Abstract
Purpose :
Traumatic brain injury (TBI) is frequently associated with a variety of cognitive deficits, primarily attention and memory deficits. Typically, vision is used an index of attention deficits following TBI and this study focussed on understanding the impact of TBI on visual attention and the degree to which the different attentional components and processes visual attention (such as selective, sustained, divided, and covert orientation of visual attention) are affect differently following TBI.
Methods :
A systematic and meta-analytic review was conducted from research examining visual attention following TBI. A literature search before May 2020 was undertaken on different databases for studies that assessed visual attention using different tasks that target specific or multiple aspect or component of visual attention. Two hundred eighty-seven potentially relevant articles were identified through the literature search and the application of the inclusion and exultation criteria yielded a total of 16 studies.
Results :
A total of 103 effect sizes were estimated form 16 studies using the random effect model from 424 cases and 437 controls. The overall combined effect size suggests considerable impact of TBI on visual attention as it was statistically significant and large TBI, but with high heterogeneity (Effect size=0.92, Q = 563.84, p < 0.0001, I2 = 81.91%). Sources of heterogeneity may be due to TBI severity, the aspect of visual attention under investigation, and the use of different tasks and paradigms used to investigate them. Combined effect sizes for severe TBI was significantly higher than mild TBI (t (92) =2.63, p=0.009), indicating greater deficits in visual attention with more injury severity. The combined effect sizes for different aspects of visual attention were significantly different (F (2, 100) = 9.682, p=0.0001). A subgroup analysis comparing outcome measures (for different aspects of attention) showed that reaction time was significantly more affected compare to performance accuracy (F (1, 96) = 25.98, P<0.0001).
Conclusions :
Large and significant deficit in visual attention was found following TBI which can last for years after the initial injury. However, different aspects visual attention was not affected to the same extent. Future TBI studies and clinical approaches should consider this when investigating potential attentional deficits following TBI.
This is a 2021 ARVO Annual Meeting abstract.