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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| multisensory training | Experimental | At the completion of this initial intervention (12 research sessions + clinical visits at the time of the first and last session), participants will receive a second kinetic visual field test and a 30-2 visual field test to measure any changes according to the clinical standard. Two additional follow-up procedures are scheduled for participants identified as showing visual recovery after the initial intervention. Three months after completing the initial treatment, participants will have an additional research visit. If testing during this visit reveals that vision has degraded from the initial series, participants will be scheduled for 2-5 additional research visits (with testing and training) to reinstate recovery with re-intervention. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Multisensory Rehabilitation | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in National Institutes of Health Stroke Scale (NIHSS) score | 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). | Month 6 |
| Change in Activity Inventory scores | 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. | Month 6 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Kimberly Hawley, RN | Contact | 3367164031 | Kimberly.Hawley@Advocatehealth.org | |
| Wendy Jenkins, BSNRN, CCRC | Contact | 336.716.3842 | Wendy.Jenkins@AdvocateHealth.org |
| Name | Affiliation | Role |
|---|---|---|
| Benjamin Rowland, PhD | Wake Forest University Health Sciences | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Wake Forest University Health Sciences | Winston-Salem | North Carolina | 27157 | United States |
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| ID | Term |
|---|---|
| D019575 | Blindness, Cortical |
| D006423 | Hemianopsia |
| D001766 | Blindness |
| ID | Term |
|---|---|
| D014786 | Vision Disorders |
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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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.
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| D005128 |
| Eye Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |