2024 American Academy of Neurology Abstract Website

Objective:

This study aims to explore whether self-reported screen intolerance could predict overall symptom burden and be a valuable screening tool for vestibular oculomotor dysfunction in concussion.

Background:

Concussions often lead to extended absences from school and work, with screen sensitivity being a significant hindrance to recovery. Individuals with concussions frequently report an intolerance to electronic displays, especially during the COVID-19 pandemic's surge in virtual work and school environments. Vestibular oculomotor dysfunction and headaches are believed to be the primary culprits behind screen intolerance.

Design/Methods:

Patients with sport and non-sport-related concussions were assessed using the SCAT5 by a board-certified sports neurologist. Participants were included if they were over 18 years old, had a single concussion between 1-12 months prior to the visit, and had a SCAT5 post-concussion symptom inventory (PCSI, range 0-132), vestibulo-oculomotor screening (VOMS, range 0-280), and screen intolerance measured on a Likert scale (0-6). A VOMS score ≥ 8 is clinically significant in distinguishing concussions.

Results:

19 patients (M age=25.89, 8 females) were included from 2022-2023. Patients reported an average symptom burden of 41.84 on the PCSI, a mean score of 64.61 on the VOMS, and a mean screen intolerance of 3 on the Likert scale. Screen intolerance correlated positively with both the VOMS (N=13, Pearson r=0.696, p=0.008) and PCSI (N=19, Pearson r=0.578, p=0.009) scores. Accounting for patient age, which positively correlated with PCSI (N=19, Pearson r=0.594, p=0.007), the partial correlation of self-reported screen intolerance with PCSI remained significant (N=19, Partial r=0.511, p=0.030). Controlling for sex and age did not modify the above findings.

Conclusions:

Self-reported screen intolerance can predict a clinically significant VOMS score and a higher PCSI burden. This finding offers value in concussion management, particularly in return to activity planning. This is especially relevant in today's context of increased screen usage in virtual environments.