{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:55:59Z","timestamp":1760057759105,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,2,22]],"date-time":"2025-02-22T00:00:00Z","timestamp":1740182400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"American College of Sports Medicine Doctoral Research award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background\/Objectives: The purpose of this study was to evaluate the association between risk-taking behaviors, vestibular symptoms\/impairment and perception\u2013action coupling behavior in recently concussed adolescents. Methods: This study utilized a cross-sectional design to evaluate the early effects of concussion on 12\u201318-year-old adolescents (n = 47) recruited from a concussion specialty clinic at their presenting clinical appointment. The Perception\u2013Action Coupling Task (PACT) was used to assess action boundary perception by evaluating the participant\u2019s ability to quickly and accurately determine whether a virtual \u201cball\u201d fits in a virtual \u201chole\u201d. Accuracy, response time and inverse efficiency were evaluated at the 0.8 and 1.2 ratios of ball\u2013hole pairings, where 0.8 indicates the ball was slightly smaller than the hole and 1.2 indicates the ball was slightly larger than the hole. The Balloon Analog Risk Task (BART) is a computerized test which measures risk-taking behavior by \u201cpumping\u201d up a balloon. Each pump provides a small amount of virtual money into their bank; the goal is to make as much money as possible without popping the virtual balloon. The Vestibular Ocular Motor Screening (VOMS) tool is a brief screening tool designed to identify ocular or vestibular dysfunction following sport-related concussion, where horizontal\/vertical vestibular ocular reflex (VOR) and visual motion sensitivity (VMS) are the primary vestibular outcomes. Pearson correlation matrices were developed to evaluate the association between BART, VOMS and PACT outcomes within the study cohort of concussed adolescents. Results: PACT inverse efficiency at the 1.2 ball\u2013hole ratio was significantly correlated with all three VOMS outcomes (r = 0.33\u20130.37). The standard deviation of pump reaction time during BART was significantly correlated with accuracy (r = \u22120.47) and inverse efficiency (r = 0.42) at the 1.2 ratio. The standard deviation of the total number of pumps during BART was significantly correlated with PACT response time at the 1.2 ratio (r = 0.34). Horizontal VOR correlated with balloons collected (r = \u22120.30) and balloons popped (r = \u22120.30). Conclusions: The results of this study suggest that risk-taking behaviors and vestibular symptoms\/impairment are associated with worse action boundary perception in adolescents following concussion. This relationship is more pronounced in male adolescents than females.<\/jats:p>","DOI":"10.3390\/brainsci15030229","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T06:47:17Z","timestamp":1740379637000},"page":"229","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of Risk-Taking Behaviors, Vestibular Provocation and Action Boundary Perception Following Sport-Related Concussion in Adolescents"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6767-1042","authenticated-orcid":false,"given":"Shawn R.","family":"Eagle","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P.","family":"Kontos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shawn D.","family":"Flanagan","sequence":"additional","affiliation":[{"name":"Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University, Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9031-2192","authenticated-orcid":false,"given":"Christopher","family":"Connaboy","sequence":"additional","affiliation":[{"name":"Center for Lower Extremity Ambulatory Research (CLEAR), Rosalind Franklin University, Chicago, IL 60064, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e20154635","DOI":"10.1542\/peds.2015-4635","article-title":"Sports-and recreation-related concussions in US youth","volume":"138","author":"Bryan","year":"2016","journal-title":"Pediatrics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1754","DOI":"10.1177\/0363546518785901","article-title":"Musculoskeletal injury risk after sport-related concussion: A systematic review and meta-analysis","volume":"47","author":"McPherson","year":"2019","journal-title":"Am. J. Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.1007\/s40279-018-0871-y","article-title":"Neuromuscular control deficits and the risk of subsequent injury after a concussion: A scoping review","volume":"48","author":"Howell","year":"2018","journal-title":"Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/s40279-019-01144-3","article-title":"Increased Risk of Musculoskeletal Injury Following Sport-Related Concussion: A Perception-Action Coupling Approach","volume":"50","author":"Eagle","year":"2020","journal-title":"Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Gibson, J.J. (2002). A theory of direct visual perception. Vision and Mind: Selected Readings in the Philosophy of Perception, Boston Review.","DOI":"10.7551\/mitpress\/7111.003.0007"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1080\/17461391.2021.2003869","article-title":"Association of impulsivity, physical development, and mental health to perceptual-motor control after concussion in