Consequences of Traumatic Brain Injury for Human Vergence Dynamics

Tyler, Christopher W.; Likova, Lora T.; Mineff, Kristyo; Elsaid, Anas M.; Nicholas, Spero

doi:10.3389/fneur.2014.00282

Cited by 6 publications

(6 citation statements)

References 15 publications

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“…Interestingly, for vergence eye movements, there was a significant slowing of the divergence velocities relative to convergence velocities for both the control and dTBI groups, though no significant difference between the groups in this respect. This slowing of divergence relative to convergence on average replicates the result in studies of normal vergence behavior in Tyler et al ( 21 , 24 ).…”

Section: Discussionsupporting

confidence: 83%

“…The human participants consisted of 12 individuals (6 female) with dTBI and 11 age-matched controls (4 female) who met the criteria of corrected letter acuity of 20/50 or better in the best eye with no visible ocular abnormalities. They were recruited into the study on the basis of their participation in a companion behavioral study of eye movements ( 21 ). The individuals were assigned to the control group if they had no past history of dTBI events (12 individuals with ages ranging from 22 to 75; mean age: 33.3 ± 13.3).…”

Section: Methodsmentioning

confidence: 99%

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Deficits in the Activation of Human Oculomotor Nuclei in Chronic Traumatic Brain Injury

et al. 2015

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Binocular eye movements form a finely tuned system that requires accurate coordination of the oculomotor dynamics of the brainstem control nuclei when tracking the fine binocular disparities required for 3D vision. They are particularly susceptible to disruption by brain injury and other neural dysfunctions. Here, we report functional magnetic resonance imaging activation of the brainstem oculomotor control nuclei by binocular saccadic and vergence eye movements, and significant reductions in their response amplitudes in mild or diffuse traumatic brain injury (dTBI). Bilateral signals were recorded from a non-TBI control group (n = 11) in the oculomotor control system of the superior colliculi, the oculomotor nuclei, the abducens nuclei, and in the supra-oculomotor area (SOA), which mediate vergence eye movements. Signals from these nuclei were significantly reduced overall in a dTBI group (n = 12) and in particular for the SOA for vergence movements, which also showed significant decreases in velocity for both the convergence and divergence directions.

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Section: Discussionsupporting

confidence: 83%

Section: Methodsmentioning

confidence: 99%

Deficits in the Activation of Human Oculomotor Nuclei in Chronic Traumatic Brain Injury

et al. 2015

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“…A growing number of studies have investigated the effects of head injuries and concussions on oculomotor,9–25,32–37 vestibular,10,11,18,19,26 and reaction time 27–30 (OVRT) performance. In this study we investigated whether combined OVRT measures can reliably distinguish concussed subjects from similarly aged controls in a population of high school students.…”

Section: Discussionmentioning

confidence: 99%

“…An innovative adjunct to current concussion assessment practice is to use high spatial and temporal resolution measurements of eye movement reflexes and responses to specific stimuli or tasks, generally known as video-oculography. Aberrations in eye movements in saccades, smooth pursuit, nystagmus, and vergence have proven to be informative indicators of brain injury,9–25 as have measurements of vestibular functions,10,11,18,19,26 and reaction time performance 27–30…”

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confidence: 99%

Oculomotor, Vestibular, and Reaction Time Effects of Sports-Related Concussion: Video-Oculography in Assessing Sports-Related Concussion

Kelly¹,

Kiderman²,

Akhavan³

et al. 2019

Journal of Head Trauma Rehabilitation

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Objective: The purpose of the study was to test the ability of oculomotor, vestibular, and reaction time (OVRT) metrics to serve as a concussion assessment or diagnostic tool for general clinical use. Setting and Participants: Patients with concussion were high school-aged athletes clinically diagnosed in a hospital setting with a sports-related concussion ( n = 50). Control subjects were previously recruited male and female high school student athletes from 3 local high schools ( n = 170). Design: Video-oculography was used to acquire eye movement metrics during OVRT tasks, combined with other measures. Measures were compared between groups, and a subset was incorporated into linear regression models that could serve as indicators of concussion. Measures: The OVRT test battery included multiple metrics of saccades, smooth pursuit tracking, nystagmoid movements, vestibular function, and reaction time latencies. Results: Some OVRT metrics were significantly different between groups. Linear regression models distinguished control subjects from concussion subjects with high accuracy. Metrics included changes in smooth pursuit tracking, increased reaction time and reduced saccade velocity in a complex motor task, and decreased optokinetic nystagmus (OKN) gain. In addition, optokinetic gain was reduced and more variable in subjects assessed 22 or more days after injury. Conclusion: These results indicate that OVRT tests can be used as a reliable adjunctive tool in the assessment of concussion and that OKN results appear to be associated with a prolonged expression of concussion symptoms.

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“…40 A metaanalysis concluded that convergence insufficiency occurs in 37% of patients with mTBI. 18 Detailed studies have showed that dynamic vergence measures are reduced, 41 and vergence instability may be reflected in greater horizontal disconjugacy during naturalistic viewing. 42 Pursuit of a predictably moving target was reduced in some studies [43][44][45] but others found little change.…”

Section: Ocular Motor Dysfunction In Traumatic Brain Injurymentioning

confidence: 99%

Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

Barton

Ranalli

2020

Annals of Neurology

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Vision therapy in the form of ocular motor training is increasingly used to treat visual complaints, particularly in the setting of persistent symptoms after mild traumatic brain injury (mTBI). In this review, we discuss the rationale behind this intervention and the evidence for its utility. Although the efficacy of exercises for primary convergence insufficiency is plausible and supported by data, there is not yet strong evidence of benefit for the post‐traumatic variant. It is not established that abnormalities in fixation, pursuit, and saccades in mTBI are the cause of post‐concussive symptoms, or that these abnormalities arise from ocular motor damage rather than being secondary effects of cognitive problems with attention or executive control. The few studies to date have significant methodological weaknesses. More substantial evidence is required before vision therapy can be accepted as a useful tool in the rehabilitation of patients with brain trauma. ANN NEUROL 2020;88:453–461

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Consequences of Traumatic Brain Injury for Human Vergence Dynamics

Cited by 6 publications

References 15 publications

Deficits in the Activation of Human Oculomotor Nuclei in Chronic Traumatic Brain Injury

Deficits in the Activation of Human Oculomotor Nuclei in Chronic Traumatic Brain Injury

Oculomotor, Vestibular, and Reaction Time Effects of Sports-Related Concussion: Video-Oculography in Assessing Sports-Related Concussion

Vision Therapy: Ocular Motor Training in Mild Traumatic Brain Injury

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