Clinical Utility of Oculomotor and Electrophysiological Measures in Identifying Concussion History

Objective:To examine whether oculomotor and electrophysiological measures improve the clinical performance of the typical concussion protocol for classifying collegiate athletes with a history of concussion.Design:Cross-sectional.Setting:University Athletic Medicine and Research Facility.Participants:Forty-five varsity collegiate athletes.Independent Variables:Collegiate varsity athletes with or without a history of a diagnosed concussion.Main Outcome Measures:Multivariate receiver operating curve and area under the curve (AUC) analyses tested the clinical performance of the typical concussion protocol (symptoms, postural control, neuropsychological abilities). We examined differences in clinical performance between this protocol and after adding reflexive saccade and event-related potential (ERP) indices. Hypotheses were formed after data collection.Results:Significant AUCs were demonstrated for the typical concussion protocol (model 1: AUC = 0.75, P = 0.007), after adding reflexive saccade eye excursion gain (model 2: AUC = 0.80, P = 0.001), and ERPs (model 3: AUC = 0.79, P = 0.002). The AUC for reflexive saccades and ERPs was significant (model 4: AUC = 0.70, P = 0.030). Model 2's increased clinical performance compared with model 1 was nonsignificant, χ²(2) = 1.871, P = 0.171.Conclusions:All 4 models demonstrated adequate sensitivity and specificity for classifying athletes with a previous concussion. Adding reflexive saccades and ERPs did not significantly increase clinical performance of the typical concussion protocol. Future research should determine the clinical utility of saccades and ERPs for acute postconcussion assessments.