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Original Article

Objective assessment of visual attention in mild traumatic brain injury (mTBI) using visual-evoked potentials (VEP)

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Pages 352-365 | Received 21 Apr 2014, Accepted 17 Oct 2014, Published online: 21 Nov 2014
 

Abstract

Purpose: To quantify visual attention objectively using the visual-evoked potential (VEP) in those having mild traumatic brain injury (mTBI) with and without a self-reported attentional deficit.

Research design and methods: Subjects were comprised of 16 adults with mTBI: 11 with an attentional deficit and five without. Three test conditions were used to assess the visual attentional state to quantify objectively the VEP alpha band attenuation ratio (AR) related to attention: (1) pattern VEP; (2) eyes-closed; and (3) eyes-closed number counting. The AR was calculated for both the individual and combined alpha frequencies (8–13 Hz). The objective results were compared to two subjective tests of visual and general attention (i.e. the VSAT and ASRS, respectively).

Results: The AR for both the individual and combined alpha frequencies was found to be abnormal in those with mTBI having an attentional deficit. In contrast, the AR was normal in those with mTBI but without an attentional deficit. The AR correlated with the ASRS, but not with the VSAT, test scores.

Conclusions: The objective and subjective tests were able to differentiate between those having mTBI with and without an attentional deficit. The proposed VEP protocol can be used in the clinic to detect and assess objectively and reliably a visual attentional deficit in the mTBI population.

Acknowledgements

We thank DIOPSYS Inc., Pine Brook, NJ for providing the VEP system for the study. We also thank Dr Kevin Willeford for his helpful comments on the manuscript. This work was supported by the College of Optometrists in Vision Development (COVD).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

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