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Poliva O, Herrera C, Sugai K, Whittle N, Leek MR, Barnes S, Holshouser B, Yi A, Venezia JH. Additive effects of mild head trauma, blast exposure, and aging within white matter tracts: A novel Diffusion Tensor Imaging analysis approach. J Neuropathol Exp Neurol 2024:nlae069. [PMID: 39053000 DOI: 10.1093/jnen/nlae069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2024] Open
Abstract
Existing diffusion tensor imaging (DTI) studies of neurological injury following high-level blast exposure (hlBE) in military personnel have produced widely variable results. This is potentially due to prior studies often not considering the quantity and/or recency of hlBE, as well as co-morbidity with non-blast head trauma (nbHT). Herein, we compare commonly used DTI metrics: fractional anisotropy and mean, axial, and radial diffusivity, in Veterans with and without history of hlBE and/or nbHT. We use both the traditional method of dividing participants into 2 equally weighted groups and an alternative method wherein each participant is weighted by quantity and recency of hlBE and/or nbHT. While no differences were detected using the traditional method, the alternative method revealed diffuse and extensive changes in all DTI metrics. These effects were quantified within 43 anatomically defined white matter tracts, which identified the forceps minor, middle corpus callosum, acoustic and optic radiations, fornix, uncinate, inferior fronto-occipital and inferior longitudinal fasciculi, and cingulum, as the pathways most affected by hlBE and nbHT. Moreover, additive effects of aging were present in many of the same tracts suggesting that these neuroanatomical effects may compound with age.
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Affiliation(s)
- Oren Poliva
- VA Loma Linda Healthcare System, Loma Linda, CA, United States
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
| | | | - Kelli Sugai
- VA Loma Linda Healthcare System, Loma Linda, CA, United States
| | - Nicole Whittle
- VA Portland Healthcare System, Portland, OR, United States
| | - Marjorie R Leek
- VA Loma Linda Healthcare System, Loma Linda, CA, United States
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Samuel Barnes
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Barbara Holshouser
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
| | - Alex Yi
- VA Loma Linda Healthcare System, Loma Linda, CA, United States
| | - Jonathan H Venezia
- VA Loma Linda Healthcare System, Loma Linda, CA, United States
- Department of Otolaryngology-Head & Neck Surgery, Loma Linda University Medical Center, Loma Linda, CA, United States
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2
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Schow T, Wehling EI, Falkenberg HK, Norup A, Kristensen KS. Assessment of visual problems after acquired brain injury: a survey of current practice in Danish hospitals. J Rehabil Med 2024; 56:jrm28793. [PMID: 38742932 PMCID: PMC11107834 DOI: 10.2340/jrm.v56.28793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVES To explore current hospital practice in relation to the assessment of vision problems in patients with acquired brain injury. DESIGN A survey study. SUBJECTS A total of 143 respondents from hospital settings, with background in occupational therapy and physical therapy, participated in the survey. METHODS The survey questionnaire, developed collaboratively by Danish and Norwegian research groups, encompassed 22 items categorically covering "Background information", "Clinical experience and current practice", "Vision assessment tools and protocols", and "Assessment barriers". It was sent out online, to 29 different hospital departments and 18 separate units for occupational therapists and physiotherapists treating patients with acquired brain injury. RESULTS Most respondents worked in acute or subacute hospital settings. Few departments had an interdisciplinary vision team, and very few therapists had formal education in visual problems after acquired brain injury. Visual assessment practices varied, and there was limited use of standardized tests. Barriers to identifying visual problems included patient-related challenges, knowledge gaps, and resource limitations. CONCLUSION The study emphasized the need for enhanced interdisciplinary collaboration, formal education, and standardized assessments to address visual problems after acquired brain injury. Overcoming these challenges may improve identification and management, ultimately contributing to better patient care and outcomes in the future.
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Affiliation(s)
- Trine Schow
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark; Neurorehabilitation-Cph, Copenhagen, Denmark.
| | - Eike Ines Wehling
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway; Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway
| | - Helle K Falkenberg
- Department of optometry, radiography and lighting design, University of South-Eastern Norway, Notodden, Norway
| | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Copenhagen, Denmark; Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
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3
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Sidhu A, Uiga L, Langley B, Masters RSW. Reduced influence of perceptual context in mild traumatic brain injury is not an illusion. Sci Rep 2024; 14:6434. [PMID: 38499578 PMCID: PMC10948892 DOI: 10.1038/s41598-024-56713-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 03/09/2024] [Indexed: 03/20/2024] Open
Abstract
Perceptual grouping is impaired following mild traumatic brain injury (mTBI). This may affect visual size perception, a process influenced by perceptual grouping abilities. We conducted two experiments to evaluate visual size perception in people with self-reported history of mTBI, using two different size-contrast illusions: the Ebbinghaus Illusion (Experiment 1) and the Müller-Lyer illusion (Experiment 2). In Experiment 1, individuals with mTBI and healthy controls were asked to compare the size of two target circles that were either the same size or different sizes. The target circles appeared by themselves (no-context condition), or were surrounded by smaller or larger circles (context condition). Similar levels of accuracy were evident between the groups in the no-context condition. However, size judgements by mTBI participants were more accurate in the context condition, suggesting that they processed the target circles separately from the surrounding circles. In Experiment 2, individuals with mTBI and healthy controls judged the length of parallel lines that appeared with arrowheads (context condition) or without arrowheads (no context condition). Consistent with Experiment 1, size judgements by mTBI participants were more accurate than size judgements by control participants in the context condition. These findings suggest that mTBI influences size perception by impairing perceptual grouping of visual stimuli in near proximity.
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Affiliation(s)
- A Sidhu
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, 3240, New Zealand.
| | - L Uiga
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Manchester, UK
| | - B Langley
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, 3240, New Zealand
| | - R S W Masters
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, 3240, New Zealand
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4
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Wibble T, Pansell T. Clinical characteristics of visual motion hypersensitivity: a systematic review. Exp Brain Res 2023:10.1007/s00221-023-06652-3. [PMID: 37341755 DOI: 10.1007/s00221-023-06652-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 06/11/2023] [Indexed: 06/22/2023]
Abstract
This qualitative systematic review presents an overview of the state of the research relating to visual motion hypersensitivity (VMH) and offers a reference tool for future studies in the field. The study set out to identify and collate articles investigating risk groups with aberrant responses to visual motion as compared to healthy control groups, presenting evidence for risk factors associated with visual motion hypersensitivity. Data were synthesized into the state of the research and analyzed in the context of the clinical characteristics of each risk factor. Literature searches were performed on Medline Ovid, EMBASE, Web of Science, and Cinahl, identifying a total of 586 studies of which 54 were finally included. Original articles published between the dates of commencement for each database and 19th January 2021 were included. JBI critical appraisal tools were implemented for each corresponding article type. In total, the following number of studies was identified for each respective risk factor: age (n = 6), migraines (n = 8), concussions (n = 8), vestibular disorders (n = 13), psychiatric conditions (n = 5), and Parkinson's disease (n = 5). Several studies described VMH as the primary concern (n = 6), though these primarily included patients with vestibulopathies. There were considerable differences in the nomenclature employed to describe VMH, depending largely on the investigating group. An overview of investigated risk factors and their evaluation methods was presented in a Sankey diagram. Posturography was the most implemented methodology but due to diverse measurements meta-analyses were not possible. One may however note that while the easily implemented Vestibular Ocular Motor Screening (VOMS) was designed for concussed patients, it may prove useful for other risk groups.
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Affiliation(s)
- Tobias Wibble
- Department of Clinical Neuroscience, Division of Ophthalmology and Vision, Marianne Bernadotte Centre, Karolinska Institutet, Stockholm, Sweden.
- St. Erik Eye Hospital, Stockholm, Sweden.
| | - Tony Pansell
- Department of Clinical Neuroscience, Division of Ophthalmology and Vision, Marianne Bernadotte Centre, Karolinska Institutet, Stockholm, Sweden
- St. Erik Eye Hospital, Stockholm, Sweden
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5
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Rauchman SH, Zubair A, Jacob B, Rauchman D, Pinkhasov A, Placantonakis DG, Reiss AB. Traumatic brain injury: Mechanisms, manifestations, and visual sequelae. Front Neurosci 2023; 17:1090672. [PMID: 36908792 PMCID: PMC9995859 DOI: 10.3389/fnins.2023.1090672] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
Traumatic brain injury (TBI) results when external physical forces impact the head with sufficient intensity to cause damage to the brain. TBI can be mild, moderate, or severe and may have long-term consequences including visual difficulties, cognitive deficits, headache, pain, sleep disturbances, and post-traumatic epilepsy. Disruption of the normal functioning of the brain leads to a cascade of effects with molecular and anatomical changes, persistent neuronal hyperexcitation, neuroinflammation, and neuronal loss. Destructive processes that occur at the cellular and molecular level lead to inflammation, oxidative stress, calcium dysregulation, and apoptosis. Vascular damage, ischemia and loss of blood brain barrier integrity contribute to destruction of brain tissue. This review focuses on the cellular damage incited during TBI and the frequently life-altering lasting effects of this destruction on vision, cognition, balance, and sleep. The wide range of visual complaints associated with TBI are addressed and repair processes where there is potential for intervention and neuronal preservation are highlighted.
