Blink Rate Behavioral Pattern Changes in Patients Affected by Acute Stroke: A Cross-Sectional Study

Spontaneous eye blinking is a synchronous, bilateral, short-term closure of the eyelids and can be quantified in terms of blink rate, the number of blinks per minute. A number of studies in healthy subjects have demonstrated that blink rate changes according to behavioral tasks (e.g. reading, writing, speaking). Blink rate and its task-induced modulation therefore represent a simple and reliable biomarker of the activity of several brain areas and/or connections. Stroke is a major worldwide source of disability: the high risk of death as well as long-term disability lead to a significant physical, psychological and financial burden for patients as well as for caregivers. The aim of this pilot cross-sectional study was to investigate the possible modulation of blink rate in patients affected by acute cerebrovascular events. We enrolled 20 consecutive patients with acute stroke (mean age±standard deviation:66.5±10.4; males:14) and 15 sex- and age-matched (mean age±standard deviation: 64.3±10.4; males:9) healthy subjects as controls. We measured the blink rate during 4 different conditions. Our findings showed that blink rate at rest was significantly higher in patients with stroke (examined within 24 hours after the ischemic event) than in healthy controls. Also, in both groups blink rate was significantly lower during writing and reading in comparison with blink rate at rest. Our findings showed that different behavioral patterns of spontaneous blinking are abnormal in the early phase of post-stroke course. In further studies we would try to use spontaneous blinking as a predictor of the residual functionality in patients with acute stroke.

Keywords: Stroke; Blink rate; Reading; Writing; Speaking

Abbreviations: NIHSS: NIH Stroke Scale/Score; MoCA: Montreal Cognitive Assessment