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      Decreased Number of Self-Paced Saccades in Post-Concussion Syndrome Associated with Higher Symptom Burden and Reduced White Matter Integrity.

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          Abstract

          The aim of this study was to examine the potential utility of a self-paced saccadic eye movement as a marker of post-concussion syndrome (PCS) and monitoring the recovery from PCS. Fifty-nine persistently symptomatic participants with at least two concussions performed the self-paced saccade (SPS) task. We evaluated the relationships between the number of SPSs and 1) number of self-reported concussion symptoms, and 2) integrity of major white matter (WM) tracts (as measured by fractional anisotropy [FA] and mean diffusivity) that are directly or indirectly involved in saccadic eye movements and often affected by concussion. These tracts included the uncinate fasciculus (UF), cingulum (Cg) and its three subcomponents (subgenual, retrosplenial, and parahippocampal), superior longitudinal fasciculus, and corpus callosum. Mediation analyses were carried out to examine whether specific WM tracts (left UF and left subgenual Cg) mediated the relationship between the number of SPSs and 1) interval from last concussion or 2) total number of self-reported symptoms. The number of SPSs was negatively correlated with the total number of self-reported symptoms (r = -0.419, p = 0.026). The number of SPSs were positively correlated with FA of left UF and left Cg (r = 0.421, p = 0.013 and r = 0.452, p = 0.008; respectively). FA of the subgenual subcomponent of the left Cg partially mediated the relationship between the total number of symptoms and the number of SPSs, while FA of the left UF mediated the relationship between interval from last concussion and the number of SPSs. In conclusion, SPS testing as a fast and objective assessment may reflect symptom burden in patients with PCS. In addition, since the number of SPSs is associated with the integrity of some WM tracts, it may be useful as a diagnostic biomarker in patients with PCS.

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          Most cited references87

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          FSL (the FMRIB Software Library) is a comprehensive library of analysis tools for functional, structural and diffusion MRI brain imaging data, written mainly by members of the Analysis Group, FMRIB, Oxford. For this NeuroImage special issue on "20 years of fMRI" we have been asked to write about the history, developments and current status of FSL. We also include some descriptions of parts of FSL that are not well covered in the existing literature. We hope that some of this content might be of interest to users of FSL, and also maybe to new research groups considering creating, releasing and supporting new software packages for brain image analysis. Copyright © 2011 Elsevier Inc. All rights reserved.
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            The techniques available for the interrogation and analysis of neuroimaging data have a large influence in determining the flexibility, sensitivity, and scope of neuroimaging experiments. The development of such methodologies has allowed investigators to address scientific questions that could not previously be answered and, as such, has become an important research area in its own right. In this paper, we present a review of the research carried out by the Analysis Group at the Oxford Centre for Functional MRI of the Brain (FMRIB). This research has focussed on the development of new methodologies for the analysis of both structural and functional magnetic resonance imaging data. The majority of the research laid out in this paper has been implemented as freely available software tools within FMRIB's Software Library (FSL).
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                Author and article information

                Journal
                J Neurotrauma
                Journal of neurotrauma
                Mary Ann Liebert Inc
                1557-9042
                0897-7151
                March 01 2018
                : 35
                : 5
                Affiliations
                [1 ] 1 Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto , Toronto, Ontario, Canada .
                [2 ] 2 Institute of Medical Science, University of Toronto , Toronto, Ontario, Canada .
                [3 ] 3 Department of Electrical and Computer Engineering, University of Toronto , Toronto, Ontario, Canada .
                [4 ] 4 Department of Neurology, Hospital for Sick Children , Toronto, Ontario, Canada .
                [5 ] 5 Division of Neurology, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network , Toronto, Ontario, Canada .
                [6 ] 6 Canadian Concussion Centre, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network , Toronto, Ontario, Canada .
                [7 ] 7 Krembil Research Institute, University Health Network , Toronto, Ontario, Canada .
                [8 ] 8 Division of Neuroradiology, Joint Department of Medical Imaging, University Health Network , Toronto, Ontario, Canada .
                [9 ] 9 Department of Rehabilitation Sciences, University of Toronto , Toronto, Ontario, Canada .
                [10 ] 11 Department of Surgery, University of Toronto , Toronto, Ontario, Canada .
                [11 ] 10 Division of Neurosurgery, Toronto Western Hospital, Krembil Neuroscience Centre, University Health Network , Toronto, Ontario, Canada .
                [12 ] 12 Department of Ophthalmology, University of Toronto , Toronto, Ontario, Canada .
                [13 ] 13 Institute of Biomaterials and Biomedical Engineering, University of Toronto , Toronto, Ontario, Canada .
                Article
                10.1089/neu.2017.5274
                29239265
                6100344f-aff6-4006-9535-664aa9f13635
                History

                concussion,oculomotor function,post-concussion syndrome,saccades,white matter

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