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Preliminary Evidence for the Clinical Utility of Tactile Somatosensory Assessments of Sport-Related mTBI

  • Joshua P McGeown
  • , Patria A Hume
  • , Stephen Kara
  • , Douglas King
  • , Alice Theadom

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

<p><b>Objectives:</b> To evaluate the clinical utility of tactile somatosensory assessments to assist clinicians in diagnosing sport-related mild traumatic brain injury (SR-mTBI), classifying recovery trajectory based on performance at initial clinical assessment, and determining if neurophysiological recovery coincided with clinical recovery.</p><p><b>Research Design:</b> Prospective cohort study with normative controls.</p><p><b> Methods:</b> At admission (<i>n</i> = 79) and discharge (<i>n</i> = 45/79), SR-mTBI patients completed the SCAT-5 symptom scale, along with the following three components from the Cortical Metrics Brain Gauge somatosensory assessment (BG-SA): temporal order judgement (TOJ), TOJ with confounding condition (TOJc), and duration discrimination (DUR). To assist SR-mTBI diagnosis on admission, BG-SA performance was used in logistic regression to discriminate cases belonging to the SR-mTBI sample or a healthy reference sample (pooled BG-SA data for healthy participants in previous studies). Decision trees evaluated how accurately BG-SA performance classified SR-mTBI recovery trajectories. </p><p><b>Results:</b> BG-SA TOJ, TOJc, and DUR poorly discriminated between cases belonging to the SR-mTBI sample or a healthy reference sample (0.54–0.70 AUC, 47.46–64.71 PPV, 48.48–61.11 NPV). The BG-SA evaluated did not accurately classify SR-mTBI recovery trajectories (> 14-day resolution 48%, ≤14–day resolution 54%, lost to referral/follow-up 45%). Mann-Whitney U tests revealed differences in BG-SA TOJc performance between SR-mTBI participants and the healthy reference sample at initial clinical assessment and at clinical recovery (<i>p</i> < 0.05). </p><p><b>Conclusions:</b> BG-SA TOJ, TOJc, and DUR appear to have limited clinical utility to assist clinicians with diagnosing SR-mTBI or predicting recovery trajectories under ecologically valid conditions. Neurophysiological abnormalities persisted beyond clinical recovery given abnormal BG-SA TOJc performance observed when SR-mTBI patients achieved clinical recovery.</p>
Original languageEnglish
Article number56
Pages (from-to)1-14
JournalSports Medicine - Open
Volume7
Issue number1
Early online date9 Aug 2021
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Brain Gauge
  • Modelling
  • Prediction
  • Diagnosis
  • Recovery
  • Sport Sciences
  • Somatosensory
  • mTBI

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