June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Visuospatial attention allocation as an indicator of cognitive deficit in traumatic brain injury: a systematic review and meta-analysis
Author Affiliations & Notes
  • Jacinta Anne Walz
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  • Revathy Mani
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  • Sieu Khuu
    School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia
  • Footnotes
    Commercial Relationships   Jacinta Walz, None; Revathy Mani, None; Sieu Khuu, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 2812. doi:
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      Jacinta Anne Walz, Revathy Mani, Sieu Khuu; Visuospatial attention allocation as an indicator of cognitive deficit in traumatic brain injury: a systematic review and meta-analysis. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2812.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Traumatic brain injury (TBI) is characterised by a host of physiological and cognitive deficits such as attention problems. In the present study, we systematically reviewed previous literature that investigated whether and how TBI affects the ability to allocate visuospatial attention i.e., the ability to use and respond to endogenous and exogenous visual cues.

Methods : A literature search using keywords such as “traumatic brain injury” and “visual attention” found 50 papers. Of these, 18 met our inclusion criteria and a systematic review was conducted. 16 studies met the criteria for inclusion in our meta-analysis and 80 effect size estimates of various visual search and attention allocation tasks were obtained. These effect sizes were computed from 459 TBI cases and 458 matched controls using the random effect model.

Results : The systematic review indicated a large degree of variability in task design and a lack of consensus for assessing attention allocation between endogenous and exogenous attention tasks. The combined effect size of the impact of TBI on visuospatial attention allocation was large (g=0.79, p<0.0001) with medium heterogeneity (I2=68.39%). Subgroup analyses revealed an increase in deficit for moderate-to-severe and severe TBI compared to mild TBI (F(2,76)=24.14, p<0.0001, g(mild)=0.32, g(moderate-to-severe)=0.95, g(severe)=1.27). Task type (no cue, endogenous or exogenous cue) had a significant impact on effect size (g(no cue)=0.98, g(endogenous cue)=0.70, g(exogenous cue)=0.45, p=0.0051) indicating that higher order processes were affected to a greater degree than bottom-up processes. Meta-regression analyses revealed significant improvement in visual attention deficit with time (p(mild)=0.031, p(moderate-to-severe)=0.002, p(severe)<0.0001) with recovery from mild injury occurring after approximately 460 days.

Conclusions : Visual attention is largely in deficit as a result of TBI. However, injury severity and the type of visual attention allocation (endogenous vs. exogenous) are significant factors in indicating the degree of deficit. Assessment of visual attention, using a systematic attention allocation task, may provide a useful clinical measure of cognitive impairment after TBI and could be used to detect and monitor TBI, indicate recovery over time or be used to assess the effectiveness of treatment and rehabilitation programs.

This is a 2021 ARVO Annual Meeting abstract.

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