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Affiliation(s)
| | - Aarij Zubair
- NYU Long Island School of Medicine, Mineola, NY, United States
| | - Benna Jacob
- NYU Long Island School of Medicine, Mineola, NY, United States
| | - Danielle Rauchman
- Department of Neuroscience, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Aaron Pinkhasov
- NYU Long Island School of Medicine, Mineola, NY, United States
| | | | - Allison B Reiss
- NYU Long Island School of Medicine, Mineola, NY, United States
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6
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Ferris LM, Kontos AP, Eagle SR, Elbin RJ, Clugston JR, Ortega J, Port NL. Optimizing VOMS for identifying acute concussion in collegiate athletes: Findings from the NCAA-DoD CARE consortium. Vision Res 2022; 200:108081. [PMID: 35926346 DOI: 10.1016/j.visres.2022.108081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/07/2022] [Accepted: 06/07/2022] [Indexed: 01/25/2023]
Abstract
The Vestibular/Ocular-Motor Screening (VOMS), an important component in acute (<72 h) sport-related concussion (SRC) assessment, is increasingly used alongside the Sport Concussion Assessment Tool (SCAT) and as part of the Military Acute Concussion Evaluation 2 (MACE2). VOMS demonstrates clinically useful diagnostic accuracy for acute SRC and improves the overall utility when added to the SCAT3. However, potential overlap among VOMS's vestibular and oculomotor items suggests the possibility of a more efficient version. VOMS and SCAT3 scores were analyzed for 3,958 preseason (47.8% female) and 496 acute-SRC (37.5% female) NCAA-DoD Concussion Assessment, Research, and Education (CARE) consortium collegiate athlete evaluations. Analyses revealed very large effect sizes (d = 2.39-2.45) and high correlations (rho = 0.95-0.99) among all VOMS items except near point of convergence distance (d = 0.79, rho ≤ 0.341). Receiver operating characteristic (ROC) curve analyses showed clinically useful discriminative utility for VOMS Total (AUC = 0.85) and the VOMS Total change score, where pretest symptoms were incorporated (AUC = 0.81). A modified VOMS (mVOMS) consisting of four items (smooth pursuits, horizontal saccades, horizontal vestibulo-ocular reflex, visual motion sensitivity) yielded identical AUCs to VOMS Total. Integer cutoff analyses suggest a score of ≥4 for VOMS Total and ≥4 for mVOMS Total optimizes concussion identification. Incorporating VOMS or mVOMS into SCAT3 (AUC = 0.79) significantly improved the combined tool's acute utility for acute concussion identification by a maximum of 4% (SCAT3+VOMS AUC = 0.84, SCAT3+mVOMS AUC = 0.83). Future versions of SCAT or MACE may want to consider incorporating a more parsimonious VOMS for the purpose of identifying acute concussion.
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Affiliation(s)
| | | | | | - R J Elbin
- University of Arkansas, United States
| | | | - Justus Ortega
- Humboldt State University Kinesiology and Recreation Administration, United States
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7
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Kaldenberg J, Newman R, Jimenez C, Walker M. Vision Therapy Interventions to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020). Am J Occup Ther 2022; 76:23917. [PMID: 36165888 DOI: 10.5014/ajot.2022/76s2006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.
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Affiliation(s)
- Jennifer Kaldenberg
- Jennifer Kaldenberg, DrPH, MSA, OTR/L, SCLV, FAOTA, is Interim OTD Program DirectorClinical Associate Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Robin Newman
- Robin Newman, OTD, MA, OTR/L, CLT, FAOTA, is Clinical Assistant Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Christine Jimenez
- Christine Jimenez, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Mary Walker
- Mary Walker, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
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8
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Kaldenberg J, Newman R, Jimenez C, Walker M. Binasal Occlusion Intervention to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020). Am J Occup Ther 2022; 76:23918. [PMID: 36165889 DOI: 10.5014/ajot.2022/76s2005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of binasal occlusion interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.
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Affiliation(s)
- Jennifer Kaldenberg
- Jennifer Kaldenberg, DrPH, MSA, OTR/L, SCLV, FAOTA, is Interim OTD Program Director and Clinical Associate Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Robin Newman
- Robin Newman, OTD, MA, OTR/L, CLT, FAOTA, is Clinical Assistant Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Christine Jimenez
- Christine Jimenez, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Mary Walker
- Mary Walker, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
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9
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Kaldenberg J, Newman R, Jimenez C, Walker M. Vestibulo-Ocular Interventions to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020). Am J Occup Ther 2022; 76:23924. [PMID: 36166579 DOI: 10.5014/ajot.2022/76s2007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of vestibulo-ocular interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.
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Affiliation(s)
- Jennifer Kaldenberg
- Jennifer Kaldenberg, DrPH, MSA, OTR/L, SCLV, FAOTA, is Interim OTD Program Director and Clinical Associate Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Robin Newman
- Robin Newman, OTD, MA, OTR/L, CLT, FAOTA, is Clinical Assistant Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Christine Jimenez
- Christine Jimenez, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Mary Walker
- Mary Walker, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
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10
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Kaldenberg J, Newman R, Jimenez C, Walker M. Filter Interventions to Support Occupational Performance for People With Traumatic Brain Injury With Visual Symptoms (June 2013-October 2020). Am J Occup Ther 2022; 76:23926. [PMID: 36166580 DOI: 10.5014/ajot.2022/76s2008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Systematic Review Briefs provide a summary of the findings from systematic reviews developed in conjunction with the American Occupational Therapy Association's Evidence-Based Practice Program. Each Systematic Review Brief summarizes the evidence on a theme related to a systematic review topic. This Systematic Review Brief presents findings from the systematic review on the effectiveness of filter interventions that address visual impairments and visual perception to improve occupational performance for adults with traumatic brain injury.
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Affiliation(s)
- Jennifer Kaldenberg
- Jennifer Kaldenberg, DrPH, MSA, OTR/L, SCLV, FAOTA, is Interim OTD Program Director and Clinical Associate Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Robin Newman
- Robin Newman, OTD, MA, OTR/L, CLT, FAOTA, is Clinical Assistant Professor, Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Christine Jimenez
- Christine Jimenez, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
| | - Mary Walker
- Mary Walker, OTS, is a graduate student at Boston University College of Health & Rehabilitation Sciences: Sargent College
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11
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Caron L, Ouellet MC, Hudon C, Predovan D, Sirois MJ, de Guise É, Lamontagne MÈ, Émond M, Le Sage N, Beaulieu-Bonneau S. Cognitive functioning following traumatic brain injury in older adults: associations with social participation and health-related quality of life. Brain Inj 2022; 36:1099-1108. [PMID: 35994259 DOI: 10.1080/02699052.2022.2110284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES To describe objective and subjective cognitive functioning older adults who sustained TBI at age 65 or over, and to determine whether cognitive functioning is associated with health-related quality of life (HRQoL) and social participation. METHOD The sample consisted of 40 individuals with TBI (mean age = 73 years; 65% mild, 35% moderate/severe TBI). On average 15 months post-injury, they completed measures of objective and subjective cognitive functioning (Telephone Interview for Cognitive Status-Modified, Alphaflex, Medical Outcomes Study Cognitive Functioning Scale), HRQoL (SF-12), and social participation (Participation Assessment with Recombined Tools - Objective). RESULTS Mean score for objective cognitive functioning was lower than normative values, while mean scores for executive functioning and subjective cognitive functioning were comparable to normative values. There was no relationship between objective and subjective measures. Subjective cognitive functioning and (to a lesser extent) global objective cognitive functioning were significantly associated with mental HRQoL but not with physical HRQoL or social participation. CONCLUSION These results underscore the importance of considering both subjective perception and objective performance when assessing and intervening on cognition to promote better mental HRQoL in older adults with TBI.
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Affiliation(s)
- Laurence Caron
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
| | - Marie-Christine Ouellet
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada.,Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Carol Hudon
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre de Recherche CERVO Brain Research Center, Québec, QC, Canada
| | - David Predovan
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
| | - Marie-Josée Sirois
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.,Département de Réadaptation, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Élaine de Guise
- Département de Psychologie, Université de Montréal, Québec, QC, Canada
| | - Marie-Ève Lamontagne
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada.,Département de Réadaptation, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Marcel Émond
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.,Département de Médecine Familiale et de Médecine d'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Natalie Le Sage
- Centre de Recherche du CHU de Québec-Université Laval, Québec, QC, Canada.,Département de Médecine Familiale et de Médecine d'urgence, Faculté de Médecine, Université Laval, Québec, QC, Canada
| | - Simon Beaulieu-Bonneau
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, QC, Canada.,Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, CIUSSS de la Capitale-Nationale, Québec, QC, Canada
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12
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Alnawmasi MM, Khuu SK. Deficits in multiple object-tracking and visual attention following mild traumatic brain injury. Sci Rep 2022; 12:13727. [PMID: 35962018 PMCID: PMC9374772 DOI: 10.1038/s41598-022-18163-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 08/05/2022] [Indexed: 11/13/2022] Open
Abstract
Difficulty in the ability to allocate and maintain visual attention is frequently reported by patients with traumatic brain injury (TBI). In the present study, we used a multiple object tracking (MOT) task to investigate the degree to which TBI affects the allocation and maintenance of visual attention to multiple moving targets. Fifteen adults with mild TBI and 20 control participants took part in this study. All participants were matched for age, gender, and IQ. The sensitivity and time taken to perform the MOT task were measured for different conditions in which the duration of the tracking, number of target, and distractor dots were systematically varied. When the number of target dots required to be tracked increased, sensitivity in correctly detecting them decreased for both groups but was significantly greater for patients with mild TBI. Similarly, increasing the number of distractor dots had a greater effect on reducing task sensitivity for patients with mild TBI than control participants. Finally, across all conditions, poorer detection performance was observed for patients with mild TBI when the tracking duration was longer compared to control participants. The present study showed that patients with mild TBI have greater deficits (compared to control participants) in their ability to maintain visual attention on tracking multiple moving objects, which was particularly hindered by increased tracking load and distraction.
