A Novel Computer Oculomotor Rehabilitation (COR) Program for Mild Traumatic Brain Injury (mTBI).

Individuals with traumatic brain injury (TBI) manifest a wide range of visual dysfunctions. One of the most prevalent involves the oculomotor system, which includes version, vergence, and accommodation. However, until recently, there has been no comprehensive, computer-based program for remediation of these oculomotor deficits.

Binasal Occlusion (BNO), Visual Motion Sensitivity (VMS), and the Visually-Evoked Potential (VEP) in mild Traumatic Brain Injury and Traumatic Brain Injury (mTBI/TBI).

The diagnosis and treatment of the possible visual sequelae in those with traumatic brain injury (TBI) represents an important area of health care in this special population. One of their most prevalent yet elusive visual symptoms is visual motion sensitivity (VMS). In this review, we present the basic VMS phenomenon and its related symptoms, clinical studies in the area, clinical research investigations using the visual-evoked potential (VEP) as a cortical probe, and possible mechanisms and related neurophysiology that may underlie VMS.

Effect of luminance on the visually-evoked potential in visually-normal individuals and in mTBI/concussion.

Purpose: To assess quantitatively the effect of luminance on VEP amplitude and latency in visually-normals (VN) and patients with mild traumatic brain injury (mTBI).

Methods: VN individuals (n = 20) and those with mTBI (n = 19) participated. Those with mTBI were assessed 1-10 years post-injury (mean = 4.

Objective assessment of visual attention in mild traumatic brain injury (mTBI) using visual-evoked potentials (VEP).

Purpose: To quantify visual attention objectively using the visual-evoked potential (VEP) in those having mild traumatic brain injury (mTBI) with and without a self-reported attentional deficit.

Research Design And Methods: Subjects were comprised of 16 adults with mTBI: 11 with an attentional deficit and five without. Three test conditions were used to assess the visual attentional state to quantify objectively the VEP alpha band attenuation ratio (AR) related to attention: (1) pattern VEP; (2) eyes-closed; and (3) eyes-closed number counting.

Proposed objective visual system biomarkers for mild traumatic brain injury.

The challenge and search for objectively based biomarkers to assess for the presence of concussion/mild traumatic brain injury is a high priority for the military establishment. We present a documented overview of specific test areas and related targeted, high-yield, objectively based parameters that may be potential "vision biomarkers" for the detection of concussion/mild traumatic brain injury based on results from our laboratory and others, with emphasis on oculomotor aspects. These findings have military relevance with respect to the initial diagnosis in the battlefield and in the far-forward medical facilities, pre-/postdeployment issues, pre-/postvisual rehabilitation evaluation, fitness-for-duty assessment, and establishment of a return-to-duty timeline.

Effect of binasal occlusion (BNO) and base-in prisms on the visual-evoked potential (VEP) in mild traumatic brain injury (mTBI).

Purpose: To assess quantitatively the effect and relative contribution of binasal occlusion (BNO) and base-in prisms (BI) on visually-evoked potential (VEP) responsivity in persons with mild traumatic brain injury (mTBI) and the symptom of visual motion sensitivity (VMS), as well as in visually-normal (VN) individuals.

Research Design And Methods: Subjects were comprised of 20 VN adults and 15 adults with mTBI and VMS. There were four test conditions: (1) conventional pattern VEP, which served as the baseline comparison condition; (2) VEP with BNO alone; (3) VEP with 2 pd BI prisms before each eye; and (4) VEP with the above BNO and BI prism combination.

Effect of oculomotor vision rehabilitation on the visual-evoked potential and visual attention in mild traumatic brain injury.

Primary Objective: The purpose of the experiment was to investigate the effect of oculomotor vision rehabilitation (OVR) on the visual-evoked potential (VEP) and visual attention in the mTBI population.

Research Design And Methods: Subjects (n = 7) were adults with a history of mild traumatic brain injury (mTBI). Each received 9 hours of OVR over a 6-week period.

Optimization of the pattern visual evoked potential (VEP) in the visually-normal and mild traumatic brain injury (mTBI) populations.

Primary Objective: The purpose of this study was to assess the effect of check size (CS) and contrast (C) on VEP amplitude and latency in visually-normal (VN) and in mild traumatic brain injury (mTBI) adults to develop an optimized test protocol in each group.

Research Design And Methods: Subjects were comprised of VN (n = 19) and individuals with mTBI (n = 16). Full-field, pattern VEP testing was employed with three different CSs (10, 20 and 40 min arc) and at two C levels (20 and 85%).

