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Abstract
PURPOSE OF REVIEW This review investigates the relationship between sensory sensitivity and traumatic brain injury (TBI), and the role sensory sensitivity plays in chronic disability. RECENT FINDINGS TBI is a significant cause of disability with a range of physical, cognitive, and mental health consequences. Sensory sensitivities (e.g., noise and light) are among the most frequently reported, yet least outwardly recognizable symptoms following TBI. Clinicians and scientists alike have yet to identify consistent nomenclature for defining noise and light sensitivity, making it difficult to accurately and reliably assess their influence. Noise and light sensitivity can profoundly affect critical aspects of independent function including communication, productivity, socialization, cognition, sleep, and mental health. Research examining the prevalence of sensory sensitivity and evidence for the association of sensory sensitivity with TBI is inconclusive. Evidence-based interventions for sensory sensitivity, particularly following TBI, are lacking.
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Simpson-Jones ME, Hunt AW. Vision rehabilitation interventions following mild traumatic brain injury: a scoping review. Disabil Rehabil 2018; 41:2206-2222. [DOI: 10.1080/09638288.2018.1460407] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Mary E. Simpson-Jones
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
| | - Anne W. Hunt
- Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, Canada
- Clinical Study Investigator Bloorview Research Institute, Toronto, Canada
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Armstrong RA. Visual problems associated with traumatic brain injury. Clin Exp Optom 2018; 101:716-726. [PMID: 29488253 DOI: 10.1111/cxo.12670] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/12/2018] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
Traumatic brain injury (TBI) and its associated concussion are major causes of disability and death. All ages can be affected but children, young adults and the elderly are particularly susceptible. A decline in mortality has resulted in many more individuals living with a disability caused by TBI including those affecting vision. This review describes: (1) the major clinical and pathological features of TBI; (2) the visual signs and symptoms associated with the disorder; and (3) discusses the assessment of quality of life and visual rehabilitation of the patient. Defects in primary vision such as visual acuity and visual fields, eye movement including vergence, saccadic and smooth pursuit movements, and in more complex aspects of vision involving visual perception, motion vision ('akinopsia'), and visuo-spatial function have all been reported in TBI. Eye movement dysfunction may be an early sign of TBI. Hence, TBI can result in a variety of visual problems, many patients exhibiting multiple visual defects in combination with a decline in overall health. Patients with chronic dysfunction following TBI may require occupational, vestibular, cognitive and other forms of physical therapy. Such patients may also benefit from visual rehabilitation, including reading-related oculomotor training and the prescribing of spectacles with a variety of tints and prism combinations.
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Matuseviciene G, Johansson J, Möller M, Godbolt AK, Pansell T, Deboussard CN. Longitudinal changes in oculomotor function in young adults with mild traumatic brain injury in Sweden: an exploratory prospective observational study. BMJ Open 2018; 8:e018734. [PMID: 29431132 PMCID: PMC5829871 DOI: 10.1136/bmjopen-2017-018734] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To assess (1) whether visual disturbances can be demonstrated with objective measures more often in patients with mild traumatic brain injury (mTBI) than in orthopaedic controls and non-injured controls, (2) whether such objectively demonstrated disturbances change over time and (3) whether self-reported visual symptoms after mTBI correlate with objectively measurable changes in visuomotor performance. DESIGN A prospective, controlled, observational study, with assessments planned 7-10 and 75-100 days after injury. SETTING Emergency department of a general hospital in Sweden. PARTICIPANTS 15 patients with mTBI, 15 patients with minor orthopaedic injury, 15 non-injured controls, aged 18-40 years. OUTCOME MEASURES Visual examination, including assessment of visual acuity, accommodation, eye alignment, saccades and stereoacuity. Symptom assessment using Convergence Insufficiency Symptoms Survey (CISS) and Rivermead PostConcussion Symptoms Questionnaire. RESULTS Assessments were performed 4-13 and 81-322 days after injury (extended time frames for logistical reasons). No statistically significant difference was found between the mTBI and control groups regarding saccade performance and stereoacuity at any time point. The accommodative amplitude was significantly lower in the mTBI group compared with non-injured controls at baseline. 6 out of 13 patients with mTBI had accommodative insufficiency at follow-up. Near point of convergence in the mTBI group was receded at baseline and improved statistically significantly at follow-up. At baseline, patients with mTBI had significantly higher CISS score than orthopaedic and non-injured controls. For patients with mTBI, the CISS score correlated with fusional vergence. CONCLUSION There were some transient measurable visual changes regarding convergence in patients with mTBI during the subacute period after the injury. Our findings of persistence of accommodative insufficiency in a considerable proportion of patients with mTBI suggest that this visual function should not be overlooked in clinical assessment.
