Placebo effect after visual restitution training: no eye-tracking controlled perimetric improvement after visual border stimulation in late subacute and chronic visual field defects after stroke

Frontiers in Neurology

Neurology

Florian Hutzler¹  Stefan Hawelka¹  Herbert Reitsamer²  Anja-Maria Ladek²  Michael Christian Leitner³ 

[1] Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria;Department of Psychology, University of Salzburg, Salzburg, Austria;Research Program for Experimental Ophthalmology and Glaucoma Research, Department of Ophthalmology and Optometry, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria;Department of Ophthalmology and Optometry, SALK, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria;Salzburg University of Applied Sciences, Salzburg, Austria;Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria;Department of Psychology, University of Salzburg, Salzburg, Austria;

关键词: stroke;    visual field;    rehabilitation;    eye tracking;    virtual reality;    restitution training;    neuroplasticity;    visual cortex;   

DOI  :  10.3389/fneur.2023.1114718

 received in 2022-12-02, accepted in 2023-06-13,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionA significant number of Restitution Training (RT) paradigms claim to ameliorate visual field loss after stroke by re-activating neuronal connections in the residual visual cortex due to repeated bright light-stimulation at the border of the blind and intact fields. However, the effectiveness of RT has been considered controversial both in science and clinical practice for years. The main points of the controversy are (1) the reliability of perimetric results which may be affected by compensatory eye movements and (2) heterogeneous samples consisting of patients with visual field defects and/or visuospatial neglect.MethodsBy means of our newly developed and validated Virtual Reality goggles Salzburg Visual Field Trainer (SVFT) 16 stroke patients performed RT on a regular basis for 5  months. By means of our newly developed and validated Eye Tracking Based Visual Field Analysis (EFA), we conducted a first-time full eye-movement-controlled perimetric pre-post intervention study. Additionally, patients subjectively rated the size of their intact visual field.ResultsAnalysis showed that patients’ mean self-assessment of their subjective visual field size indicated statistically significant improvement while, in contrast, objective eye tracking controlled perimetric results revealed no statistically significant effect.DiscussionBright-light detection RT at the blind-field border solely induced a placebo effect and did not lead to training-induced neuroplasticity in the visual cortex of the type needed to ameliorate the visual field size of stroke patients.

【 授权许可】

Unknown   
Copyright © 2023 Leitner, Ladek, Hutzler, Reitsamer and Hawelka.