adolescents","volume":"22","author":"Eagle","year":"2022","journal-title":"Eur. J. Sport Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"13","DOI":"10.7874\/kja.2013.17.1.13","article-title":"Clinical characteristics of labyrinthine concussion","volume":"17","author":"Choi","year":"2013","journal-title":"Korean J. Audiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"107965","DOI":"10.1016\/j.neuropsychologia.2021.107965","article-title":"Galvanic Vestibular Stimulation influences risk-taking behaviour","volume":"160","author":"Bottini","year":"2021","journal-title":"Neuropsychologia"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport\u2014The 5th international conference on concussion in sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br. J. Sport Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"77","DOI":"10.3357\/AMHP.5190.2019","article-title":"Intersession reliability and within-session stability of a novel perception-action coupling task","volume":"90","author":"Connaboy","year":"2019","journal-title":"Aerosp. Med. Hum. Perform."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1080\/02640414.2020.1756675","article-title":"Utility of a novel perceptual-motor control test for identification of sport-related concussion beyond current clinical assessments","volume":"38","author":"Eagle","year":"2020","journal-title":"J. Sport Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1177\/0363546518756979","article-title":"Reliability and normative reference values for the vestibular\/ocular motor screening (VOMS) tool in youth athletes","volume":"46","author":"Moran","year":"2018","journal-title":"Am. J. Sports Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1177\/0363546518768750","article-title":"Test performance and test-retest reliability of the vestibular\/ocular motor screening and King-Devick test in adolescent athletes during a competitive sport season","volume":"46","author":"Worts","year":"2018","journal-title":"Am. J. Sports Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1080\/21622965.2022.2163172","article-title":"Long-term test-retest reliability of the vestibular\/ocular motor screening for concussion in child athletes: A preliminary study","volume":"13","author":"Moran","year":"2024","journal-title":"Appl. Neuropsychol. Child"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1037\/1076-898X.8.2.75","article-title":"Evaluation of a behavioral measure of risk taking: The Balloon Analogue Risk Task (BART)","volume":"8","author":"Lejuez","year":"2002","journal-title":"J. Exp. Psychol. Appl."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1037\/a0014083","article-title":"Test-retest characteristics of the Balloon Analogue Risk Task (BART)","volume":"16","author":"White","year":"2008","journal-title":"Exp. Clin. Psychopharmacol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.brs.2017.11.011","article-title":"Transcranial Direct Current Stimulation (tDCS) paired with a decision-making task reduces risk-taking in a clinically impulsive sample","volume":"11","author":"Gilmore","year":"2018","journal-title":"Brain Stimul."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Reniers, R.L., Murphy, L., Lin, A., Bartolom\u00e9, S.P., and Wood, S.J. (2016). Risk perception and risk-taking behaviour during adolescence: The influence of personality and gender. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0153842"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","article-title":"Correlation coefficients: Appropriate use and interpretation","volume":"126","author":"Schober","year":"2018","journal-title":"Anesth. Analg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1037\/0012-1649.31.5.866","article-title":"Relations between children\u2019s overestimation of their physical abilities and accident proneness","volume":"31","author":"Plumert","year":"1995","journal-title":"Dev. Psychol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Schlienger, R., De Giovanni, C., Guerraz, M., and Kavounoudias, A. (2023). When proprioceptive feedback enhances visual perception of self-body movement: Rehabilitation perspectives. Front. Hum. Neurosci., 17.","DOI":"10.3389\/fnhum.2023.1144033"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Kearney, J., and Brittain, J.-S. (2021). Sensory attenuation in sport and rehabilitation: Perspective from research in Parkinson\u2019s disease. Brain Sci., 11.","DOI":"10.3390\/brainsci11050580"},{"key":"ref_23","first-page":"e402","article-title":"The Relationship Between Impulsivity, Sensation Seeking, and Concussion History in Collegiate Student-Athletes","volume":"13","author":"Beidler","year":"2021","journal-title":"Athl. Train. Sports Health Care"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Liebel, S.W., Van Pelt, K.L., Garcia, G.G.P., Czerniak, L.L., McCrea, M.A., McAllister, T.W., Broglio, S.P., and CARE Consortium Investigators (2020). The relationship between sport-related concussion and sensation-seeking. Int. J. Mol. Sci., 21.","DOI":"10.3390\/ijms21239097"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s40621-020-0233-8","article-title":"Adolescents\u2019 engagement in multiple risk behaviours is associated with concussion","volume":"7","author":"Shore","year":"2020","journal-title":"Inj. Epidemiol"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.jebo.2011.06.007","article-title":"Strong evidence for gender differences in risk taking","volume":"83","author":"Charness","year":"2012","journal-title":"J. Econ. Behav. 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