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Affiliation(s)
- Giedre Matuseviciene
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Jan Johansson
- Department of Clinical Neuroscience, Eye and Vision, Karolinska Institutet, Stockholm, Sweden
| | - Marika Möller
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Alison K. Godbolt
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Tony Pansell
- Department of Clinical Neuroscience, Eye and Vision, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Nygren Deboussard
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Mutlu U, Bonnemaijer PW, Ikram MA, Colijn JM, Cremers LG, Buitendijk GH, Vingerling JR, Niessen WJ, Vernooij MW, Klaver CC, Ikram MK. Retinal neurodegeneration and brain MRI markers: the Rotterdam Study. Neurobiol Aging 2017; 60:183-191. [DOI: 10.1016/j.neurobiolaging.2017.09.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 09/05/2017] [Accepted: 09/05/2017] [Indexed: 10/18/2022]
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Wood RL. Accelerated cognitive aging following severe traumatic brain injury: A review. Brain Inj 2017; 31:1270-1278. [DOI: 10.1080/02699052.2017.1332387] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Rodger Ll. Wood
- Neuropsychology Clinic, Institute of Life Sciences, College of Medicine, Swansea University, Swansea, UK
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DeWalt GJ, Eldred WD. Visual system pathology in humans and animal models of blast injury. J Comp Neurol 2017; 525:2955-2967. [PMID: 28560719 DOI: 10.1002/cne.24252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 05/12/2017] [Accepted: 05/14/2017] [Indexed: 12/20/2022]
Abstract
Injury from blast exposure is becoming a more prevalent cause of death and disability worldwide. The devastating neurological impairments that result from blasts are significant and lifelong. Progress in the development of effective therapies to treat injury has been slowed by its heterogeneous pathology and the dearth of information regarding the cellular mechanisms involved. Within the last decade, a number of studies have documented visual dysfunction following injury. This brief review examines damage to the visual system in both humans and animal models of blast injury. The in vivo use of the retina as a surrogate to evaluate brain injury following exposure to blast is also highlighted.
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Affiliation(s)
- Gloria J DeWalt
- Department of Biology, Boston University, Boston, Massachusetts
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Kolakowsky-Hayner SA, Bellon K, Yang Y. Unintentional injuries after TBI: Potential risk factors, impacts, and prevention. NeuroRehabilitation 2017; 39:363-70. [PMID: 27497469 DOI: 10.3233/nre-161368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND The top three causes of fatal unintentional injuries are falls, motor vehicle crashes, and being struck against or struck by objects or persons. These etiologies also happen to be the leading causes of TBI, a serious public health problem, in the US. Reduced cognitive functioning, poor decision making, increased risk taking, disinhibition, diminished safety skills and substance use, place individuals with TBI at an increased risk for subsequent unintentional injuries. The caregiving, psychological, social and financial burden of initial injuries is enormous. Unintentional injuries post-TBI add to that burden significantly. Many unintentional injuries can be prevented with simple education and environment and lifestyle changes. Injury prevention requires collaboration among many. OBJECTIVE This literature review will share information regarding potential triggers or causes of unintentional injuries after TBI to identify potential issues. The many impacts of these injuries will be reviewed. Best practices in prevention will be presented. CONCLUSION Ultimately, education, discussion, and awareness across multiple stakeholders can aid in preventing unintentional injuries after TBI.
