Stroke, Visual Field Defect
Conditions
Keywords
Stroke, Visual Field Defect, Visual perceptual learning, Brain connectivity
Brief summary
This study will test the hypothesis whether visual field defect caused by chronic stroke could be improved by visual perceptual learning. The secondary hypothesis is that improvement of visual field defect would be accompanied by connectivity changes in visual networks. In addition, investigators will evaluate whether improvement of visual field defect could achieve improvement of subjective visual function.
Detailed description
Study design: A PROBE (Prospective, Randomized, Open-label, Blinded-endpoint) design Methods: 1. Visual perceptual learning (VPL) group 1. Visual perceptual learning (24 times for 2 months, 3 times per week) in visual field defect areas 2. At baseline and post-VPL evaluations (2 months after): Structural & Functional MRIs, Visual field tests, Visual evoked potential, Visual cognitive tests, Subjective visual function questionnaires 2. Control group 1. At baseline and 2-months later: No VPL, Structural & Functional MRIs, Visual field tests, Visual evoked potential, Visual cognitive tests, Subjective visual function questionnaires 2. Visual perceptual learning after 2-month follow-up evaluation (24 times for 2 months, 3 times per week) (The patients who were stratified by age (over 65 years old or not) and degree of visual field defect (quadrantanopia or complete hemianopia) will be randomly assigned into the learning and control group.) 3. Investigations 1. Improvement of visual field test scores between VPL group and control group 2. Analysis of brain network changes in MRI data 3. Correlation analysis of improvement of visual field defect and MRI data 4. Correlation analysis of improvement of visual field defect and visual evoked potential (VEP) data 5. Correlation analysis of improvement of visual field defect and neuropsychological data
Interventions
BEHAVIORALVisual perceptual learning
24 times of training for visual perceptual learning
Sponsors
Asan Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
1. The patient has chronic stroke more than 6 months after onset. 2. The patient has visual field defect (Quadrantanopia or Hemianopia). 3. The patient has corrected eyesight 0.7 or above.
Exclusion criteria
1. The patient has contraindication to MRI scan. 2. The patient has cognitive impairment (Mini-Mental Status Exam score \<24). 3. The patient has ophthalmologic diseases (e.g., glaucoma, cataract).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Improvement of visual field scores in visual field defect areas | At 2 months (plus or minus 7 days) after baseline evaluation | Improvement of mean deviation scores in defected areas by Humphrey 750i Field test |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Performance of visual perceptual learning | At 2 months (plus or minus 7 days) after baseline evaulation | Performance (scores) of visual perceptual learning |
| Connectivity changes in MRI | Between baseline and 2 months (plus or minus 7 days) after | 1. Functional connectivity changes in resting-state functional MRI 2. Structural connectivity changes in diffusion tensor imaging |
| Improvement of visual field score in whole visual field area | At 2 months (plus or minus 7days) after baseline evaluation | Improvement of mean deviation scores in whole visual field by Humphrey 750i Field test |
| Change of subjective visual function | At 2 months (plus or minus 7days) after baseline evaluation | 1. Change in Korean version of National Eye institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) 2. Change of subjective visual field area |
| Changes of visual evoked potential | Between baseline and 2 months (plus or minus 7 days) after | Changes between baseline and 2 months after in half-field visual evoked potential (VEP) data |
Countries
South Korea
Outcome results
None listed