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Affiliation(s)
- Mohammed M Alnawmasi
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia. .,College of Applied Medical Science, Department of Optometry, Qassim University, Buraydah, Saudi Arabia.
| | - Sieu K Khuu
- School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia
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13
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Maffit J, Lueders KS, Vasile E. Individualized Glare Evaluation for Wearable Filters for Individuals With Low Vision or Neurological Visual Impairment. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x221120020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Jamie Maffit
- Department of Blindness and Low Vision Studies, Orientation and Mobility Program, College of Health Sciences, Education and Rehabilitation, Salus University, Elkins Park, PA, USA
| | - Kerry S. Lueders
- Department of Blindness and Low Vision Studies, Orientation and Mobility Program, College of Health Sciences, Education and Rehabilitation, Salus University, Elkins Park, PA, USA
| | - Emily Vasile
- Department of Blindness and Low Vision Studies, Orientation and Mobility Program, College of Health Sciences, Education and Rehabilitation, Salus University, Elkins Park, PA, USA
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14
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Snegireva N, Derman W, Patricios J, Welman KE. Blink duration is increased in concussed youth athletes: a validity study using eye tracking in male youth and adult athletes of selected contact sports. Physiol Meas 2022; 43. [PMID: 35709708 DOI: 10.1088/1361-6579/ac799b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/16/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Diagnosing a sports-related concussion (SRC) remains challenging, and research into diagnostic tools is limited. This study investigated whether selected eye tracking variables would be a valid tool to diagnose and monitor SRC in adult and youth participants in selected contact sports, such as Rugby Union (rugby) and football (soccer). METHODS This prospective cohort study, with 70 concussed and 92 non-concussed adult and youth athletes, assessed the validity of five previously selected eye tracking variables for SRC diagnostics and management. The performance between concussed and age-matched control (non-concussed) athletes, as well as between three successive testing sessions in the concussed athletes were compared. Self-paced saccade count in adult group; blink duration in the memory-guided saccade and sinusoidal smooth pursuit tasks, proportion of antisaccade errors, and gain of diagonal smooth pursuit in the youth group were assessed. RESULTS The youth concussed group had higher blink duration in the fast memory-guided saccades task (p = 0.001, η2 = 0.17) and a tendency for higher blink duration in the sinusoidal smooth pursuit task (p = 0.016, η2 = 0.06) compared to the youth control group. In both tasks the blink duration in the concussed youth group decreased from session 1 to session 2 by 24% and 18%, accordingly, although statistical significance was not reached. The concussed adult group demonstrated a lower number of self-paced saccades compared to controls (p = 0.05, η2 = 0.09), which gradually increased, with the largest difference between session 1 and session 3 (p = 0.02). CONCLUSIONS Blink duration in youth athletes holds promise as a valid metric for concussion diagnostics and monitoring. It is recommended to focus future studies on comparing eye tracking performance within the same concussed athletes over time rather than comparing them to healthy controls.
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Affiliation(s)
- Nadja Snegireva
- Sports Science, Stellenbosch University Faculty of Medicine and Health Sciences, Suidwal Road, Coetzenburg, Cape Town, Western Cape, 7601, SOUTH AFRICA
| | - Wayne Derman
- Institute of Sport and Exercise Medicine, Stellenbosch University Faculty of Medicine and Health Sciences, Francie Van Zijl Dr, Parow, Cape Town, Western Cape, 7505, SOUTH AFRICA
| | - Jon Patricios
- Wits Institute for Sport and Health, University of the Witwatersrand Faculty of Health Sciences, 27 St Andrews Rd, Parktown, Johannesburg, Gauteng, 2193, SOUTH AFRICA
| | - Karen Estelle Welman
- Sports Science, Stellenbosch University Faculty of Medicine and Health Sciences, Suidwal Road, Coetzenburg, Cape Town, Western Cape, 7601, SOUTH AFRICA
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15
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Thiagarajan P, Ciuffreda KJ. Accommodative and pupillary dysfunctions in concussion/mild traumatic brain injury: A Review. NeuroRehabilitation 2022; 50:261-278. [DOI: 10.3233/nre-228011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Visual dysfunctions are common in individuals following concussion/mild traumatic brain injury (C/mTBI). Many deficits have been uncovered in their oculomotor system, such as in the pupil and accommodation. OBJECTIVE: To describe the static and dynamic abnormalities in the pupillary and accommodative systems in those with C/mTBI. This includes both diagnostic and therapeutic aspects, with emphasis on objectively-based test findings, as well as their basic and clinical ramifications. METHODS: PubMed, Google Scholar, and Semantic Scholar databases were searched from 1980–2020, using key words of accommodation, pupil, vision therapy, vision rehabilitation, and objective testing, for peer-reviewed papers, as well as related textbooks in the area, in those with C/mTBI. RESULTS: For both systems, most static and dynamic response parameters were abnormal: they were typically reduced, slowed, delayed, and/or more variable. Most of the abnormal accommodative parameters could be significantly improved with vision therapy. CONCLUSIONS: For both systems, most response parameters were abnormal, which could explain their visual symptoms and related problems. For accommodation, the improvements following vision therapy suggest the presence of considerable visual system plasticity, even in older adults with chronic brain injury.
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16
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Gormley J, Fager SK. Preference and visual cognitive processing demands of alphabetic and QWERTY keyboards of individuals with and without brain injury. Assist Technol 2022; 34:341-351. [PMID: 32955379 PMCID: PMC9122035 DOI: 10.1080/10400435.2020.1826006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2020] [Indexed: 10/23/2022] Open
Abstract
Following a severe brain injury (BI), some literate individuals who require augmentative and alternative communication (AAC) strategies to support communication may benefit from the use of onscreen keyboards to generate text. A range of layouts are available to these individuals within specialized communication software. However, a paucity of information is available to describe user preferences, user perceptions, as well as the visual-cognitive processing demands of such layouts. Such information is critical to guide clinical decision-making for keyboard selection and to provide patient-centered services. This study: (a) described the preferences and perceptions of two onscreen keyboard layouts (QWERTY and alphabetic) and (b) used eye-tracking analysis to investigate the visual-cognitive processing demands between these onscreen keyboards for individuals with and without BI. Results indicated participants in both groups held a strong preference for QWERTY keyboard interfaces and had extensive prior experience using the QWERTY keyboard layout on mobile devices. Eye-tracking analysis revealed less visual-cognitive processing demands using a QWERTY keyboard layout for both groups but were only statistically significant for those without BI. Results suggest that use of a keyboard layout that aligns with client preferences and prior experiences (i.e., the QWERTY keyboard for these participants) may lead to increased satisfaction with the communication experience and increased communication efficiency.
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Affiliation(s)
- Jessica Gormley
- Department of Speech-Language Pathology Department, Munroe-Meyer Institute, University of Nebraska Medical Center, 985450 Nebraska Medical Center Omaha, NE, 68198-5450
| | - Susan Koch Fager
- Institute for Rehabilitation Science and Engineering, Madonna Rehabilitation Hospital, Lincoln, NE
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17
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Blacker KJ, McHail DG. Effects of Acute Hypoxia on Early Visual and Auditory Evoked Potentials. Front Neurosci 2022; 16:846001. [PMID: 35546885 PMCID: PMC9082933 DOI: 10.3389/fnins.2022.846001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/31/2022] [Indexed: 11/28/2022] Open
Abstract
Reduced levels of environmental oxygen lead to hypoxic hypoxia and are a primary threat in tactical aviation. The visual system is particularly vulnerable to hypoxia, and its impairment can severely impact performance. The auditory system is relatively spared by hypoxia, although which stages of auditory processing are most impacted by hypoxia remains unclear. Previous work has used electroencephalography (EEG) to assess neural markers of cognitive processing for visual and auditory stimuli and found that these markers were sensitive to a normobaric hypoxic exposure. In the current study, we assessed whether early sensory evoked potentials, that precede cognitive activity, are also impaired by normobaric hypoxia. In a within-subjects design, we compared visual (P100) and auditory evoked potentials (sensory gating for the P50, N100, and P200) in 34 healthy adults during normoxic (21% O2) and two separate hypoxic (9.7% O2) exposures. Self-reported symptoms of hypoxia were also assessed using the Hypoxia Symptom Questionnaire (HSQ). We found that P100 mean amplitude was not reduced under hypoxic compared to normoxic conditions, suggesting no statistically significant impairment of early visual processing. The sensory gating ratio for auditory stimuli was intact for paired responses of the P50 and N100. However, the P200 sensory gating ratio was attenuated under hypoxic compared to normoxic conditions, suggesting disruption of the auditory system specific to the level of allocating attention that follows basic auditory processing. Exploratory analyses of HSQ scores identified a robust effect of hypoxia. However, consistency of symptoms reported between the two hypoxia exposures exhibited high intra-individual variability, which may have implications for the theory that individuals have a consistent hypoxia signature or reliable constellation of responses to hypoxia. These findings suggest that early sensory processing is not impaired during hypoxia, but for the auditory system there is impairment at the level of attentional processing. Given the previous findings of impaired visual performance under hypoxia, these results suggest that this impairment does not stem from early visual processing deficits in visual cortex. Together these findings help focus the search on when and where hypoxia-induced deficits occur and may guide the development of countermeasures for hypoxia in tactical aviation.
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Affiliation(s)
- Kara J. Blacker
- Naval Medical Research Unit-Dayton, Wright-Patterson Air Force Base (AFB), Dayton, OH, United States
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18
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Hac NEF, Gold DR. Neuro-Visual and Vestibular Manifestations of Concussion and Mild TBI. Curr Neurol Neurosci Rep 2022; 22:219-228. [PMID: 35235169 DOI: 10.1007/s11910-022-01184-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW Mild traumatic brain injury, or concussion, is a major cause of disability. Vestibular and visual dysfunction following concussion is common and can negatively affect patients' well-being and prolong recovery. Etiologies of visual and vestibular symptoms are numerous, including ocular, neuro-ophthalmic, otologic, and neuro-vestibular conditions. Some etiologies are benign and may be treatable, while others are potentially vision or life-threatening, making a focused history and examination essential. This review offers an approach to the evaluation and treatment of the most common neuro-visual and vestibular impairments that may result from concussion. RECENT FINDINGS Treatment of concussion including exercise, computerized programs, transcranial magnetic stimulation, gene therapy, stem cell therapy, and nanoparticles has shown promise. Many novel therapies are in the pipework for visual and vestibular recovery after concussion; however, the treatment mainstay remains therapy and evaluation for co-existing diseases.