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Affiliation(s)
- Stephanie A Kolakowsky-Hayner
- Brain Trauma Foundation, Campbell, CA, USA.,Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA
| | - Kimberly Bellon
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA
| | - Yvonne Yang
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, CA, USA
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de Vries SM, Heutink J, Melis-Dankers BJM, Vrijling ACL, Cornelissen FW, Tucha O. Screening of visual perceptual disorders following acquired brain injury: A Delphi study. APPLIED NEUROPSYCHOLOGY-ADULT 2017; 25:197-209. [DOI: 10.1080/23279095.2016.1275636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- S. M. de Vries
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - J. Heutink
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - B. J. M. Melis-Dankers
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - A. C. L. Vrijling
- Royal Dutch Visio, Centre of Expertise for Blind and Partially Sighted People, Huizen, The Netherlands
| | - F. W. Cornelissen
- Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - O. Tucha
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
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Gall C, Schmidt S, Schittkowski MP, Antal A, Ambrus GG, Paulus W, Dannhauer M, Michalik R, Mante A, Bola M, Lux A, Kropf S, Brandt SA, Sabel BA. Alternating Current Stimulation for Vision Restoration after Optic Nerve Damage: A Randomized Clinical Trial. PLoS One 2016; 11:e0156134. [PMID: 27355577 PMCID: PMC4927182 DOI: 10.1371/journal.pone.0156134] [Citation(s) in RCA: 81] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 05/10/2016] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Vision loss after optic neuropathy is considered irreversible. Here, repetitive transorbital alternating current stimulation (rtACS) was applied in partially blind patients with the goal of activating their residual vision. METHODS We conducted a multicenter, prospective, randomized, double-blind, sham-controlled trial in an ambulatory setting with daily application of rtACS (n = 45) or sham-stimulation (n = 37) for 50 min for a duration of 10 week days. A volunteer sample of patients with optic nerve damage (mean age 59.1 yrs) was recruited. The primary outcome measure for efficacy was super-threshold visual fields with 48 hrs after the last treatment day and at 2-months follow-up. Secondary outcome measures were near-threshold visual fields, reaction time, visual acuity, and resting-state EEGs to assess changes in brain physiology. RESULTS The rtACS-treated group had a mean improvement in visual field of 24.0% which was significantly greater than after sham-stimulation (2.5%). This improvement persisted for at least 2 months in terms of both within- and between-group comparisons. Secondary analyses revealed improvements of near-threshold visual fields in the central 5° and increased thresholds in static perimetry after rtACS and improved reaction times, but visual acuity did not change compared to shams. Visual field improvement induced by rtACS was associated with EEG power-spectra and coherence alterations in visual cortical networks which are interpreted as signs of neuromodulation. Current flow simulation indicates current in the frontal cortex, eye, and optic nerve and in the subcortical but not in the cortical regions. CONCLUSION rtACS treatment is a safe and effective means to partially restore vision after optic nerve damage probably by modulating brain plasticity. This class 1 evidence suggests that visual fields can be improved in a clinically meaningful way. TRIAL REGISTRATION ClinicalTrials.gov NCT01280877.
