Research Reports - Oculomotor neurorehabilitation for reading in mild traumatic brain injury

NeuroRehabilitation. 2013 Nov 27

Thiagarajan P, Ciuffreda KJ, Capo-Aponte JE, Ludlam DP, Kapoor N

BACKGROUND: Considering the extensive neural network of the oculomotor
subsystems, traumatic brain injury (TBI) could affect oculomotor control and
related reading dysfunction.
OBJECTIVE: To evaluate comprehensively the effect of oculomotor-based vision
rehabilitation (OBVR) in individuals with mTBI.
METHODS: Twelve subjects with mTBI participated in a cross-over, interventional
study involving oculomotor training (OMT) and sham training (ST). Each training
was performed for 6 weeks, 2 sessions a week. During each training session, all
three oculomotor subsystems (vergence/accommodation/version) were trained in a
randomized order across sessions. All laboratory and clinical parameters were
determined before and after OMT and ST. In addition, nearvision-related symptoms
using the Convergence Insufficiency Symptom Survey (CISS) scale and subjective
visual attention using the Visual Search and Attention Test (VSAT) were assessed.
RESULTS: Following the OMT, over 80% of the abnormal parameters significantly
improved. Reading rate, along with the amplitudes of vergence and accommodation,
improved markedly. Saccadic eye movements demonstrated enhanced rhythmicity and
accuracy. The improved reading-related oculomotor behavior was reflected in
reduced symptoms and increased visual attention. None of the parameters changed
with ST.
CONCLUSIONS: OBVR had a strong positive effect on oculomotor control, reading
rate, and overall reading ability. This oculomotor learning effect suggests
considerable residual neuroplasticity following mTBI.

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