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Affiliation(s)
- Nicholas E F Hac
- Department of Neurology, The Johns Hopkins School of Medicine, 600 N Wolfe St, Path 2-210, Baltimore, MD, 21287, USA.
| | - Daniel R Gold
- Department of Neurology, The Johns Hopkins School of Medicine, 600 N Wolfe St, Path 2-210, Baltimore, MD, 21287, USA
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19
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Mani R, Ngo S, Walz J, Khuu SK. Evaluating the extent of change in near point of convergence in traumatic brain injury: a systematic review and meta-analysis. Brain Inj 2022; 36:306-320. [DOI: 10.1080/02699052.2022.2034188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- Revathy Mani
- School of Optometry and Vision Science, The University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Steven Ngo
- School of Optometry and Vision Science, The University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Jacinta Walz
- School of Optometry and Vision Science, The University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
| | - Sieu K. Khuu
- School of Optometry and Vision Science, The University of New South Wales (UNSW) Sydney, Sydney, NSW, Australia
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20
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Lee YJ, Lee SC, Wy SY, Lee HY, Lee HL, Lee WH, Oh BM, Jeoung JW. Ocular Manifestations, Visual Field Pattern, and Visual Field Test Performance in Traumatic Brain Injury and Stroke. J Ophthalmol 2022; 2022:1703806. [PMID: 35036002 PMCID: PMC8759901 DOI: 10.1155/2022/1703806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/21/2021] [Indexed: 12/04/2022] Open
Abstract
PURPOSE To analyze ocular manifestations, visual field (VF) pattern, and VF test performance in traumatic brain injury (TBI) and stroke patients. METHODS This retrospective, cross-sectional study included 118 patients (236 eyes) with TBI and stroke who had undergone VF testing by standard automated perimetry with the central 24-2 threshold test. Clinical features including best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular manifestations, and VF test results including VF defect pattern, reliability, and global indices were analyzed and compared between the TBI and stroke patients. RESULTS In TBI patients, ocular manifestations included strabismus (11.1%), cataract (4.2%), and glaucoma suspect (2.8%), whereas in stroke patients, cataract (15.2%), strabismus (8.5%), diabetic retinopathy (4.9%), extraocular movement (EOM) limitation (3.0%), glaucoma suspect (3.0%), nystagmus (2.4%), drusen (1.2%), and vitreous hemorrhage (1.2%) were found. The VF test results showed that 47 eyes (85.5%) in TBI and 86 (65.2%) in stroke had VF defect; in TBI, the scattered pattern was the most common (56.4%), followed by homonymous hemianopsia (14.5%), homonymous quadrantanopia (10.9%), and total defect (3.6%), whereas in stroke, homonymous hemianopsia was the most common (31.8%), followed by scattered pattern (16.7%), homonymous quadrantanopia (12.1%), and total defect (4.5%). Only 15 eyes (27.3%) in TBI and 32 (24.2%) in stroke showed reliable VF indices. The mean deviation (MD) was -10.5 ± 7.1 dB in TBI and -9.5 ± 6.8 dB in stroke, and the pattern standard deviation (PSD) was 4.9 ± 3.3 dB in TBI and 6.1 ± 3.9 dB in stroke, without statistically significant differences between the two groups. CONCLUSION Various ocular manifestations were found, and a considerable proportion of patients were experiencing VF defects and showed unreliable VF test performance. Our findings suggest that accurate evaluation and rehabilitation of visual function should be a matter of greater concern and emphasis in the management of TBI and stroke patients, besides systemic diseases.
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Affiliation(s)
- Yun Jeong Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seung Chan Lee
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Seo Young Wy
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hoo Young Lee
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyang Lim Lee
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung-Mo Oh
- National Traffic Injury Rehabilitation Hospital, Yangpyeong, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
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21
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Wagener SG. Participation experience for persons with oculomotor impairments after acquired brain injury. Br J Occup Ther 2021. [DOI: 10.1177/03080226211031804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction While individuals with acquired brain injury (ABI) often receive occupational therapy, relatively little is known about how those with related oculomotor problems characterize their ability to participate in everyday activities and life roles. This study describes the difficulties experienced by this population. Method This study is a thematic analysis of qualitative responses to open-ended questions based on answers to a standardized assessment. Thirty rehabilitation outpatients with ABI-related oculomotor impairments participated in semi-structured interviews to describe their experiences of difficulties in everyday activities. Results Difficulties were associated with three themes: challenges of the activities and environments (activity requirements, physical and socioeconomic environments, and time), self-identified personal difficulties (physical, cognitive, and socioemotional), and changes in habits/roles/priorities (modifications to activities and environments, loss and negative consequences, and life management changes). Conclusion How people with ABI-related oculomotor impairments experience difficulties while participating in activities is dynamic and complex. Challenging activity requirements and environments often led to personal difficulties, which limited participation. Activity modifications, changes in priorities, and managing energy budget enhanced participation. A model of the experience is proposed. Findings suggest using activity analysis and teaching compensatory methods and life management strategies with individuals may assist in ability to participate.
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Affiliation(s)
- Sharon G Wagener
- Courage Kenny Rehabilitation Institute, Allina Health, Minneapolis, MN, USA
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22
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Rajič Bumber J, Pilipović K, Janković T, Dolenec P, Gržeta N, Križ J, Župan G. Repetitive Traumatic Brain Injury Is Associated With TDP-43 Alterations, Neurodegeneration, and Glial Activation in Mice. J Neuropathol Exp Neurol 2021; 80:2-14. [PMID: 33212475 DOI: 10.1093/jnen/nlaa130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Increasing evidence points to a relationship between repetitive mild traumatic brain injury (mTBI), the Tar DNA binding protein 43 (TDP-43) pathology and some neurodegenerative diseases, but the underlying pathophysiological mechanisms are still unknown. We examined TDP-43 regulation, neurodegeneration, and glial responses following repetitive mTBI in nontransgenic mice and in animals with overexpression of human mutant TDP-43 protein (TDP-43G348C). In the frontal cortices of the injured nontransgenic animals, early TDP-43 cytoplasmatic translocation and overexpression of the protein and its pathological forms were detected. In the injured animals of both genotypes, neurodegeneration and pronounced glial activity were detected in the optic tract. In TDP-43G348C mice, these changes were significantly higher at day 7 after the last mTBI compared with the values in the nontransgenic animals. Results of this study suggest that the changes in the TDP-43 regulation in the frontal cortices of the nontransgenic animals were a transient stress response to the brain injury. Repetitive mTBI did not produce additional TDP-43 dysregulation or neurodegeneration or pronounced gliosis in the frontal cortex of TDP-43G348C mice. Our research also suggests that overexpression of mutated human TDP-43 possibly predisposes the brain to more intense neurodegeneration and glial activation in the optic tract after repetitive mTBI.
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Affiliation(s)
- Jelena Rajič Bumber
- From the Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Kristina Pilipović
- From the Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Tamara Janković
- From the Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Petra Dolenec
- From the Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Nika Gržeta
- From the Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - Jasna Križ
- Department of Psychiatry and Neuroscience, Faculty of Medicine, University of Laval, Quebec, QC, Canada
| | - Gordana Župan
- From the Department of Pharmacology, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
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23
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Pilipović K, Rajič Bumber J, Dolenec P, Gržeta N, Janković T, Križ J, Župan G. Long-Term Effects of Repetitive Mild Traumatic Injury on the Visual System in Wild-Type and TDP-43 Transgenic Mice. Int J Mol Sci 2021; 22:ijms22126584. [PMID: 34205342 PMCID: PMC8235442 DOI: 10.3390/ijms22126584] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/11/2021] [Accepted: 06/17/2021] [Indexed: 01/29/2023] Open
Abstract
Little is known about the impairments and pathological changes in the visual system in mild brain trauma, especially repetitive mild traumatic brain injury (mTBI). The goal of this study was to examine and compare the effects of repeated head impacts on the neurodegeneration, axonal integrity, and glial activity in the optic tract (OT), as well as on neuronal preservation, glial responses, and synaptic organization in the lateral geniculate nucleus (LGN) and superior colliculus (SC), in wild-type mice and transgenic animals with overexpression of human TDP-43 mutant protein (TDP-43G348C) at 6 months after repeated closed head traumas. Animals were also assessed in the Barnes maze (BM) task. Neurodegeneration, axonal injury, and gliosis were detected in the OT of the injured animals of both genotypes. In the traumatized mice, myelination of surviving axons was mostly preserved, and the expression of neurofilament light chain was unaffected. Repetitive mTBI did not induce changes in the LGN and the SC, nor did it affect the performance of the BM task in the traumatized wild-type and TDP-43 transgenic mice. Differences in neuropathological and behavioral assessments between the injured wild-type and TDP-43G348C mice were not revealed. Results of the current study suggest that repetitive mTBI was associated with chronic damage and inflammation in the OT in wild-type and TDP-43G348C mice, which were not accompanied with behavioral problems and were not affected by the TDP-43 genotype, while the LGN and the SC remained preserved in the used experimental conditions.
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Affiliation(s)
- Kristina Pilipović
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia; (K.P.); (J.R.B.); (P.D.); (N.G.); (T.J.)
| | - Jelena Rajič Bumber
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia; (K.P.); (J.R.B.); (P.D.); (N.G.); (T.J.)
| | - Petra Dolenec
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia; (K.P.); (J.R.B.); (P.D.); (N.G.); (T.J.)
| | - Nika Gržeta
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia; (K.P.); (J.R.B.); (P.D.); (N.G.); (T.J.)
| | - Tamara Janković
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia; (K.P.); (J.R.B.); (P.D.); (N.G.); (T.J.)
| | - Jasna Križ
- Department of Psychiatry and Neuroscience, Faculty of Medicine, University Laval, Québec City, QC G1V 0A6, Canada;
| | - Gordana Župan
- Department of Basic and Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia; (K.P.); (J.R.B.); (P.D.); (N.G.); (T.J.)