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Affiliation(s)
- Carolin Gall
- Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
- * E-mail:
| | - Sein Schmidt
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michael P. Schittkowski
- Department of Ophthalmology, University Medical Center, Georg-August University of Goettingen, Goettingen, Germany
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University, Goettingen, Germany
| | - Géza Gergely Ambrus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University, Goettingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, Georg-August University, Goettingen, Germany
| | - Moritz Dannhauer
- Center for Integrative Biomedical Computing and the Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, United States of America
| | - Romualda Michalik
- Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Alf Mante
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Michal Bola
- Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Anke Lux
- Institute for Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Siegfried Kropf
- Institute for Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
| | - Stephan A. Brandt
- Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernhard A. Sabel
- Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany
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61
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First- and second-order contrast sensitivity functions reveal disrupted visual processing following mild traumatic brain injury. Vision Res 2016; 122:43-50. [DOI: 10.1016/j.visres.2016.03.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/16/2016] [Accepted: 03/18/2016] [Indexed: 11/17/2022]
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Sub-Chronic Neuropathological and Biochemical Changes in Mouse Visual System after Repetitive Mild Traumatic Brain Injury. PLoS One 2016; 11:e0153608. [PMID: 27088355 PMCID: PMC4835061 DOI: 10.1371/journal.pone.0153608] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 03/31/2016] [Indexed: 11/29/2022] Open
Abstract
Repetitive mild traumatic brain injury (r-mTBI) results in neuropathological and biochemical consequences in the human visual system. Using a recently developed mouse model of r-mTBI, with control mice receiving repetitive anesthesia alone (r-sham) we assessed the effects on the retina and optic nerve using histology, immunohistochemistry, proteomic and lipidomic analyses at 3 weeks post injury. Retina tissue was used to determine retinal ganglion cell (RGC) number, while optic nerve tissue was examined for cellularity, myelin content, protein and lipid changes. Increased cellularity and areas of demyelination were clearly detectable in optic nerves in r-mTBI, but not in r-sham. These changes were accompanied by a ~25% decrease in the total number of Brn3a-positive RGCs. Proteomic analysis of the optic nerves demonstrated various changes consistent with a negative effect of r-mTBI on major cellular processes like depolymerization of microtubules, disassembly of filaments and loss of neurons, manifested by decrease of several proteins, including neurofilaments (NEFH, NEFM, NEFL), tubulin (TUBB2A, TUBA4A), microtubule-associated proteins (MAP1A, MAP1B), collagen (COL6A1, COL6A3) and increased expression of other proteins, including heat shock proteins (HSP90B1, HSPB1), APOE and cathepsin D. Lipidomic analysis showed quantitative changes in a number of phospholipid species, including a significant increase in the total amount of lysophosphatidylcholine (LPC), including the molecular species 16:0, a known demyelinating agent. The overall amount of some ether phospholipids, like ether LPC, ether phosphatidylcholine and ether lysophosphatidylethanolamine were also increased, while the majority of individual molecular species of ester phospholipids, like phosphatidylcholine and phosphatidylethanolamine, were decreased. Results from the biochemical analysis correlate well with changes detected by histological and immunohistochemical methods and indicate the involvement of several important molecular pathways. This will allow future identification of therapeutic targets for improving the visual consequences of r-mTBI.
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63
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Berger S, Kaldenberg J, Selmane R, Carlo S. Effectiveness of Interventions to Address Visual and Visual–Perceptual Impairments to Improve Occupational Performance in Adults With Traumatic Brain Injury: A Systematic Review. Am J Occup Ther 2016; 70:7003180010p1-7. [DOI: 10.5014/ajot.2016.020875] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Abstract
OBJECTIVE. Visual and visual–perceptual impairments occur frequently with traumatic brain injury (TBI) and influence occupational performance. This systematic review examined the effectiveness of interventions within the scope of occupational therapy to improve occupational performance for adults with visual and visual–perceptual impairments as a result of TBI.
METHOD. Medline, PsycINFO, CINAHL, OTseeker, and the Cochrane Database of Systematic Reviews were searched, and 66 full text articles were reviewed. Sixteen articles were included in the review.
RESULTS. Strong evidence supports the use of scanning, limited evidence supports the use of adaptive strategies, and mixed evidence supports the use of cognitive interventions to improve occupational performance for adults with TBI. Evidence related to vision therapy varies on the basis of the specific intervention implemented.
CONCLUSION. Although the strength of the research varied, implications are discussed for practice, education, and research.
