Is near point of convergence associated with symptom profiles or recovery in adolescents after concussion?

Abstract

Our purpose was to compare the clinical and injury characteristics of concussion patients with a receded near point of convergence (NPC) vs those without a receded NPC. Concussion patients were seen within 14\xa0days of injury. We compared those with receded a NPC (>6 cm) break point distance and those with a normal NPC distance on symptom, behavioral, and clinical assessments. We also compared NPC break points between those who did/did not recover within 28\xa0days of injury. 123 patients completed the assessment. 77/123 (63%) of participants demonstrated a receded NPC when tested within 14\xa0days of injury. Those with receded a NPC break point (n\xa0=\xa077; mean\xa0=\xa014.9, SD\xa0=\xa01.5\xa0years; 47% female) were significantly younger than those with a normal NPC break point (n\xa0=\xa046; mean\xa0=\xa015.7, SD\xa0=\xa01.7\xa0years; 46% female). The receded NPC break point group had a significantly greater proportion of patients reporting headaches (86% vs. 61%), as well as significantly greater cognitive (mean\xa0=\xa013.4, SD\xa0=\xa08.7 vs. mean\xa0=\xa08.8, SD\xa0=\xa08.6), somatic (mean\xa0=\xa010.0, SD\xa0=\xa05.9 vs. mean\xa0=\xa06.9, SD\xa0=\xa06.6), and overall (mean\xa0=\xa023.7, SD\xa0=\xa013.6 vs. mean\xa0=\xa015.8, SD\xa0=\xa014.4) symptom severity. Our multivariable model indicated among all potential predictor variables, more severe somatic symptoms were significantly associated with a greater NPC break point (β\xa0=\xa00.26; 95% CI\xa0=\xa00.01, 0.52). The group who went onto experience persistent symptoms had a significantly greater NPC break point at initial evaluation than those without persistent symptoms (mean\xa0=\xa09.7, SD\xa0=\xa07.5\xa0cm vs. mean\xa0=\xa07.0, SD\xa0=\xa04.0\xa0cm). Those with a receded NPC break point at initial evaluation showed an increased symptom burden, most notable with somatic symptoms, compared with those without a receded NPC break point.