Mild Traumatic Brain Injury Clinical Trial
— PPCS-CIOfficial title:
Functional Mechanism of Neural Control in Persistent Post-Concussion Symptoms Convergence Insufficiency
Our successful R01 discovered 1) the neural mechanistic difference between typically occurring convergence insufficiency (TYP-CI) and binocularly normal controls and 2) the underlying mechanism of office-based vergence and accommodative therapy (OBVAT) that is effective in remediating symptoms. Adolescent and young adult concussion is considered a substantial health problem in the United States where our team has shown that about half of patients with persistent post-concussion symptoms have convergence insufficiency (PPCS-CI), causing significant negative impact associated with reading or digital screen-related activities, and is believed to be one factor causing delayed recovery impacting return to school, sports, or work. The results of this randomized clinical trial will impact the lives of adolescents and young adults with PPCS-CI to guide professionals on how to manage and treat those with PPCS-CI by 1) comparing the differences between PPCS-CI and TYP-CI, 2) discovering the neural mechanism of OBVAT for PPCS-CI compared to standard-community concussion care, and 3) determining the effectiveness of 12 one-hour sessions compared to 16 one-hour sessions of OBVAT.
Status | Recruiting |
Enrollment | 100 |
Est. completion date | August 28, 2026 |
Est. primary completion date | September 1, 2025 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 11 Years to 35 Years |
Eligibility | Inclusion Criteria: - Between 11 to 35 years - Concussion diagnosed by a clinical 1 to 6 months ago - Best-corrected visual acuity of 20/25 in both eyes at distance and near - willing to wear glasses or contact to correct refractive error if needed - Global stereopsis of 500 sec of arc or better and 70 sec of arc of better using Randot Stereo Test - Diagnosis of convergence insufficiency from an optometrist defined as near point of convergence of greater than or equal to 6 cm, positive fusional vergence at 40 cm not meeting Sheard's criteria of at least twice the near phoria or a range of less than or equal to 15 prism diopters, and a convergence insufficiency symptom survey score of 21 or greater for adults or 16 or greater for children. Exclusion Criteria: - History of performing office or home-based vision therapy, orthoptics, home-based near target push-ups, or pencil push ups - Amblyopia (lazy eye) or constant strabismus or strabismus surgery - Any conditions or diseases that affect accommodation, vergence or ocular motility, such as Multiple Sclerosis, Graves' thyroid disease, Myastheria Gravis, Diabetes, Chemotherapy, or Parkinson's Disease - Non-removable metal in the body - Pregnant, planning on becoming pregnant during the study duration, or breastfeeding - Metal worker |
Country | Name | City | State |
---|---|---|---|
United States | NJIT | Newark | New Jersey |
United States | The Children's Hospital of Philadelphia | Philadelphia | Pennsylvania |
Lead Sponsor | Collaborator |
---|---|
New Jersey Institute of Technology | Children's Hospital of Philadelphia, National Eye Institute (NEI), Rutgers University, Salus University |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Near Point of Convergence with Positive Fusional Vergence | Composite score of how close a participant can view a target a single along midline combined with positive fusional vergence range. | after 12 therapy session spanning 6 weeks | |
Secondary | Vergence Peak Velocity | The maximum speed of a person looking from far to near along midline | after 12 therapy session spanning 6 weeks | |
Secondary | Functional Activity within vergence neural circuit | The amount of blood oxygenation level dependent signal from vergence neural circuit | after 12 therapy session spanning 6 weeks |
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