Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology · 2026
Selective Attention Deficits in Mild Traumatic Brain Injury using Steady-State Visual Evoked Potentials; Neural Correlates of Attention.
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Norouzpour Amir, Haensel Jennifer X, Lee Minyoung, Hu Amber, Vandiver Tyler J, Slinger Kristin E, Ameyaw Baah Christabel A, Leonen Joellen, Lew Caitlyn Y, Srinivasan Gayathri, Lumba-Brown Angela, Gardner Justin L, Raghuram Aparna, Norcia Anthony M, Roberts Tawna L
Аннотация
OBJECTIVE: To objectively quantify visuospatial selective and divided attention using steady-state visual evoked potentials (SSVEPs) in adults with persistent visual symptoms after mild traumatic brain injury (mTBI).
METHODS: Eighteen adults with mTBI (40-350 days post-mTBI) and 27 healthy controls participated. Frequency-tagged SSVEPs to eccentric flickering stimuli along with concurrent behavioral yes/no contrast-decrement-detection task were recorded under three cued covert spatial attention conditions: Selective Attention (SelAtt), Divided Attention (DivAtt), and Ignore. EEG epochs associated with eye fixation loss were excluded using two independent procedures: automated EEG artifact-rejection algorithms and concurrent EyeLink eye-tracking data.
RESULTS: The mTBI group showed no significant change in task accuracy and complex-value SSVEP responses across attentional conditions (P > 0.05). In contrast, controls showed significant improvements in task accuracy (P < 0.001) and significant SSVEP modulations across conditions (P = 0.03), with stronger SSVEP during SelAtt compared with Ignore (P = 0.008). SelAtt SSVEPs in mTBI were significantly weaker than controls (P = 0.04). Unlike mTBI, control SSVEP amplitude and inter-trial phase coherence (ITPC) significantly increased across conditions (P = 0.02 and < 0.001, respectively). Both groups did not show any significant modulation in SSVEP phase across attentional conditions (P > 0.05). The significant ITPC-amplitude correlation within each group (P < 0.001) was associated with attention status, whereby SelAtt was associated with higher neural ITPC-amplitude response.
CONCLUSIONS: These findings indicate impaired visuospatial selective attention in adults with persistent post-mTBI visual symptoms. Our results support neural synchronization theory on population-level neural correlates of attention and suggest impaired synchronization may underlie attention deficits in mTBI.
SIGNIFICANCE: SSVEP provides objective neurophysiological indices of attentional processing in mTBI.
METHODS: Eighteen adults with mTBI (40-350 days post-mTBI) and 27 healthy controls participated. Frequency-tagged SSVEPs to eccentric flickering stimuli along with concurrent behavioral yes/no contrast-decrement-detection task were recorded under three cued covert spatial attention conditions: Selective Attention (SelAtt), Divided Attention (DivAtt), and Ignore. EEG epochs associated with eye fixation loss were excluded using two independent procedures: automated EEG artifact-rejection algorithms and concurrent EyeLink eye-tracking data.
RESULTS: The mTBI group showed no significant change in task accuracy and complex-value SSVEP responses across attentional conditions (P > 0.05). In contrast, controls showed significant improvements in task accuracy (P < 0.001) and significant SSVEP modulations across conditions (P = 0.03), with stronger SSVEP during SelAtt compared with Ignore (P = 0.008). SelAtt SSVEPs in mTBI were significantly weaker than controls (P = 0.04). Unlike mTBI, control SSVEP amplitude and inter-trial phase coherence (ITPC) significantly increased across conditions (P = 0.02 and < 0.001, respectively). Both groups did not show any significant modulation in SSVEP phase across attentional conditions (P > 0.05). The significant ITPC-amplitude correlation within each group (P < 0.001) was associated with attention status, whereby SelAtt was associated with higher neural ITPC-amplitude response.
CONCLUSIONS: These findings indicate impaired visuospatial selective attention in adults with persistent post-mTBI visual symptoms. Our results support neural synchronization theory on population-level neural correlates of attention and suggest impaired synchronization may underlie attention deficits in mTBI.
SIGNIFICANCE: SSVEP provides objective neurophysiological indices of attentional processing in mTBI.