- Correspondence:
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Blacker KJ, Seech TR, Funke ME, Kinney MJ. Deficits in Visual Processing During Hypoxia as Evidenced by Visual Mismatch Negativity. Aerosp Med Hum Perform 2021; 92:326-332. [PMID: 33875065 DOI: 10.3357/amhp.5735.2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: Hypoxia is an ever-present threat in tactical aviation and gained recent attention due to its putative role in physiological episodes. Previous work has demonstrated that hypoxia negatively impacts a variety of sensory, cognitive, and motor systems. In particular, the visual system is one of the earliest systems affected by hypoxia. While the majority of previous studies have relied on self-report and behavioral testing, the use of event-related potentials as a novel tool to monitor responses to low oxygen in humans has recently been investigated. Specifically, ERP components that are evoked passively in response to unattended changes in background sensory stimulation have been explored.METHOD: Subjects (N 28) completed a continuous visuomotor tracking task while EEG was recorded. During the tracking task, a series of standard color checkerboard patterns were presented in the periphery while occasionally a deviant color checkerboard was presented. The visual mismatch negativity (MMN) component was assessed in response to the deviant compared to the standard stimuli. Subjects completed two sessions in counterbalanced order that only differed by the oxygen concentration breathed (10.6% vs. 20.4%).RESULTS: Results demonstrated a significant reduction in the amplitude of the visual MMN under hypoxic compared to normoxic conditions, showing a 50% reduction in amplitude during hypoxia. Our results suggest that during low-oxygen exposure the ability to detect environmental changes and process sensory information is impaired.DISCUSSION: The visual MMN may represent an early and reliable predictor of sensory and cognitive deficits during hypoxia exposure, which may be of great use to the aviation community.Blacker KJ, Seech TR, Funke ME, Kinney MJ. Deficits in visual processing during hypoxia as evidenced by visual mismatch negativity. Aerosp Med Hum Perform. 2021; 92(5):326332.
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25
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Pei Y, O'Brien KH. Reading Abilities Post Traumatic Brain Injury in Adolescents and Adults: A Systematic Review and Meta-Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:789-816. [PMID: 33755512 DOI: 10.1044/2020_ajslp-20-00213] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose People with traumatic brain injury (TBI) often struggle with complex reading, limiting participation in work and educational settings. This systematic review and meta-analysis examined studies of reading conducted with adolescents and adults with TBI to describe reading problems post TBI and investigate underlying factors for the effects of TBI on reading abilities. Method The search was conducted in EBSCO (including MEDLINE, PsycINFO, etc.), BIOSIS, ProQuest, and Web of Science. Empirical studies that used samples with a mean age greater than 10 years, reported injury characteristics, and investigated complex reading abilities (defined as greater than single-word reading) were eligible for this review. Study quality was evaluated using QualSyst. Study and sample characteristics, measures, and outcomes of interest were extracted and synthesized in the review. Studies that compared reading abilities between people with and without TBI were included in the meta-analysis. Results Twenty-four studies met inclusion criteria, six of which addressed reading in pediatric samples. Findings from heterogeneous samples supported the existence of reading deficits post TBI, including mild TBI. In studies of children, comprehension was examined most frequently, whereas reading speed was the focus of most adult studies. Oculomotor functions and processing speed were related to reading speed; cognitive functions, such as attention and memory, were associated with reading comprehension. Intervention studies were limited, but most reported positive effects. The meta-analysis confirmed the impact of TBI on reading with a large effect size (g = 1.23). Demographic, injury, and study variables did not moderate overall reading outcomes, but male sex was a significant moderator of impairment in reading speed. Discussion Global reading ability, including both comprehension and speed, is negatively impacted by TBI. Future research should continue to explore reading after TBI, including its underlying mechanisms, effects on complex reading activities such as inferencing, development of screening and assessment tools that address a range of functional reading needs, and efficacy of reading-related interventions.
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Affiliation(s)
- Yalian Pei
- Department of Communication Sciences and Special Education, University of Georgia, Athens
| | - Katy H O'Brien
- Department of Communication Sciences and Special Education, University of Georgia, Athens
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26
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Berthold-Lindstedt M, Johansson J, Ygge J, Borg K. How to assess visual function in acquired brain injury-Asking is not enough. Brain Behav 2021; 11:e01958. [PMID: 33230981 PMCID: PMC7882154 DOI: 10.1002/brb3.1958] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 10/21/2020] [Accepted: 10/28/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Acquired brain injury affects many brain areas and causes a range of dysfunctions including vision-related issues. These issues can have negative impacts on rehabilitation progress and activities of daily life but may easily be overlooked. There is no common recommendation about how to assess visual impairments after ABI. The purpose of this study was to estimate the frequency of objectively measures oculomotor dysfunctions, and also how these findings are related to two inventories intended to support detection of visual impairment. METHODS The study was cross-sectional and included 73 outpatients. In addition to the standard evaluation program, the patients went through a comprehensive optometric examination. The inventories used were the Vision Interview (VI) and the Convergence Insufficiency Symptom Survey (CISS). RESULTS All three types of examinations showed a high proportion vision-related symptoms. Fusion vergence was the most common objectively measured finding, 83%. There were seven statistically significant associations between five VI items and five visual deficits. The strength of associations was moderate (Phi 0.261-0.487, p < .05). The sensitivity and specificity of the CISS were moderate. CONCLUSION We found high percentages of the patients with visual symptoms and dysfunctions. Due to the complexity of visual symptoms and functional deficits in ABI, we find it necessary to combine both symptom assessment and vision examination in order to capture visual function issues.
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Affiliation(s)
- Märta Berthold-Lindstedt
- Division of Rehabilitation Medicine, Department of Clinical Science, Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden
| | - Jan Johansson
- Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jan Ygge
- Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Kristian Borg
- Division of Rehabilitation Medicine, Department of Clinical Science, Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden
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Mase Y, Matsui Y, Uchiyama E, Matsubara H, Sugimoto M, Kubo A, Kondo M. Cerebral trauma-induced dyschromatopsia in the left hemifield: case presentation. BMC Ophthalmol 2021; 21:63. [PMID: 33504343 PMCID: PMC7839217 DOI: 10.1186/s12886-020-01800-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acquired color anomalies caused by cerebral trauma are classified as either achromatopsias or dyschromatopsias (Zeki, Brain 113:1721-1777, 1990). The three main brain regions stimulated by color are V1, the lingual gyrus, which was designated as human V4 (hV4), and the fusiform gyrus, designated as V4α. (Zeki, Brain 113:1721-1777, 1990). An acquired cerebral color anomaly is often accompanied by visual field loss (hemi- and quadrantanopia), facial agnosia, prosopagnosia, visual agnosia, and anosognosia depending on the underlying pathology (Bartels and Zeki, Eur J Neurosci 12:172-193, 2000), (Meadows, Brain 97:615-632, 1974), (Pearman et al., Ann Neurol 5:253-261, 1979). The purpose of this study was to determine the characteristics of a patient who developed dyschromatopsia following a traumatic injury to her brain. CASE PRESENTATION The patient was a 24-year-old woman who had a contusion to her right anterior temporal lobe. After the injury, she noticed color distortion and that blue objects appeared green in the left half of the visual field. Although conventional color vision tests did not detect any color vision abnormalities, short wavelength automated perimetry (SWAP) showed a decrease in sensitivity consistent with a left hemi-dyschromatopsia. Magnetic resonance imaging (MRI) detected abnormalities in the right fusiform gyrus, a part of the anterior temporal lobe. At follow-up 14 months later, subjective symptoms had disappeared, but the SWAP abnormalities persisted and a thinning of the sectorial ganglion cell complex (GCC) was detected. CONCLUSION The results indicate that although the subjective symptoms resolved early, a reduced sensitivity of SWAP remained and the optical coherence tomography (OCT) showed GCC thinning. We conclude that local abnormalities in the anterior section of fusiform gyrus can cause mild cerebral dyschromatopsia without other symptoms. These findings indicate that it is important to listen to the symptoms of the patient and perform appropriate tests including the SWAP and OCT at the early stage to objectively prove the presence of acquired cerebral color anomaly.
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Affiliation(s)
- Yoko Mase
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan.
| | - Yoshitsugu Matsui
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Eriko Uchiyama
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Hisashi Matsubara
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Masahiko Sugimoto
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
| | - Akiko Kubo
- Kinan Hospital, 4750 Atawa, Mihama Town, Mie, 519-5204, Japan.,The Jikei University Hospital, 3-19-18 Nishishinnbashi, Minato-ku, Tokyo, 105-0003, Japan
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu City, Mie, 514-8507, Japan
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Crampton A, Teel E, Chevignard M, Gagnon I. Vestibular-ocular reflex dysfunction following mild traumatic brain injury: A narrative review. Neurochirurgie 2021; 67:231-237. [PMID: 33482235 DOI: 10.1016/j.neuchi.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 01/10/2021] [Indexed: 12/28/2022]
Abstract
Mild traumatic brain injury (mTBI) is a prevalent injury which occurs across many populations, including children and adolescents, athletes, military personnel, and the elderly. mTBI can result in various subjective symptoms and clinical deficits, such as abnormalities to the vestibulo-ocular reflex (VOR). Over 50% of individuals with mTBI are reported to have VOR abnormalities, which strongly contribute to feelings of dizziness and unsteadiness. Dizziness is a strong predictor for prolonged recovery following mTBI and is additionally linked with mental health difficulties and functional limitations affecting likelihood of return to work. Early diagnosis, and subsequent treatment, of VOR deficits following mTBI may greatly improve recovery outcomes and a patient's quality of life, but a thorough comprehension of the related pathophysiology is necessary to understand the assessments used to diagnose VOR abnormalities. Therefore, the purpose of this article is i) provide readers with an introduction on the VOR physiology to facilitate understanding about mTBI-related abnormalities, and ii) to discuss current assessments that are commonly used to measure VOR function following mTBI. As the VOR and oculomotor (OM) systems are heavily linked and often work in tandem, discussion of the relevant aspects of the OM system is also provided.