The effect of retinal defocus on simple eye-hand and eye-foot reaction time in traumatic brain injury (TBI).

Primary Objective: The purpose of the experiment was to assess the effect of retinal defocus on simple eye-hand (E-H) and eye-foot (E-F) reaction time (RT) in traumatic brain injury (TBI).

Design And Methods: Sixteen subjects with traumatic brain injury (five males and 11 females; aged 22-34 years) participated in the experiment. These were compared with 16 visually-normal, age/gender-match subjects.

Distance perception in mild traumatic brain injury (mTBI).

Background: The purpose of this study was to assess monocular and binocular distance perception, and stereoacuity, in individuals with mild traumatic brain injury (mTBI) who reported the symptom of "poor depth perception";

Methods: Ten patients with mTBI were tested and compared with ten visually-normal asymptomatic individuals in the following areas: perceived distance, stereoacuity at distance (3 meters) and near (40 cm), and a 9-item 5-point rating-scale questionnaire related to distance perception. Distance perception was assessed under monocular and binocular viewing conditions in both clustered and isolated static environments. Magnitude estimation was used to obtain the distance perception response function of physical versus perceived distance using common objects positioned at distances of 0.

Effect of test duration on the visual-evoked potential (VEP) and alpha-wave responses.

Primary Objective: The purpose of this study was to assess the effect of test duration on the visual-evoked potential (VEP) and related alpha power spectrum measures.

Design And Methods: Two conditions (eyes-closed and eyes-open) were tested using four different durations: 10, 20, 45, and 60 s. The Diopsys™ NOVA-TR system was used to obtain the visual-evoked potential (VEP) and extracted alpha wave with its related power spectrum.

Objective assessment of the human visual attentional state.

Primary Objective: The purpose of this study was to develop an objective way to assess human visual attention using the alpha-band component of the visual-evoked potential (VEP).

Design And Methods: Six different attentional conditions were tested: eyes-open, eyes-closed, eyes-closed with backwards number counting, and three rapid-serial visual presentation (RSVP) tasks. Eighteen visually normal, young-adult subjects (ages 21-28 years) were tested binocularly at 1 m for each condition on two separate days.

Effect of binasal occlusion (BNO) on the visual-evoked potential (VEP) in mild traumatic brain injury (mTBI).

Primary Objective: The purpose of the experiment was to assess the effect of binasal occlusion (BNO) on the visually-evoked potential (VEP) in visually-normal (VN) individuals and in those with mild traumatic brain injury (mTBI) for whom BNO frequently reduces their primary symptoms related to abnormally-increased visual motion sensitivity (VMS).

Design And Methods: Subjects were comprised of asymptomatic VN adults (n = 10) and individuals with mTBI (n = 10) having the symptom of VMS. Conventional full-field VEP testing was employed under two conditions: without BNO and with opaque BNO which blocked regions on either side of the VEP test stimulus.

Effect of different stimulus configurations on the visual evoked potential (VEP).

The purpose of this study was to assess changes in the response profile of the pattern visual evoked potential (VEP) using three stimulus configurations simulating visual-field scotomas: central circular and central blank fields increasing incrementally in diameter from 1° to 15°, hemi-field, and quadrant patterns. Five visually normal adult subjects (ages 22-68 years) were tested binocularly at 1 m for each stimulus configuration on 5 separate days. A checkerboard test pattern (64 × 64 black-and-white checks, 85% contrast, 64 cd/m(2) luminance, 20 s of stimulus duration, 2-Hz temporal frequency) was used.

Effects of sweep VEP parameters on visual acuity and contrast thresholds in children and adults.

Background: There are many parameters that may impact the thresholds obtained with sweep visually evoked potentials (sVEP), yet a number of these parameters have not been systematically studied, and there is no recognised standard for sVEP recording. In this study, the effects of electrode placement, temporal frequency, sweep direction, presence of a fixation target, stimulus area, and sweep duration on visual acuity (VA) and contrast thresholds of the sVEP were investigated. Additionally, the effect of these parameters on the number of viable threshold readings obtained from five active electrodes was investigated.

Threshold determination in sweep VEP and the effects of criterion.

In order to develop criteria for the range of data points used for regression line fitting in sweep visually evoked potential (sVEP), which would be objective, clearly specified and give good repeatability and validity, and in order to investigate the effect of luminance on sVEP measurement, visual acuity (VA) and contrast sensitivity (CS) were measured with sVEP in adults aged 17-30 years and children aged 6-8 years. Six to ten participants took part in each experiment. Five criteria (C0-C4) for fitting the regression line were implemented.