9 Clinical Trials for Various Conditions
This project aims to develop a novel visual training paradigm for use in visually-intact participants and those sufferings from stroke-induced visual impairments. Our task design is built upon theories of statistical learning to reduce the overall training burden while still producing profound improvements to visual abilities. Efficacy will be first established in visually-intact controls before testing in stroke survivors to assess the feasibility of this form of learning in the damaged visual system.
This project is intended to collect data using standard clinical tests and psychophysics to quantify the effect of visual cortical damage on the structure of the residual visual system, visual perception, spatial awareness, and brain function. The investigators will also assess the effect of intensive visual retraining on the residual visual system, processing of visual information and the use of such information in real-world situations following damage. This research is intended to improve our understanding of the consequences of permanent visual system damage in humans, of methods that can be used to reverse visual loss, and of brain mechanisms by which visual recovery is achieved.
This study seeks to determine the extent of the visual capabilities that can be restored in hemianopic stroke patients by a multisensory training technique and evaluate changes in the brain that the training induces. The effectiveness of the technique will be evaluated in two interventional contexts: patients whose blindness is long-standing and stable, and another in which intervention is as soon as possible after the stroke.
This is a randomized, pilot interventional study in participants with visual field deficit (VFD) caused by cortical lesion. Damage to the primary visual cortex (V1) causes a contra-lesional, homonymous loss of conscious vision termed hemianopsia, the loss of one half of the visual field. The goal of this project is to elaborate and refine a rehabilitation protocol for VFD participants. It is hypothesized that visual restoration training using moving stimuli coupled with noninvasive current stimulation on the visual cortex will promote and speed up recovery of visual abilities within the blind field in VFD participants. Moreover, it is expected that visual recovery positively correlates with reduction of the blind field, as measured with traditional visual perimetry: the Humphrey visual field test or an eye-tracker based visual perimetry implemented in a virtual reality (VR) headset. Finally, although results will vary among participants depending on the extent and severity of the cortical lesion, it is expected that a bigger increase in neural response to moving stimuli in the blind visual field in cortical motion area, for those participants who will show the largest behavioral improvement after training. The overarching goals for the study are as follows: Group 1a will test the basic effects of transcranial random noise stimulation (tRNS) coupled with visual training in stroke cohorts, including (i) both chronic/subacute ischemic and chronic hemorrhagic VFD stroke participants, and (ii) longitudinal testing up to 6 months post-treatment. Group 1b will test the effects of transcranial tRNS coupled with visual training on a Virtual Reality (VR) device in stroke cohorts, including both chronic/subacute ischemic and chronic hemorrhagic VFD stroke participants. Group 2 will examine the effects of tRNS alone, without visual training, also including chronic and subacute VFD stroke participants and longitudinal testing.
The purpose of this study is to provide data that would give the investigators a better understanding of the physiologic changes that occur and may contribute to post operative blindness. An improved understanding may lead to the development of protocols or devices that reduce the chance of catastrophic visual loss.
This is an early feasibility study of a new device, the Orion Visual Cortical Prosthesis System. The device is intended to stimulate the surface of the visual cortex to induce visual perception in blind individuals.
The study's objective is to measure changes in human visual cortex organization that may arise as a result of injury to the visual pathways. Subjects with retinal or cortical injury will be studied and compared to appropriate controls. Functional magnetic resonance imaging methods are used to monitor cortical topography in time. The main aims of the study are to determine: 1) what are the patterns of cortical reorganization that are seen spontaneously after injury, and 2) whether rehabilitative training can promote adaptive reorganization enhancing recovery.
This study will examine whether blind people develop changes in the brain that improve memory function. Previous studies have shown that blind people, on average, perform better in memory tasks than sighted people. A possible reason for this is that parts of the brain that process visual information in sighted individuals are engaged in processing mnemonic (remembering) information in blind people. Blind and sighted people 18 years of age and older are eligible for this study. Healthy, sighted individuals may participate in Part 1 of the study, which is designed to find appropriate words to use in tests for Part 2 of the study. Part 2 will include sighted people and blind people. It will examine whether the (visual) brain in blind people is processing mnemonic information in a way that helps with day-to-day memory functions. Blind participants in this study must have lost their sight by age 4. Candidates will be screened with a medical interview and examination and a brief test of short-term and long-term verbal memory. Sighted patients will also be tested for visual memory and for handedness. Part 1 - Word Recognition Testing (2 sessions) * Session 1: Participants listen to a number of words over a loudspeaker and try to remember them for a memory test that will be given 30 minutes later. For the test, subjects listen to words again and press one of three buttons as quickly as possible after hearing the word. The buttons signal whether the subject does or does not recognize the word with a 1) high level of confidence or 2) low level of confidence. * Session 2: Participants hear a noun over a loudspeaker and have to find an appropriate verb for it, such as the verb (read) for the noun (book). Part 2 - MRI Scanning and TMS Experiments (5 - 7 sessions) * Magnetic resonance imaging (MRI): Participants perform the same procedures as described above for Part 1 while undergoing MRI of the brain. For this test, the subject lies on a table inside the MRI scanner - a narrow cylindrical tube with a strong magnetic field. Scanning time varies from 20 minutes to 3 hours, with most scans lasting between 45 and 90 minutes. (Earphones are used to hear the words for this test instead of a loudspeaker.) * Transcranial magnetic stimulation (TMS): Participants undergo TMS while performing the same procedures described for Part 1. For TMS, a wire coil is held over the scalp. A brief electrical current is passed through the coil, creating a magnetic pulse that stimulates the brain. Subjects may hear a click and feel a pulling sensation on the skin under the coil. There may be a twitch in muscles of the arm or leg. During the TMS, electrical muscle activity is recorded through the electrodes with a computer or other recording device. Each session lasts a maximum of 3 hours.
The current proposal is to generate "proof of concept" evidence that hemianopia can be successfully rehabilitated in humans when this multisensory rehabilitation paradigm is used.