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Affiliation(s)
- Adrienne Crampton
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.
| | - Elizabeth Teel
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
| | - Mathilde Chevignard
- Rehabilitation Department for Children with Acquired Neurological Injury and Outreach Team for Children and Adolescents with Acquired Brain Injury, Saint Maurice Hospitals, Paris, France; Laboratoire d'Imagerie Biomédicale, Sorbonne Université, INSERM, CNRS, Paris, France; GRC 24 HaMCRe, Handicap Moteur et Cognitif et Réadaptation, Sorbonne Université, Paris, France
| | - Isabelle Gagnon
- School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada; Montreal Children Hospital, McGill University Health Center, Montreal, QC, Canada
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Abstract
Alexia refers to a reading disorder caused by some form of acquired brain pathology, most commonly a stroke or tumor, in a previously literate subject. In neuropsychology, a distinction is made between central alexia (commonly seen in aphasia) and peripheral alexia (a perceptual or attentional deficit). The prototypical peripheral alexia is alexia without agraphia (pure alexia), where patients can write but are impaired in reading words and letters. Pure alexia is associated with damage to the left ventral occipitotemporal cortex (vOT) or its connections. Hemianopic alexia is associated with less extensive occipital damage and is caused by a visual field defect, which creates problems reading longer words and passages of text. Reading impairment can also arise due to attentional deficits, most commonly following right hemisphere or bilateral lesions. Studying patients with alexia, along with functional imaging studies of normal readers, has improved our understanding of the neurobiological processes involved in reading. A key question is whether an area in the left ventral occipitotemporal cortex is specialized for or selectively involved in word processing, or whether reading relies on tuning of more general purpose perceptual areas. Reading deficits may also be observed in dementia and traumatic brain injury, but often with less consistent deficit patterns than in patients with focal lesions.
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Affiliation(s)
- Randi Starrfelt
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
| | - Zoe Woodhead
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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Clinical Practice Guidelines for Occupational Therapists in the Evaluation and Treatment of Oculomotor Impairment Following Traumatic Brain Injury. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021; 9:93-99. [PMID: 34094719 PMCID: PMC8171233 DOI: 10.1007/s40141-021-00310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2021] [Indexed: 02/08/2023]
Abstract
Purpose of review Currently, a lack of guidelines exists regarding best practices for occupational therapists (OTs) in the treatment and evaluation of oculomotor dysfunction following traumatic brain injury (TBI). Furthermore, individuals with TBI would benefit significantly from collaboration between OTs and optometrists during inpatient rehab. Recent findings Although few articles examine interdisciplinary models of inpatient rehab care that include optometry, a recent pilot study is explored. Emerging evidence from the field of optometry supports the use of restorative approaches for oculomotor impairment in mild TBI; however, cases with moderate to severe TBI are not addressed. Summary We describe an interdisciplinary approach involving collaboration between optometry and occupational therapy, yielding a comprehensive model to effectively evaluate and treat oculomotor impairments in those with TBI and facilitate improved performance in daily activities. We also provide guidelines useful for OTs working in settings where collaboration with optometry is not feasible.
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Johansson J, Berthold Lindstedt M, Borg K. Vision therapy as part of neurorehabilitation after acquired brain injury - a clinical study in an outpatient setting. Brain Inj 2020; 35:82-89. [PMID: 33297770 DOI: 10.1080/02699052.2020.1858495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Introduction: Oculomotor (OM) functions may be affected by acquired brain injury (ABI). The ability to benefit from rehabilitation or to perform daily activities may be affected by OM dysfunctions and associated symptoms. The purpose of this study was to investigate the effects of vision therapy (VT) as part of neurorehabilitation after ABI.Materials and Methods: The study included two groups of outpatients (median 49.5-52.0 years, range 27-67) admitted to neurorehabilitation due to moderate to severe ABI. One group received VT while the other group served as controls to monitor the course of OM dysfunctions without VT.Results: The intervention group showed significant improvements in convergence (Z = 2.26, p = .02), vergence facility (Z = -2.16, p = .03) and vergence reserves (Z = -2.44, p < .01 and t = -4.47, DF = 15, p < .01) along with a significant reduction in vision-related symptoms (Z = 2.97, p < .01).Discussion: We conclude that OM issues were frequent and that targeted VT, as part of neurorehabilitation, can be an efficient treatment resulting in improved functions and reduced symptoms. Further study will be required to understand how improved functions link to performance and satisfaction with everyday activities.
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Affiliation(s)
- J Johansson
- Department of Clinical Neuroscience, Eye and Vision, Karolinska Institute, Stockholm, Sweden
| | - M Berthold Lindstedt
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden.,Department of Clinical Sciences, Division of Rehabilitation Medicine, Karolinska Institute, Stockholm, Sweden
| | - K Borg
- Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden.,Department of Clinical Sciences, Division of Rehabilitation Medicine, Karolinska Institute, Stockholm, Sweden
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Modrak CG, Giesler LP, Vonder Haar C. Traumatic brain injury substantially reduces the conditioned reinforcing effects of environmental cues in rats. Brain Res 2020; 1748:147084. [PMID: 32871136 DOI: 10.1016/j.brainres.2020.147084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/22/2022]
Abstract
Traumatic brain injury affects millions of people each year and is an established risk factor for addiction. Recent animal studies have causally demonstrated that injuries can increase drug self-administration across a variety of substances. One potential behavioral mediator for this finding is an increased responsivity to drug-associated cues. This endophenotype can be identified by profiling non-drug-related behaviors. The current study evaluated several paradigms (conditioned approach, conditioned reinforcement, extinction from variable interval responding, conditioned facilitation) to determine how rats with a frontal TBI differed in their response to Pavlovian conditioning in response to food-paired cues. Surprisingly, rats with a TBI demonstrated increased goal-tracking in a conditioned approach paradigm and exerted less effort for a conditioned reinforcer. Moreover, they had slightly facilitated extinction (as demonstrated by significantly larger interresponse times) in the face of reinforcer-associated cues. Despite these effects, TBI rats still demonstrated conditioned facilitation to an auditory stimulus. Together, these effects suggest a phenotype in the opposite direction of what might be anticipated. Cues still served a strong discriminative function and altered behavior; however, they did not function as strong conditioned reinforcers for TBI animals. One potential reason for this is that substantial changes to the dopamine system after TBI may reduce the conditioned reinforcing effects of cues, but sensitize the brain to potent drugs of abuse. More research will be needed to determine whether this is the case.
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Affiliation(s)
- Cassandra G Modrak
- Injury and Recovery Laboratory, Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Lauren P Giesler
- Injury and Recovery Laboratory, Department of Psychology, West Virginia University, Morgantown, WV, USA
| | - Cole Vonder Haar
- Injury and Recovery Laboratory, Department of Psychology, West Virginia University, Morgantown, WV, USA; Department of Neuroscience, West Virginia University, Morgantown, WV, USA.
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Validity of the Wide-range Assessment of Vision-related Essential Skills in Japanese Children with Learning Problems. Optom Vis Sci 2020; 97:275-285. [PMID: 32304537 DOI: 10.1097/opx.0000000000001504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
SIGNIFICANCE Our study revealed that the validity of a new Japanese visual-perceptual test was acceptable. Visual-perceptual abilities are important to activities of daily living; thus, accurate assessment of visual perception is especially important for children with neurodevelopmental disorders and particularly so for those with learning problems. PURPOSE Visual perception refers to the process by which one receives visual information through sensory impulses and then translates those impulses into meaning based on a previously developed view of the environment. A problem in Japan is the paucity of visual perception tests that use normative data from children who are native Japanese. The Wide-range Assessment of Vision-related Essential Skills (WAVES), which measures visual perception and eye-hand coordination skills and is based on Japanese normative data, was recently published in Japan. The validity of this test has not been comprehensively established. METHODS To investigate the validity of the WAVES, we used the Pearson correlation coefficient to calculate the degrees of association among WAVES scaled and index scores compared with Developmental Test of Visual Perception, Third Edition, scores from 108 elementary school children with symptoms of learning problems. Participants were recruited at Osaka Medical College Learning Disability Center and Sakai Seikeikai Learning Disability Center. RESULTS The concurrent validity of the WAVES was supported by moderate correlation (r = 0.67, P < .01) between the total scores for visual perception and eye-hand coordination index from the WAVES and general visual perception index from the Developmental Test of Visual Perception, Third Edition, even though a correlation analysis of subtests found differences between the two tests. CONCLUSIONS Our results showed that the indices from the two tests measured nearly the same underlying visual-perceptual constructs and indicated that the WAVES had acceptable levels of concurrent validity.
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McDonnall MC, Cmar JL, McKnight ZS. Service factors and personal characteristics associated with employment and job quality for vocational rehabilitation consumers with combined traumatic brain injury and visual impairment. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Michele C. McDonnall
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, Mississippi State, MS, USA
| | - Jennifer L. Cmar
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, Mississippi State, MS, USA
| | - Zhen Sui McKnight
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, Mississippi State, MS, USA
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Yoo PY, Scott K, Myszak F, Mamann S, Labelle A, Holmes M, Guindon A, Bussieres AE. Interventions Addressing Vision, Visual-perceptual Impairments Following Acquired Brain Injury: A Cross-sectional Survey. The Canadian Journal of Occupational Therapy 2020; 87:117-126. [PMID: 31896281 DOI: 10.1177/0008417419892393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND. The existing literature on the effectiveness of interventions targeting vision, visual-perceptual impairments following acquired brain injury (ABI) is scarce and unlinked to occupational performance. PURPOSE. To explore current occupational therapy practice in vision-rehabilitation among adults with ABI in Canada, and to determine the evidence-practice gaps. METHODS. An online survey was made available through the Canadian Association of Occupational Therapists (CAOT) website, and disseminated to seven public healthcare institutions in Quebec. The survey collected respondent demographic information, and the types and frequency of treatments delivered. Descriptive statistics were conducted to determine interventions' frequency. Participant comments were collected and grouped into recurring themes. FINDINGS. Over half (55%) of respondents regularly use evidence-based interventions when addressing visual acuity (VA) and visual field (VF) deficits, but only very few (3%) use it when dealing with oculomotor function and visual stress impairments. IMPLICATIONS. Results gave a glimpse of interventions used and suggested the need for further research in vision rehabilitation.
