Cortical Blindness
Conditions
Keywords
hemianopia, blindness, multisensory training
Brief summary
Damage to visual cortex on one side of the brain frequently produces a profound and permanent blindness in contralesional space (hemianopia), a debilitating condition that causes enormous suffering for patients and their families.
Detailed description
The over-arching objective of the current proposal is to evaluate the functional recovery of vision in hemianopic (blindness in one hemifield) and quadrantanopic (blindness in one quadrant) patients engaged with a multisensory training paradigm. This will pave the way for clinical trials in which this simple, non-invasive training paradigm can be developed for therapeutic use to treat blindness resulting from cortical damage.
Interventions
BEHAVIORALMultisensory Rehabilitation
12 research sessions + clinical visits at the time of the first and last session - In each session, there will be a "training phase" in which subjects will be exposed (and respond) to spatiotemporally congruent pairs of visual-auditory stimuli presented within their blinded field, with occasional probes of unisensory visual stimuli on both sides of space. There will also be a "testing" phase during which they are presented with visual stimuli in virtual reality (VR) to assess multiple aspects of visual function. This "visual battery" consists of innocuous stimuli, e.g., flashes of light or moving bars, presented at intensities consistent with those experienced during daily life. Subjects detect or discriminate the stimuli (e.g., judge whether a stimulus was flashed, or which stimulus is brighter) and report confidence in assessments.
Sponsors
Wake Forest University Health Sciences
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
A group of 30 hemianopic or quadrantanopic participants - Subjects will participate in weekly research sessions (\ 2 hours.) for the next three months. This purposely extends beyond the window of expected recovery.
Eligibility
Sex/Gender
ALL
Age
18 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
* Patients will be recruited from the local subject population hospitalized/seen by Ophthalmology, Neurosurgery, and Neurology at Atrium Health Wake Forest Baptist * diagnosis of stable homonymous hemianopia (\>4 weeks) with absence of hemineglect * a lesion encompassing at least primary visual cortex but sparing parietal cortex, to include lesions caused by an ischemic or hemorrhagic stroke or post-surgical changes due to an oncologic or non-oncologic tumor * normal or correctable auditory and cognitive function * willingness to participate in the three-month program * ability to perform visual discriminations in their intact field * life expectancy ≥12 months
Exclusion criteria
* diagnosis of an unstable homonymous hemianopia and/or with hemineglect, * Abnormal or uncorrectable auditory and cognitive function * unwillingness to participate in the program * inability to perform the visual testing in their intact field * life expectancy \< 12 months * Any other condition that would compromise their ability to complete the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in National Institutes of Health Stroke Scale (NIHSS) score | Month 6 | The National Institutes of Health Stroke Scale (NIHSS) is a standardized, 15-item physical and mental examination used by healthcare providers to objectively quantify the severity of an acute stroke. Scores range from 0 (no neurological deficit) to 42 (severe impairment). |
| Change in Activity Inventory scores | Month 6 | A questionnaire that asks how vision affects everyday activities. It helps show which daily tasks are most important to the participant and how difficult those tasks may be because of vision problems. Patients rate the importance of a goal and the difficulty of tasks, resulting in an individually tailored dataset. This adaptive approach provides a comprehensive profile of how visual limitations affect everyday life. |
Countries
United States
Contacts
CONTACTKimberly Hawley, RN
CONTACTWendy Jenkins, BSNRN, CCRC
PRINCIPAL_INVESTIGATORBenjamin Rowland, PhD
Wake Forest University Health Sciences
Outcome results
None listed