Journal of Modern Rehabilitation

Challenges in Refractive Correction in Duane Retraction Syndrome

Masoud Khorrami-Nejad — 2026-04-29

Duane Retraction Syndrome (DRS) is a congenital cranial dysinnervation disorder characterized by limitation of horizontal ocular movements, globe retraction, and narrowing of the palpebral fissure on attempted adduction. Although surgical alignment has traditionally been emphasized in the management of DRS, refractive abnormalities and amblyopia represent critical determinants of long‑term visual outcome that are often underrecognized. Large clinical series demonstrate that unilateral involvement predominates, with type I being the most common subtype, and consistent female and left‑eye preponderance. Across studies, refractive errors are frequently encountered, with hyperopia and hyperopic astigmatism most commonly reported, although myopia, astigmatism, and anisometropia are also prevalent. Amblyopia affects approximately one‑fifth of patients overall and occurs more frequently in bilateral disease. Both strabismic and anisometropic mechanisms contribute, reflecting the combined impact of ocular misalignment, suppression, and unequal refractive input during critical periods of visual development. Accurate refractive assessment in DRS poses unique clinical challenges. Abnormal head posture, ocular motility limitation, co‑contraction of horizontal recti, and fixation instability—particularly in children with amblyopia—may compromise the reliability of subjective refraction. Subtle interocular differences in unilateral cases can be amblyogenic and require careful detection. Careful refraction, with meticulous attention to head position and fixation stability, is therefore essential. Early identification and timely optical correction are fundamental to preventing avoidable visual impairment. Refractive management should be regarded as a cornerstone of comprehensive DRS care, complementing surgical and orthoptic strategies to optimize visual development and functional outcomes.

Non-surgical Management of Abnormal Head Posture in Duane Retraction Syndrome

Milad Naseri — 2026-04-28

Duane retraction syndrome (DRS) is a congenital ocular motility disorder characterized by dysinnervation of the lateral rectus muscle, globe retraction and palpebral fissure narrowing on adduction, and limitation of horizontal eye movements. Many affected children adopt an abnormal head posture (AHP) to maintain binocular single vision and avoid diplopia. When such postures appear early in life and persist through the years of rapid craniofacial growth, they may predispose to facial asymmetry and musculoskeletal imbalance. Surgical correction can improve alignment and reduce AHP in selected cases but is often deferred in very young children or when primary position deviation is small. This short communication summarizes the patterns of AHP in the main clinical types of DRS, reviews key elements of non-surgical management—including amblyopia therapy, optical correction, simple positioning strategies, and the use of the patch test—and highlights the importance of early intervention to prevent permanent craniofacial changes.

Pathophysiology and Inflammatory Pathway in Vestibular Neuritis

Mohammad Akbar Fayaz — 2026-04-28

Introduction: Vestibular neuritis (VN) causes acute vertigo from sudden unilateral vestibular dysfunction, mainly in adults aged 30–60. Previous reviews have focused on clinical and therapeutic aspects, but the inflammatory and immune mechanisms are less well understood. This review summarizes recent evidence on viral, immune, and vascular pathways in VN.
Method: A narrative review was conducted using PubMed, Scopus, and Web of Science databases. Forty articles published between 2001 and 2025 were included, focusing on pathophysiology, immune pathways, and therapeutic approaches implications.
Results: VN is primarily caused by HSV-1 reactivation, leading to vestibular nerve inflammation. Other viruses, such as SARS-CoV-2 and Epstein–Barr, are also involved. Immune dysregulation, characterized by alterations in leukocytes and cytokines, drives neuroinflammation. Vascular issues, especially blood-labyrinth barrier disruption, worsen swelling. Corticosteroids reduce inflammation; vestibular rehab aids recovery. Combining treatments improves early outcomes.
Conclusion: VN is a complex disorder caused by viral reactivation, immune inflammation, and vascular issues. Recovery primarily depends on central compensation, rather than peripheral nerve regeneration. Combining anti-inflammatory treatment with early rehab yields the best results. Future research should investigate the molecular connections between viral infection, immune response, and vestibular damage to develop targeted therapies.

The Impact of Breastfeeding on Auditory, Speech, and Language Development: A Narrative Review

Nasrin Gohari — 2026-04-27

Introduction: The type of feeding has different effects, and the effects of breastfeeding on the auditory system, speech and language has also been confirmed. The aim of this study is to provide a comprehensive review of various studies conducted on the effects of different feeding types on the auditory system, speech and language.
Materials and Methods: A narrative review was conducted using PubMed, Scopus, Medline, Web of Science, Google Scholar, ScienceDirect, and the Cochrane Library to identify English-language studies on the effects of feeding type on auditory, speech, and language development. A total of 57 studies published between 1981 and 2025 were identified and selected based on predefined inclusion criteria, and the findings were synthesized to evaluate developmental outcomes.
Results: Breastfeeding has different effects on various aspects of hearing, speech, language, and cognition in children compared to formula feeding. Breastfeeding, as a protective factor against middle ear. Breastfeeding is associated with better speech and language development, including verbal intelligence, better receptive and expressive language, improved language skills, and the natural development of oral-motor skills necessary for speech production.
Conclusion: As the optimal source of nutrition for infants, breast milk not only meets physical and motor needs but also contributes to optimal functioning of the peripheral and central auditory systems. It plays a significant role in enhancing communication skills, speech and language development, and related abilities.This review is limited by its narrative design and the heterogeneity of existing studies; future research should employ standardized, longitudinal methodologies to clarify causal mechanisms.

Event-Related Potentials in Verbal Episodic Memory in Mild Cognitive Impairment: A Scoping Review

Hamidreza Farmani — 2026-02-24

Introduction: Mild Cognitive Impairment (MCI) is considered a transitional stage between normal cognitive aging and Alzheimer’s disease. Given the challenges in accurately distinguishing MCI from the healthy elderly (HE), researchers have increasingly turned to event-related potentials (ERPs) to identify early neural changes, particularly in verbal and episodic memory processing.
Methods: This review synthesizes ERP studies from 2000 to 2025 that utilized verbal episodic memory paradigms to differentiate between MCI and HE. The databases PsycINFO and PubMed were searched for peer-reviewed articles. The reporting of this review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist.
Results: In these studies, core aspects of verbal processing—including semantic congruity and recognition—combined with episodic memory manipulation have consistently reported alterations in ERP components such as the N400, FN400, and Late Positive Component (LPC) in MCI. Reduced or delayed N400 and LPC responses, as well as altered scalp distributions, have been shown to be sensitive to verbal memory deficits in MCI, often preceding behavioral impairments. Moreover, ERP paradigms integrating semantic and episodic memory have shown that the interaction between memory systems further enhances diagnostic precision.
Conclusion: The reviewed literature highlights that verbal ERP paradigms are not only effective in differentiating MCI from HE but also capture subtle neurophysiological changes that might be overlooked by behavioral measures alone. These results underscore the potential of ERPs as non-invasive, cost-effective biomarkers for early cognitive impairment.