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Affiliation(s)
- Sue Berger
- Sue Berger, PhD, OTR/L, BCG, FAOTA, is Clinical Associate Professor, Department of Occupational Therapy, Boston University, College of Health and Rehabilitation Sciences: Sargent College, Boston, MA;
| | - Jennifer Kaldenberg
- Jennifer Kaldenberg, MSA, OTR/L, SCLV, FAOTA, is Clinical Assistant Professor and Academic Fieldwork Coordinator, Department of Occupational Therapy, Boston University, College of Health and Rehabilitation Sciences: Sargent College, Boston, MA
| | - Romeissa Selmane
- Romeissa Selmane, MS, OTR/L, is Occupational Therapist, The Home for Little Wanderers, Boston, MA. She was Entry-Level Master’s Student, Department of Occupational Therapy, Boston University, College of Health and Rehabilitation Sciences: Sargent College, Boston, MA, at the time of this research
| | - Stephanie Carlo
- Stephanie Carlo, MS, OTR/L, is Occupational Therapist, Integrated Children’s Therapy, Miami, FL. She was Entry-Level Master’s Student, Department of Occupational Therapy, Boston University, College of Health and Rehabilitation Sciences: Sargent College, Boston, MA, at the time of this research
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64
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Radomski MV, Finkelstein M, Llanos I, Scheiman M, Wagener SG. Composition of a vision screen for servicemembers with traumatic brain injury: consensus using a modified nominal group technique. Am J Occup Ther 2016; 68:422-9. [PMID: 25005505 DOI: 10.5014/ajot.2014.011445] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Vision impairment is common in the first year after traumatic brain injury (TBI), including among service members whose brain injuries occurred during deployment in Iraq and Afghanistan. Occupational therapy practitioners provide routine vision screening to inform treatment planning and referral to vision specialists, but existing methods are lacking because many tests were developed for children and do not screen for vision dysfunction typical of TBI. An expert panel was charged with specifying the composition of a vision screening protocol for servicemembers with TBI. A modified nominal group technique fostered discussion and objective determinations of consensus. After considering 29 vision tests, the panel recommended a nine-test vision screening that examines functional performance, self-reported problems, far-near acuity, reading, accommodation, convergence, eye alignment and binocular vision, saccades, pursuits, and visual fields. Research is needed to develop reliable, valid, and clinically feasible vision screening protocols to identify TBI-related vision disorders in adults.
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Affiliation(s)
- Mary Vining Radomski
- Mary Vining Radomski, PhD, OTR/L, is Clinical Scientist, Courage Kenny Research Center, 800 East 28th Street @ Chicago (No. 12212), Minneapolis, MN 55407;
| | - Marsha Finkelstein
- Marsha Finkelstein, MS, is Senior Scientific Advisor, Courage Kenny Research Center, Minneapolis, MN
| | - Imelda Llanos
- Imelda Llanos, MS, OTR/L, is Vision Impairment Clinic Program Manager, James A. Haley Veterans Hospital, Tampa, FL
| | - Mitchell Scheiman
- Mitchell Scheiman, OD, is Professor, Pennsylvania College of Optometry, Philadelphia
| | - Sharon Gowdy Wagener
- Sharon Gowdy Wagener, MAOT, OTR/L, is Occupational Therapist, Courage Kenny Rehabilitation Institute, Minneapolis, MN
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Wilson RL, Paterson KB, Hutchinson CV. Increased Vulnerability to Pattern-Related Visual Stress in Myalgic Encephalomyelitis. Perception 2015; 44:1422-6. [DOI: 10.1177/0301006615614467] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to determine vulnerability to pattern-related visual stress in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). A total of 20 ME/CFS patients and 20 matched (age, gender) controls were recruited to the study. Pattern-related visual stress was determined using the Pattern Glare Test. Participants viewed three patterns, the spatial frequencies (SF) of which were 0.3 (low-SF), 2.3 (mid-SF), and 9.4 (high-SF) cycles per degree (c/deg). They reported the number of distortions they experienced when viewing each pattern. ME/CFS patients exhibited significantly higher pattern glare scores than controls for the mid-SF pattern. Mid-high SF differences were also significantly higher in patients than controls. These findings provide evidence of altered visual perception in ME/CFS. Pattern-related visual stress may represent an identifiable clinical feature of ME/CFS that will prove useful in its diagnosis. However, further research is required to establish if these symptoms reflect ME/CFS-related changes in the functioning of sensory neural pathways.
