Sensory Integration for Spatial Navigation After Concussion - PROJECT SUMMARY/ABSTRACT The reasons for persistent symptoms following a concussion, such as dizziness and imbalance, are not well understood. While common perceptions attribute dizziness and imbalance after concussion to vestibular problems, recent evidence points towards abnormal integration of sensory information, as measured by static assessments (i.e., balance while standing), rather than peripheral sensory dysfunction. However, many everyday tasks, like navigation, require dynamic central sensory integration of vestibular, visual, and proprioceptive cues. The lack of knowledge of central sensory integration during dynamic activities leaves a critical gap in understanding the consequences of concussion during daily life. Our central hypothesis is that concussion alters central sensory integration required for dynamic mobility, including spatial updating and control of balance. This exploratory proposal will begin to address the role of sensory integration in the dynamic task of spatial updating, which is a process that is required for effective navigation and uses visual, proprioceptive, and vestibular information to keep track of one’s location and orientation in space. Spatial updating is a necessary component for forming an accurate cognitive map of the environment, which is crucial for independent living. The proposed work will consider the overlap and potential interference between spatial updating, a cognitive application of central sensory integration, and the control of balance, a motor application of central sensory integration. The long-term goal of the work is to improve rehabilitative care for people with persisting imbalance after concussion by directing patients to targeted treatments that improve their mobility and navigation in daily life. As traditional rehabilitation for post-concussion imbalance focuses on sensory integration for balance, we will use virtual reality to determine how concussion affects sensory integration during spatial updating and how this integration relates to sensory integration for balance. In Specific Aim 1, we will assess concussion-related differences in performance and sensory integration on an ambulatory VR spatial updating task by varying visual and self-motion cues. In Specific Aim 2, we will determine the association between sensory integration for dynamic spatial updating and sensory integration for balance. In Specific Aim 3, we will test the extent of dual-task interference between spatial updating and dynamic balance. Overall, our innovative study will use state-of-the-art technology (virtual reality) to assess central sensory integration during a dynamic spatial updating task and then relate performance on that task to the ability to control balance. Overall, the results of this study will open a new significant line of research that can use virtual reality as an innovative and clinically-translatable assessment, and potentially future treatment, of sensory integration for spatial updating and sensory integration for balance in clinical settings for people with persisting symptoms after concussion.