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Cortical visual impairment as an initial clinical manifestation of post-traumatic brain injury: A case report and review of literature. INTERDISCIPLINARY NEUROSURGERY-ADVANCED TECHNIQUES AND CASE MANAGEMENT 2019. [DOI: 10.1016/j.inat.2019.100485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Desai A, Chen H, Kim HY. Multiple Mild Traumatic Brain Injuries Lead to Visual Dysfunction in a Mouse Model. J Neurotrauma 2019; 37:286-294. [PMID: 31530220 DOI: 10.1089/neu.2019.6602] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Visual dysfunction is a common occurrence after traumatic brain injury (TBI). We investigated in this study effects of single or multiple mild TBI on visual function in mice using a closed head injury model that permits unconstrained head movement after impact. Adult mice were briefly anesthetized with isoflurane and given one or three mild TBI with the closed head injury by mechanically engineered rotational acceleration (CHIMERA) device with an interinjury interval of 24 h. Mice were then tested in the Morris water maze, visual cliff, and open field tests from day 19 to day 32 and for visual evoked potential at 5 weeks after the last injury and euthanized. Mice with multiple TBI showed impaired performance in the visible platform water maze test and had increased errors in the visual cliff test. Further, there was a graded difference in visual evoked potential, with the single injury mice showing modest reduction in N1 amplitude whereas the multiple injuries produced significant reduction compared to sham and single injury groups. The optic tract of the injured mice showed increases in glial cell immunostaining. The increase in glial fibrillary acid protein immunostaining reached statistical significance for both injured groups whereas the ionized calcium binding adaptor molecule 1 immunostaining was only significantly increased in the optic tract of repeatedly injured mice. These results indicate that multiple injuries using CHIMERA may result in visual deficits, which can affect certain behavioral performances. The change in vision may be a useful marker when monitoring repeated TBI outcome and screening for protective agents from TBI.
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Affiliation(s)
- Abhishek Desai
- Laboratory of Molecular Signaling, NIAAA, NIH, Rockville, Maryland
| | - Huazhen Chen
- Laboratory of Molecular Signaling, NIAAA, NIH, Rockville, Maryland.,Center for Neuroscience and Regenerative Medicine at the Uniformed Services University of Health Sciences, Bethesda, Maryland
| | - Hee-Yong Kim
- Laboratory of Molecular Signaling, NIAAA, NIH, Rockville, Maryland
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The association between health-related quality of life and noise or light sensitivity in survivors of a mild traumatic brain injury. Qual Life Res 2019; 29:665-672. [PMID: 31667708 DOI: 10.1007/s11136-019-02346-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Sensory impairment is a common aftereffect of mild traumatic brain injury (TBI); however, their influence upon treatment outcomes and quality of life has yet to be investigated. This study sought to determine the effects of noise and light sensitivity upon the quality of life of individuals diagnosed with a TBI. METHODS A cross-sectional adult sample obtained from a longitudinal study (n = 293) provided measures of light and noise sensitivity and quality of life 12 months post injury. Sensitivities were taken from the Rivermead Post-concussion Symptoms Questionnaire, while quality of life was estimated using the Short-Form 36 health survey (SF-36). RESULTS Approximately 42% of participants reported ongoing difficulties with noise and light sensitivity. Additionally, those reporting sensory difficulties also reported lower SF-36 domain and composite scores compared to those reporting no such symptoms. After controlling for known co-factors, hierarchical multiple regression analyses indicated that the combination of light and noise sensitivity explained between 8 and 35% of the variance in SF-36 scores. CONCLUSIONS Light and noise sensitivity appear to degrade the quality of life of those with a mild TBI. Our findings challenge contemporary rehabilitation practices that tend to sideline sensory complaints and instead focus on the remediation of acute TBI symptoms.
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Luckie H, Hollands K, Williamson T, Nester C, Williams A. Comfortably numb? Experiences of people with stroke and lower limb sensation deficits: impact and solutions. Disabil Rehabil Assist Technol 2019; 16:262-269. [PMID: 31597494 DOI: 10.1080/17483107.2019.1673490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE To explore personal experiences of loss of foot sensation following stroke in order to inform the focus of clinical assessments and development of a vibrotactile insole. METHODS Qualitative design with an interpretive phenomenological approach to data collection and analysis. Eight community dwelling adults with stroke (>6 months) and sensory impairment in the feet participated. Data was collected via conversational style interviews which were transcribed and analyzed using a thematic framework. Themes were verified with co-researchers and a lay advisory group. RESULTS Data formed four themes: Sensory deficits are prevalent and constant, but individual and variable; Sensory deficits have a direct impact on balance, gait, mobility and falls; Sensory deficits have consequences for peoples' lives; Footwear is the link between function, the environment and identity. They embraced the concept of discrete vibrotactile insoles, their potential benefits and demonstrated a willingness to try it. CONCLUSIONS Sensory deficit contributes to effects upon physical function, mobility and activity. Clinical outcome measures need to capture the emotional, psychological and social impacts of sensory deficit. Participants demonstrated a resilience and resourcefulness through adaption in daily living and self-management of footwear. The participants focus on footwear provides the opportunity to develop discrete and non-burdensome vibrotactile insoles for this patient group.IMPLICATIONS FOR REHABILITATIONSensory deficits are wide ranging and varied and are not distinct from motor deficits though contribute to the overall effect on physical function, mobility and activity.The physical effects impact on participants' lives emotionally, psychologically and socially. Measurement of outcomes need to capture specific activities that are valued by patients.The participants have revealed resilience and resourcefulness to create a "new normal" for their lives through adaption and self-management with a focus being on footwear as a solution.The participants have revealed the need for insole interventions to be discreet and non-burdensome, welcoming insole technology and contributing to the design and features of such insoles.
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Affiliation(s)
- Helen Luckie
- Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - Kristen Hollands
- School of Health and Society, University of Salford, Salford, UK
| | - Tracey Williamson
- School of Allied Health and Community, University of Worcester, Worcester, UK
| | - Chris Nester
- School of Health and Society, University of Salford, Salford, UK
| | - Anita Williams
- School of Health and Society, University of Salford, Salford, UK
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Faried A, Kurniawan CB, Halim D, Arifin MZ. A rare case of depressed skull fractures at the anterior cranial fossa associated with communicating hydrocephalus resulting a progressive vision loss. INTERDISCIPLINARY NEUROSURGERY 2019. [DOI: 10.1016/j.inat.2019.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Das M, Tang X, Mohapatra SS, Mohapatra S. Vision impairment after traumatic brain injury: present knowledge and future directions. Rev Neurosci 2019; 30:305-315. [PMID: 30226209 DOI: 10.1515/revneuro-2018-0015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/15/2018] [Indexed: 01/23/2023]
Abstract
Traumatic brain injury (TBI) is a major cause of mortality and morbidity in the USA as well as in the world. As a result of TBI, the visual system is also affected often causing complete or partial visual loss, which in turn affects the quality of life. It may also lead to ocular motor dysfunction, defective accommodation, and impaired visual perception. As a part of the therapeutic strategy, early rehabilitative optometric intervention is important. Orthoptic therapy, medication, stem cell therapy, motor and attention trainings are the available treatment options. Gene therapy is one of the most promising emerging strategies. Use of state-of-the-art nanomedicine approaches to deliver drug(s) and/or gene(s) might enhance the therapeutic efficacy of the present and future modalities. More research is needed in these fields to improve the outcome of this debilitating condition. This review focuses on different visual pathologies caused by TBI, advances in pre-clinical and clinical research, and available treatment options.
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Affiliation(s)
- Mahasweta Das
- James A. Haley Veterans Administration Hospital, Tampa, FL 33612, USA.,Department of Molecular Medicine, University of South Florida College of Medicine, Tampa, FL 33612, USA
| | - Xiaolan Tang
- James A. Haley Veterans Administration Hospital, Tampa, FL 33612, USA.,Department of Molecular Medicine, University of South Florida College of Medicine, Tampa, FL 33612, USA
| | - Shyam S Mohapatra
- James A. Haley Veterans Administration Hospital, Tampa, FL 33612, USA.,Department of Internal Medicine, University of South Florida College of Medicine, Tampa, FL 33612, USA
| | - Subhra Mohapatra
- James A. Haley Veterans Administration Hospital, Tampa, FL 33612, USA.,Department of Molecular Medicine, University of South Florida College of Medicine, Tampa, FL 33612, USA
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Jang SH, Lee HD. Diagnostic Approach to Traumatic Axonal Injury of the Optic Radiation in Mild Traumatic Brain Injury. Am J Phys Med Rehabil 2019; 98:e92-e96. [PMID: 31318757 DOI: 10.1097/phm.0000000000001078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
We describe a diffusion tensor tractography-based diagnostic approach to traumatic axonal injury of the optic radiation in a patient who showed visual field defect after mild traumatic brain injury. A 43-yr-old female patient experienced head trauma during a motor vehicle accident. After the head trauma, she noticed visual disturbance. Peripheral field defects were detected in both eyes on the Humphrey visual field test. After diffusion tensor tractography-based reconstruction of the optic radiation, We determined the fractional anisotropy and fiber number of each whole optic radiation. Four regions of interest were placed on the optic radiations based on diffusion tensor tractography configuration. The right optic radiation showed narrowing, and the left optic radiation revealed partial tearing in the posterior portion. The fiber number of the right optic radiation was more than two standard deviations lower than the control mean. The fractional anisotropy values of the regions of interest 2 (the narrowed area of the right optic radiation) and regions of interest 3 (the partially torn area of the left optic radiation) were more than two standard deviations lower than the control mean. Our results suggest that analysis of the configuration and parameters of the optic radiation based on three-dimensionally reconstructed diffusion tensor tractography results is a useful technique in the detection of traumatic axonal injury of the optic radiation in individual patients with mild traumatic brain injury.
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Affiliation(s)
- Sung Ho Jang
- From the Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Taegu, Republic of Korea
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43
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Jennings BJ, Schmidtmann G, Wehbé F, Kingdom FAA, Farivar R. Detection of distortions in images of natural scenes in mild traumatic brain injury patients. Vision Res 2019; 161:12-17. [PMID: 31129288 DOI: 10.1016/j.visres.2019.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 05/09/2019] [Accepted: 05/12/2019] [Indexed: 10/26/2022]
Abstract
Mild traumatic brain injuries (mTBI) frequently lead to the impairment of visual functions including blurred and/or distorted vision, due to the disruption of visual cortical mechanisms. Previous mTBI studies have focused on specific aspects of visual processing, e.g., stereopsis, using artificial, low-level, stimuli (e.g., Gaussian patches and gratings). In the current study we investigated high-level visual processing by employing images of real world natural scenes as our stimuli. Both an mTBI group and control group composed of healthy observers were tasked with detecting sinusoidal distortions added to the natural scene stimuli as a function of the distorting sinusoid's spatial frequency. It was found that the mTBI group were equally as sensitive to high frequency distortions as the control group. However, sensitivity decreased more rapidly with decreasing distortion frequency in the mTBI group relative to the controls. These data reflect a deficit in the mTBI group to spatially integrate over larger regions of the scene.