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Affiliation(s)
- Rachel L. Wilson
- College of Medicine, Biological Sciences and Psychology, University of Leicester, UK
| | - Kevin B. Paterson
- College of Medicine, Biological Sciences and Psychology, University of Leicester, UK
| | - Claire V. Hutchinson
- College of Medicine, Biological Sciences and Psychology, University of Leicester, UK
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Smith MP, Colyer MH, Weichel ED, Stutzman RD. Traumatic cataracts secondary to combat ocular trauma. J Cataract Refract Surg 2015; 41:1693-8. [DOI: 10.1016/j.jcrs.2014.12.059] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/10/2014] [Accepted: 12/11/2014] [Indexed: 12/01/2022]
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Inter-hemispheric wave propagation failures in traumatic brain injury are indicative of callosal damage. Vision Res 2015; 109:38-44. [DOI: 10.1016/j.visres.2015.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 02/20/2015] [Accepted: 02/26/2015] [Indexed: 11/22/2022]
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Brown J, Thiessen A, Beukelman D, Hux K. Noun Representation in AAC Grid Displays: Visual Attention Patterns of People with Traumatic Brain Injury. Augment Altern Commun 2015; 31:15-26. [DOI: 10.3109/07434618.2014.995224] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Tomaszczyk JC, Green NL, Frasca D, Colella B, Turner GR, Christensen BK, Green REA. Negative neuroplasticity in chronic traumatic brain injury and implications for neurorehabilitation. Neuropsychol Rev 2014; 24:409-27. [PMID: 25421811 PMCID: PMC4250564 DOI: 10.1007/s11065-014-9273-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 09/29/2014] [Indexed: 02/04/2023]
Abstract
Based on growing findings of brain volume loss and deleterious white matter alterations during the chronic stages of injury, researchers posit that moderate-severe traumatic brain injury (TBI) may act to “age” the brain by reducing reserve capacity and inducing neurodegeneration. Evidence that these changes correlate with poorer cognitive and functional outcomes corroborates this progressive characterization of chronic TBI. Borrowing from a framework developed to explain cognitive aging (Mahncke et al., Progress in Brain Research, 157, 81–109, 2006a; Mahncke et al., Proceedings of the National Academy of Sciences of the United States of America, 103(33), 12523–12528, 2006b), we suggest here that environmental factors (specifically environmental impoverishment and cognitive disuse) contribute to a downward spiral of negative neuroplastic change that may modulate the brain changes described above. In this context, we review new literature supporting the original aging framework, and its extrapolation to chronic TBI. We conclude that negative neuroplasticity may be one of the mechanisms underlying cognitive and neural decline in chronic TBI, but that there are a number of points of intervention that would permit mitigation of this decline and better long-term clinical outcomes.
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Affiliation(s)
- Jennifer C Tomaszczyk
- Research Department, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
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Postural perturbations induced by a moving virtual environment are reduced in persons with brain injury when gripping a mobile object. J Neurol Phys Ther 2014; 38:125-33. [PMID: 24572500 DOI: 10.1097/npt.0000000000000035] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Gripping a mobile (unfixed) object increases standing postural stability in healthy individuals. We tested whether the same strategy is effective for stabilizing upright posture perturbed by a moving environment (virtual perturbation) in participants with traumatic brain injury (TBI). METHODS Fifteen participants with mild-to-moderate postural deficits after TBI and a comparison group of 15 age-matched healthy subjects participated in the study. Participants stood for 1 minute in front of a large screen with a projected three-dimensional image of a boat; for 30 seconds the boat remained stationary (no visual stimulation condition), and for 30 seconds the boat rocked on the water at a speed of 15°/s (visual stimulation condition). The visual stimulation was applied in pseudorandom order (during either the first or second half of the 1-minute trial). To analyze postural stability, the displacement and velocity of the center of mass in the sagittal and frontal planes were compared between groups and across 4 experimental conditions, including standing with/without visual stimulation and with/without gripping a 300-g object (short wooden stick) in the dominant hand. RESULTS Participants with TBI showed greater instability under all experimental conditions. The visual stimulation significantly increased postural oscillations in the sagittal plane by 35% to 63% across groups. Gripping a stick significantly reduced the stimulation-induced instability in the sagittal plane by 19% to 29%, although not to the level of the no-stimulation condition in either group. CONCLUSION The stabilizing effect of gripping an external object in participants with TBI was confirmed. A possibility of using this effect as a balance aid strategy requires further investigation.
