title: Oculomotor neurorehabilitation for reading in mild traumatic brain injury (mTBI): an integrative approach.
abstract: BACKGROUND
  Considering the extensive neural network of the oculomotor subsystems, traumatic brain injury (TBI) could affect oculomotor control and related reading dysfunction.
  
  
  OBJECTIVE
  To evaluate comprehensively the effect of oculomotor-based vision rehabilitation (OBVR) in individuals with mTBI.
  
  
  METHODS
  Twelve subjects with mTBI participated in a cross-over, interventional study involving oculomotor training (OMT) and sham training (ST). Each training was performed for 6 weeks, 2 sessions a week. During each training session, all three oculomotor subsystems (vergence/accommodation/version) were trained in a randomized order across sessions. All laboratory and clinical parameters were determined before and after OMT and ST. In addition, nearvision-related symptoms using the Convergence Insufficiency Symptom Survey (CISS) scale and subjective visual attention using the Visual Search and Attention Test (VSAT) were assessed.
  
  
  RESULTS
  Following the OMT, over 80% of the abnormal parameters significantly improved. Reading rate, along with the amplitudes of vergence and accommodation, improved markedly. Saccadic eye movements demonstrated enhanced rhythmicity and accuracy. The improved reading-related oculomotor behavior was reflected in reduced symptoms and increased visual attention. None of the parameters changed with ST.
  
  
  CONCLUSIONS
  OBVR had a strong positive effect on oculomotor control, reading rate, and overall reading ability. This oculomotor learning effect suggests considerable residual neuroplasticity following mTBI.
authors.affiliation: Department of Biological and Vision Sciences, SUNY State College of Optometry, New York, NY, USA.
authors.forename: Preethi
authors.initials: P
authors.lastname: Thiagarajan
authors.affiliation: Department of Biological and Vision Sciences, SUNY State College of Optometry, New York, NY, USA.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ciuffreda
authors.affiliation: Optometry Service, Womack Army Medical Center, Fort Bragg, NC, USA.
authors.forename: Jose E
authors.initials: JE
authors.lastname: Capo-Aponte
authors.affiliation: Department of Biological and Vision Sciences, SUNY State College of Optometry, New York, NY, USA.
authors.forename: Diana P
authors.initials: DP
authors.lastname: Ludlam
authors.affiliation: Department of Clinical Sciences, SUNY State College of Optometry, New York, NY, USA.
authors.forename: Neera
authors.initials: N
authors.lastname: Kapoor
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D018592:Cross-Over Studies; D005133:Eye Movements / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000209:etiology / Q000534:rehabilitation*; D011932:Reading; D055815:Young Adult
keywords: Traumatic brain injury; eye movements; mTBI; nearvision symptoms; neuroplasticity; oculomotor deficiency; oculomotor learning; oculomotor rehabilitation; reading dysfunction