Abstract T P121: Combinations of Fast and Slow Eye Movement Strategies Improve Clinical Outcomes and EEG Activity in Stroke Patients, a Randomized Controlled Trial

Abstract

Introduction: The majority of our patients with middle cerebral artery (MCA) infarcts have impaired latency of visual saccades, saccadic dysmetria and saccadic intrusions of pursuits. We wanted to see if the utilization of eye movement rehabilitation in cases of middle cerebral artery infarction would result in changes of brain function and patient clinical outcomes. Hypothesis: We assessed the hypothesis that visual training of fast and slow eye movements to novel targets will result in changes in EEG activity, decrease physical and cognitive impairment and increase clinical outcomes in stroke patients. Methods: A sample size of 60 subjects (80% power, alpha of 0.05 at 95% CI) with acute MCA ischemic stroke within the first 48 hours of clinical evolution were randomized to an active treatment (n=30) group that performed eye movement strategies and a matched control group (n= 30) that did not. All subjects underwent CT and MRI and received standard therapies and NIH Stroke Scales and QEEG. Results: A significant reduction of the NIHSS scale was found after a week of practicing our eye movement strategies, indicating a clinical improvement. There was a significant reduction of the DAR index after eye movement exercises. QEEG brain mapping demonstrated a significant reduction of the spectral power in the Delta and an increment in the Alpha bands also demonstrated with the reduction of the DAR index. The brain symmetry index significantly increased after eye movement exercises indicating an augmentation of balance of the absolute mean value of the hemispheric power difference in the frequency range from 1 to 30 Hz. There was a significant reduction of the PRI index after eye movement exercises, indicating an increment of the fast (alpha +beta), compared with the slow (delta + theta) activities. A significant correlation was found between NIHSS (before) and DAR (after). Conclusions: The stroke patients undergoing eyes exercises had a significant neurological recovery with decreased impairment and improvement of electrical brain activity both reflected in the modifications of the NIHSS scale, and the DAR and BSI QEEG indices and strong correlations of DAR post-exercise with NIHSS scores before eye movement training strategies.