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Truong JQ, Ciuffreda KJ, Han MHE, Suchoff IB. Photosensitivity in mild traumatic brain injury (mTBI): a retrospective analysis. Brain Inj 2014; 28:1283-7. [PMID: 24945993 DOI: 10.3109/02699052.2014.915989] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PRIMARY OBJECTIVE To determine whether photosensitivity (PS) changes over time and, if so, what factors may be related to the change; furthermore, to determine whether tint density changes over time, all in mild traumatic brain injury (mTBI). DESIGN AND METHODS A retrospective analysis of 62 patient records (aged 18-40 years) with mTBI and PS was conducted. All charts were obtained from the SUNY/College of Optometry clinics from 2004-2011. RESULTS Fifty per cent demonstrated reduced PS over time, with most occurring after year 1 post-injury (40%). Promotion of PS reduction appears to be associated with the lack of spectacle tint usage (p = 0.01) and the use of contact lenses (p = 0.03). Inhibition of PS reduction appears to be associated with tinted lenses (p = 0.06), hyperacusis (p = 0.03), dry eye (p = 0.04), migraines (p = 0.03) and loss of consciousness at the time of injury (p = 0.05). Concerning tint density changes over time, 71% (p = 0.002) maintained the same degree over time, while 27% (p = 0.002) reduced and 2% waxed and waned. CONCLUSION Neural adaptation to PS appears to be a long-term process. Tint usage may act to inhibit this adaptive process, while the use of contact lenses may act to promote it. These findings may provide guidance in the clinical management of photosensitivity in the mTBI population.
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Affiliation(s)
- James Q Truong
- Department of Biological and Vision Sciences, SUNY College of Optometry , New York, NY , USA
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Repetitive mild traumatic brain injury causes optic nerve and retinal damage in a mouse model. J Neuropathol Exp Neurol 2014; 73:345-61. [PMID: 24607965 DOI: 10.1097/nen.0000000000000059] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
There is increasing evidence that long-lasting morphologic and functional consequences can be present in the human visual system after repetitive mild traumatic brain injury (r-mTBI). The exact location and extent of the damage in this condition are not well understood. Using a recently developed mouse model of r-mTBI, we assessed the effects on the retina and optic nerve using histology and immunohistochemistry, electroretinography (ERG), and spectral-domain optical coherence tomography (SD-OCT) at 10 and 13 weeks after injury. Control mice received repetitive anesthesia alone (r-sham). We observed decreased optic nerve diameters and increased cellularity and areas of demyelination in optic nerves in r-mTBI versus r-sham mice. There were concomitant areas of decreased cellularity in the retinal ganglion cell layer and approximately 67% decrease in brain-specific homeobox/POU domain protein 3A-positive retinal ganglion cells in retinal flat mounts. Furthermore, SD-OCT demonstrated a detectable thinning of the inner retina; ERG demonstrated a decrease in the amplitude of the photopic negative response without any change in a- or b-wave amplitude or timing. Thus, the ERG and SD-OCT data correlated well with changes detected by morphometric, histologic, and immunohistochemical methods, thereby supporting the use of these noninvasive methods in the assessment of visual function and morphology in clinical cases of mTBI.
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Puopolo C, Martelli M, Zoccolotti P. Role of sensory modality and motor planning in the slowing of patients with traumatic brain injury: A meta-analysis. Neurosci Biobehav Rev 2013; 37:2638-48. [DOI: 10.1016/j.neubiorev.2013.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 08/29/2013] [Accepted: 08/30/2013] [Indexed: 11/29/2022]
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