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Optokinetic Responses, and Center of Pressures following Neurological Rehabilitation for a 13-year-old male with Attention-Deficit/ Hyperactivity Disorder (ADHD).

Matthew M. Antonucci1, 2, 3*, Frederick R. Carrick1, 4, 5, 6, Emily Kalambaheti2, 3, Mia Cozart3, 7 and Derek A. Barton1, 2, 3
  • 1 Carrick Institute, United States
  • 2 Plasticity Brain Centers, United States
  • 3 Accelerate Multidisciplinary Neuroscience Research Center, College of Medicine, University of Central Florida, United States
  • 4 Bedfordshire Centre for Mental Health Research, University of Cambridge, United Kingdom
  • 5 MGH Institute of Health Professions, United States
  • 6 University of Central Florida College of Medicine, United States
  • 7 University of Central Florida, United States

Background: Optokinetic responses are visual orientation reflexes that are well-documented for their inter-subject consistency. Boot et al in 2009 also identified intra-individual repeatability of oculomotor function, and 8 years later, Panagiotidi et al (2017) found positive associations between Attention Deficit Hyperactivity Disorder (ADHD) and oculomotor variability from controls. Janesn et al (2018) also identified that adults with ADHD also have postural deficits. This report presents a case of a 13-year-old male patient that presented to Plasticity Brain Centers for evaluation and treatment for (ADHD). Findings: Upon examination, both deviant oculomotor function and postural stability were identified. The patient's mother had noted his difficulties in school and had a hard time concentrating. A Comprehensive Assessment of Postural Systems (CAPS®) (Pagnacco 2014) was performed assessing balance and stability, on a solid and foamed surface, with eyes opened and closed. On a solid surface, the patient’s average center of pressure (CoP) was recorded at 1.51 inches posterior. Upon intake, the optokinetic reflex (OKR) was measured recording vertical and horizontal responses and is displayed in figure 1 and 2. Unremarkable responses were omitted from this abstract. Methods: A 5-day, multi-modal program of neurological exercises was administered in 10 one-hour treatment sessions similar to the work published by Antonucci (2016) and Carrick et al (2017). Each session consisted of repetitive peripheral somatosensory stimuli, neuromuscular reeducation exercises, vestibular rehabilitation exercises, orthoptic exercises, and off-vertical axis rotation utilizing a multi-axis rotational chair (MARC, ReNeuro Robotics, Dallas, TX, USA).   Outcome: Upon exit, the exam findings demonstrated a center of pressure on a solid surface 0.07 inches posterior (Change of -95.36%). Optokinetic reflex showed improvements in the vertical and horizontal planes and is displayed in figures 3 and 4. Conclusion: This report demonstrates deviant oculomotor and postural findings in a case of ADHD, and improvement of those findings after a 5-day, multi-modal, intensive neurorehabilitation program. In this case, we have also observed a correlation between improved oculomotor and postural responses with improved focus, calmness, compliance, and sleep.

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Acknowledgements

We would like to thank the administrative and clinical staff of Plasticity Brain Centers for their support of this family during their care.

References

Antonucci MM, Link PE, Barton DA and Carrick FR (2016). Improvement in muscle tone, coordination, balance, ocular-motor function, and communication in a 6-year-old male with developmental delays after 5 days of ReceptorBased treatment. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience: Clinical Neuroscience for Optimization of Human Function. doi: 10.3389/conf.fneur.2016.59.00067 Jansen, I., Philipsen, A., Dalin, D., Wiesmeier, I. K., & Maurer, C. (2018). Postural instability in adult ADHD – a pilot study. Gait & Posture. doi:10.1016/j.gaitpost.2018.10.016 Pagnacco G, Carrick FR, Wright CH, Oggero E. In-situ verification of accuracy, precision and resolution of force and balance platforms. Biomed Sciences instrumentation (2014) 50:171-8  Panagiotidi, M., Overton, P., & Stafford, T. (2017). Increased microsaccade rate in 24 individuals with ADHD traits. Journal of Eye Movement Research, 10(1). 25 https://doi.org/10.16910/10.1.6

Keywords: ADHD (Attention Deficit and Hyperactivity Disorder), Optokinetic (OKN) system, Center of Pressure (COP), Intensive rehabilitation, Optokinetic Response

Conference: International Symposium on Clinical Neuroscience, Orlando, United States, 24 May - 26 May, 2019.

Presentation Type: Poster Presentation

Topic: Clinical Neuroscience

Citation: Antonucci MM, Carrick FR, Kalambaheti E, Cozart M and Barton DA (2019). Optokinetic Responses, and Center of Pressures following Neurological Rehabilitation for a 13-year-old male with Attention-Deficit/ Hyperactivity Disorder (ADHD).. Front. Neurol. Conference Abstract: International Symposium on Clinical Neuroscience. doi: 10.3389/conf.fneur.2019.62.00077

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Received: 18 May 2019; Published Online: 27 Sep 2019.

* Correspondence: Dr. Matthew M Antonucci, Carrick Institute, Cape Canaveral, United States, drnucci@gmail.com