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Affiliation(s)
- B J Jennings
- Centre for Cognitive Neuroscience, Department of Life Sciences, College of Health and Life Sciences, Brunel University, London, UK; McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada.
| | - G Schmidtmann
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada; Eye & Vision Research Group, Department of Optometry, University of Plymouth, Plymouth, UK
| | - F Wehbé
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - F A A Kingdom
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada
| | - R Farivar
- McGill Vision Research Unit, Department of Ophthalmology, McGill University, Montreal, Canada; Traumatic Brain Injury Program, Research Institute of the McGill University Health Centre, Montreal, Canada
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Gupta R, Saha P, Sen T, Sen N. An augmentation in histone dimethylation at lysine nine residues elicits vision impairment following traumatic brain injury. Free Radic Biol Med 2019; 134:630-643. [PMID: 30790655 PMCID: PMC6588499 DOI: 10.1016/j.freeradbiomed.2019.02.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 01/16/2019] [Accepted: 02/13/2019] [Indexed: 12/26/2022]
Abstract
Traumatic Brain Injury (TBI) affects more than 1.7 million Americans each year and about 30% of TBI-patients having visual impairments. The loss of retinal ganglion cells (RGC) in the retina and axonal degeneration in the optic nerve have been attributed to vision impairment following TBI; however, the molecular mechanism has not been elucidated. Here we have shown that an increase in histone di-methylation at lysine 9 residue (H3K9Me2), synthesized by the catalytic activity of a histone methyltransferase, G9a is responsible for RGC loss and axonal degeneration in the optic nerve following TBI. To elucidate the molecular mechanism, we found that an increase in H3K9Me2 results in the induction of oxidative stress both in the RGC and optic nerve by decreasing the mRNA level of antioxidants such as Superoxide dismutase (sod) and catalase through impairing the transcriptional activity of Nuclear factor E2-related factor 2 (Nrf2) via direct interaction. The induction of oxidative stress is associated with death in RGC and oligodendrocyte precursor cells (OPCs). The death in OPCs is correlated with a reduction in myelination, and the expression of myelin binding protein (MBP) in association with degeneration of neurofilaments in the optic nerve. This event allied to an impairment of the retrograde transport of axons and loss of nerve fiber layer in the optic nerve following TBI. An administration of G9a inhibitor, UNC0638 attenuates the induction of H3K9Me2 both in RGC and optic nerve and subsequently activates Nrf2 to reduce oxidative stress. This event was concomitant with the rescue in the loss of retinal thickness, attenuation in optic nerve degeneration and improvement in the retrograde transport of axons following TBI.
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Affiliation(s)
- Rajaneesh Gupta
- Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, Scaife Hall, Pittsburgh, 15213, USA
| | - Pampa Saha
- Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, Scaife Hall, Pittsburgh, 15213, USA
| | - Tanusree Sen
- Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, Scaife Hall, Pittsburgh, 15213, USA
| | - Nilkantha Sen
- Department of Neurological Surgery, University of Pittsburgh, 200 Lothrop Street, Scaife Hall, Pittsburgh, 15213, USA.
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45
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Wagener SG, Kreiger R. Participation and quality of life for persons with oculomotor impairments after acquired brain injury. Br J Occup Ther 2019. [DOI: 10.1177/0308022619827262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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46
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Active Rehabilitation After Childhood and Adolescent Mild Traumatic Brain Injury: a Narrative Review and Clinical Practice Implications. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-0207-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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47
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Snegireva N, Derman W, Patricios J, Welman KE. Eye tracking technology in sports-related concussion: a systematic review and meta-analysis. Physiol Meas 2018; 39:12TR01. [DOI: 10.1088/1361-6579/aaef44] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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48
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Oagaz H, Schoun B, Pooji M, Choi MH. Neurocognitive Assessment in Virtual Reality Through Behavioral Response Analysis. IEEE J Biomed Health Inform 2018; 23:1899-1910. [PMID: 30442624 DOI: 10.1109/jbhi.2018.2881455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ability to detect and diagnose neurocognitive disorders at the earliest possible moment is key to a better prognosis for the patient. Two of the earliest indicators of potential neurocognitive problems are motor and visual dysfunction. Motor disorders and problems in visual cognition can be seen in many neurocognitive disorders, resulting in abnormal physical reactions to visual stimuli. Analyzing physical behaviors when presented with such stimuli can provide insights into the visual perception and motor abilities of an individual, yet there is currently no unbiased, objective, general-purpose tool that analyzes attention and motor behavior to assess neurocognitive function. We propose a novel method of neurocognitive function assessment that tests the patient's cognition using virtual reality with eye tracking and motion analysis. By placing the patient in a controlled virtual environment and analyzing their movements, we can evoke certain physical responses from subjects for neurocognitive assessment. We have developed a prototype system that places the subject in a virtual baseball field and captures their full body motion as they try to catch baseballs. This scenario tests the subject's ability to determine the landing time and position of the ball, as well as the test subject's balance, motor skills, attention, and memory. Preliminary tests with 20 healthy normal individuals demonstrate the ability of this tool to assess the test subject's balance, memory, attention, and reaction to visual stimuli. This platform has a twofold contribution: it is used to assess several neurocognitive constructs that affect visual and motor capability neutrally and objectively based on controlled stimuli, and it enables objective comparison between different neurocognitive disorders research in this field.
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Burgess G, Jewell VD. Occupational therapists' perspectives on binocular diplopia in neurorehabilitation: A national survey. NeuroRehabilitation 2018; 42:223-233. [PMID: 29562559 DOI: 10.3233/nre-172263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Oculomotor dysfunction affects a significant number of adults with neurological conditions and binocular diplopia is a common symptom which impacts an individual's ability to participate in meaningful daily activities. Occupational therapists use partial and complete occlusion to minimize binocular diplopia, however a review of the literature reflected a lack of standardized protocol for each intervention technique. The purpose of this study was to examine occupational therapists' perspectives on the use of partial and complete occlusion and the clinical reasoning process used. METHODS An electronic survey was distributed to occupational therapists working in a variety of practice settings. The survey contained questions relating to demographics, the selected occlusion technique, and clinical reasoning for that selection. RESULTS More than half of the 106 respondents used partial occlusion more frequently than complete occlusion. There was no correlation between respondent experience and self-report of competence in managing binocular diplopia. Respondents based their clinical reasoning on available evidence, client factors, and clinical expertise. CONCLUSION Respondents offered conflicting perspectives on each occlusion technique. Future studies are required to examine which occlusion technique benefits clients.
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Affiliation(s)
- Gillian Burgess
- University of California, San Francisco Medical Center, San Francisco, CA, USA.,School of Pharmacy and Health Professions, Creighton University, Omaha, NE, USA
| | - Vanessa D Jewell
- Assistant Professor and Director of the Post-Professional Doctorate of Occupational Therapy Program, Creighton University, Omaha, NE, USA
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Elliott JE, Opel RA, Weymann KB, Chau AQ, Papesh MA, Callahan ML, Storzbach D, Lim MM. Sleep Disturbances in Traumatic Brain Injury: Associations With Sensory Sensitivity. J Clin Sleep Med 2018; 14:1177-1186. [PMID: 29991430 PMCID: PMC6040790 DOI: 10.5664/jcsm.7220] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 03/29/2018] [Accepted: 04/05/2018] [Indexed: 01/21/2023]
Abstract
STUDY OBJECTIVES Sleep disturbances following traumatic brain injury (TBI) in Veterans are very common and often persist as chronic sequelae. In addition, sensory sensitivity, ie, discomfort upon exposure to light and noise, is common after TBI. However, the relationship between sleep disturbances and sensory sensitivity in Veterans following TBI has not yet been examined, yet both are established early markers of neurodegeneration. METHODS Veterans (n = 95) in the chronic phase of recovery from TBI at the VA Portland Health Care System completed an overnight polysomnography and provided self-report data on sensory (eg, light and noise) sensitivity, and sleep disturbances. Participants were categorized into four sensory sensitivity groups: (1) "neither," neither light nor noise sensitivity (n = 36); (2) "light," only light sensitivity (n = 12); (3) "noise," only noise sensitivity (n = 24); and (4) "both," light and noise sensitivity (n = 23). RESULTS Veterans with TBI reported sleep disturbances that were significantly correlated with the severity of their sensory sensitivity and associated with posttraumatic stress disorder (PTSD). Multiple linear regression revealed insomnia severity to be the strongest predictor of the relationship between sleep disturbances and sensory sensitivity. Furthermore, sensory sensitivity was associated with a higher mean heart rate during sleep, even after controlling for PTSD status. CONCLUSIONS These data are the first to report the prevalence and association between sensory sensitivity and sleep disturbances in Veterans with TBI. These data also suggest that the underlying mechanism of the sleep-sensory relationship could be due in part to comorbid PTSD and autonomic nervous system hyperarousal.
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Affiliation(s)
- Jonathan E. Elliott
- VA Portland Health Care System, Portland, Oregon
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
| | - Ryan A. Opel
- VA Portland Health Care System, Portland, Oregon
| | - Kris B. Weymann
- VA Portland Health Care System, Portland, Oregon
- School of Nursing, Oregon Health and Science University, Portland, Oregon
| | - Alex Q. Chau
- VA Portland Health Care System, Portland, Oregon
| | | | | | - Daniel Storzbach
- VA Portland Health Care System, Portland, Oregon
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Department of Psychiatry, Oregon Health and Science University, Portland, Oregon
| | - Miranda M. Lim
- VA Portland Health Care System, Portland, Oregon
- Department of Neurology, Oregon Health and Science University, Portland, Oregon
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon
- Department of Behavioral Neuroscience, Oregon Health and Science University, Portland, Oregon
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon
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