Assessment of Three Clinical Tests for Evaluation of Concussion/Mild Traumatic Brain Injury

A focus of both basic and clinical research on concussion/mild traumatic brain injury has been to ascertain which test, or combination of tests, is best for its detection. In the present retrospective analysis, three potential clinical tests were evaluated to determine which one, or combination, best differentiated between visually-symptomatic concussed (n=52) versus asymptomatic non-concussed (n=24) patients. The three tests were: distance horizontal vergence facility, peripheral visual motion, and critical flicker fusion. Each test was found to differentiate the two groups. The peripheral visual motion test was the best, with a sensitivity of 93.8% and a specificity of 83.3%. When this test was combined with the distance horizontal vergence facility test, specificity remained the same whereas sensitivity increased to 94.4%. Addition of the critical flicker fusion test did not affect these values. Thus, of the three, the combination of the peripheral visual motion and distance horizontal vergence facility tests has a high probability of assisting in concussion detection and diagnosis.