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Preethi Thiagarajan, Kenneth J Ciuffreda; Persistence of oculomotor training effects in mild traumatic brain injury (mTBI). Invest. Ophthalmol. Vis. Sci. 2014;55(13):2662.
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Our previous study found considerable positive oculomotor training (OMT) effects in individuals with mTBI and nearwork-related visual symptoms/clinical signs. Here, persistence of the initial post-training improvements in the same individuals were assessed during the 3 and 6 months follow-up period.
Basic clinical measures of oculomotor behavior were assessed in 15 young-adults (age range: 18-40 years) with mTBI before and after OMT using standardized clinical assessment methods. In addition, reading eye movements were objectively recorded using the Visagraph system. Furthermore, nearvision symptoms were assessed using the Convergence Insufficiency Symptom Survey (CISS), and subjective visual attention was tested with the Visual Search and Attention Test (VSAT). Eight out of the original 15 individuals who completed the OMT were reassessed at 3-months and 6-months following the OMT.
Thirteen out of the 18 clinical parameters tested were abnormal at baseline. Repeated measures, one-way ANOVA (with missing data compensation) demonstrated the following: 3 parameters showed a significant effect (p<0.05) immediately after OMT, with persistence at 3 and 6 months (p<0.05): near point of convergence (NPC) break, NPC recovery, and positive fusional vergence (PFV) recovery. Four parameters showed a significant effect (p<0.05) at the 3 and 6 month follow-up only: vergence facility, Visagraph reading rate, fixations/100 words, and grade-level efficiency. Two other parameters showed a 'trend' (p=0.08) for improvement immediately after OMT: binocular accommodative amplitude and binocular accommodative facility. Thus, 7 parameters showed a persistent and positive, significant OMT effect out of the 13 parameters that were abnormal at baseline.
The results demonstrate both short-term and long-term OMT effects. The short-term effects demonstrate presence of robust and rapid visual neuroplasticity, even in a damaged adult brain, whereas the latter suggests a combined neural 'consolidation' effect and an oculomotor learning/practice effect with the now improved visual/oculomotor system, following the OMT.
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