Author(s): FREITAG, C., BEHRENS, M., AL-NOSAIRY, K., STOLLE, F., PRABHAKARAN, G., THIEME, H., HOFFMANN, M., SCHEGA, L., Institution: OTTO VON GUERICKE UNIVERSITÄT MAGDEBURG, Country: GERMANY, Abstract-ID: 838

INTRODUCTION:
Open-angle glaucoma (OAG) causes peripheral visual field loss and might alter saccadic eye movements. Moreover, a strong morpho-functional interconnection between the eye and the brain in OAG suggests shared neurodegenerative pathways and diminished cognitive function, similar to those observed in Alzheimer’s disease. Since glaucomatous visual field defects and impaired cognitive performance might promote the risk of falls, strengthening skeletal muscles with resistance training represents a potential countermeasure. The effect might be enhanced using motor-cognitive training addressing visual, motor, and cognitive mechanisms. Targeting executive functions, such training may increase the efficiency of visual search strategies. Notably, studies on motor-cognitive training have demonstrated increased functional connectivity between the visual cortex and premotor regions, including the frontal eye fields, which play a key role in motion planning and sensorimotor integration. The present study investigated the effects of a 12-week resistance training (unimodal, UM) and resistance plus motor-cognitive training (multimodal, MM) on gaze behavior in OAG patients during visuo-cognitive-motor tasks involving changes in movement direction.
METHODS:
Nineteen OAG patients performed either UM (N=9, 69.8±4.9years) or MM (N=10, 71.5±6.7years) twice weekly (60min) for 12 weeks. Before and after the interventions, participants performed two visuo-cognitive-motor tasks with a change of movement direction:(i) the “Speed-Court-Test” (SCT), requiring stepping on sensors which were displayed on two screen sizes (165”, 55”), (ii) the “Trail-Walking-Test” (TWT) requiring walking to 16 cones labeled with numbers (1-8) or letters (A-G) in an alternately ascending order. During these tasks, the time needed for completing each task was measured and gaze behavior was recorded via eye tracking (e.g. saccade duration, fixation duration).
RESULTS:
Due to drop out/processing issues, 15 participants (UM=8, MM=7) were included in the final analyses. Independent of UM or MM and based on the effect sizes, both interventions decreased saccade frequency (p=0.085, η_p^2=0.246) during the SCT. Furthermore, both interventions decreased task completion time (p=0.018, η_p^2=0.358) and increased saccade frequency (p=0.068, η_p^2=0.271) during the TWT.
CONCLUSION:
Both interventions improved the performance during the cognitively demanding TWT, which might indicate an improved physical and/or cognitive performance. Furthermore, it seems that both UM and MM changed saccade frequency, indicating an optimized task-dependent visual search strategy. These results could help to understand the impact of therapeutic training approaches on movement and gaze behavior in glaucoma patients.
Trial Registration: German Clinical Trial Register ID: DRKS00022519