, in both persistent PCS and in depression when comorbid PCS-depression present.
Finally, the effect of mTBI on other sensory systems, in particular, that closely linked visual system was examined. Given the prevalence of convergence insufficiency (CI) among the mTBI population, as well as the link between the vestibular and oculomotor system, the effect of the mTBI on the CI was investigated and found to be significantly correlated with the EVestG features and PCS clinical assessment.
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Keywords
Post-concussion syndrome, ElectroVestibulography, Vestibular system, Transcranial magnetic stimulation, Convergence insufficiency
Citation
- Suleiman, A., Lithgow, B., Dastghieb, Z., Mansouri, B., & Moussavi, Z. (2017). Quantitative measurement of post-concussion syndrome Using Electrovestibulography. Scientific reports, 7(1), 16371.
- Suleiman, A., Lithgow, B., Mansouri, B. & Moussavi, Z. Investigating the validity and reliability of Electrovestibulography (EVestG) for detecting post-concussion syndrome (PCS) with and without comorbid depression. Sci. Rep. 8, 14495 (2018).
- Suleiman, A., Lithgow, B., Mansouri, B. & Moussavi, Z. Investigating the validity and reliability of Electrovestibulography (EVestG) for detecting post-concussion syndrome (PCS) with and without comorbid depression. Sci. Rep. 8, 14495 (2018).