Improving Visual Field Deficits With Noninvasive Brain Stimulation
Visual Field Defect, Peripheral, Stroke, Visual Impairment
About this trial
This is an interventional treatment trial for Visual Field Defect, Peripheral focused on measuring Visual Field defects, Occipital Stroke, Ischemic Stroke, visual cortex, noninvasive brain stimulation, transcranial direct current stimulation, visual training, visual recovery, vision loss, quadrantanopia
Eligibility Criteria
Inclusion Criteria:
- 18 years of age or older,
- Presence of some intact visual cortical areas (other than primary visual cortex) in the damaged brain hemisphere. This assessment will be made from MRI or CT scans of the subject's head, which will be obtained via standard release from their neurologist.
- First ever ischemic stroke with damage to primary visual cortex, and rendered blind over a portion of their visual field.
- Must demonstrate a clear deficit in either simple or complex visual perception in portions of their visual field as measured by visual perimetry.
- Willing and able to participate in the study protocol and to comply with study procedures
Exclusion Criteria:
- No evidence of damage to the primary visual cortex
- Radiologic evidence that the stroke was hemorrhagic or non-vascular in nature
- Visual cortex damage a result of a subsequent stroke (not primary)
- Total cortical blindness, covering both left and right visual fields
- Unable to fixate visual targets precisely or unable to perform the visual training exercises as directed.
- Complete loss of reading abilities
- Current or prior history of any neurological disorder other than stroke, such as epilepsy, a progressive neurologic disease (e.g. multiple sclerosis) or intracranial brain lesions other than the qualifying stroke lesion
- Current history of poorly controlled migraines including chronic medication for migraine prevention
- History of seizures, diagnosis of epilepsy, history of abnormal (epileptiform) EEG or immediate (1st degree relative) family history of epilepsy; with the exception of a single seizure of benign etiology (e.g. febrile seizure) in the judgment of the investigator
- History of fainting spells of unknown or undetermined etiology that might constitute seizures
- Past or current history of major depression, bipolar disorder or psychotic disorders, or any other major psychiatric condition
- Participants who are suffering from one-sided attentional neglect as determined by standard neuropsychological tests: figure cancellation and line bisection tasks.
- Contraindication for receiving tRNS
- Chronic (particularly) uncontrolled medical conditions that may cause a medical emergency in case of a provoked seizure (cardiac malformation, cardiac dysrhythmia, asthma, etc.)
- Any complex, uncontrolled/unstable or terminal medical illness
- Substance abuse or dependence within the past six months.
- Medications will be reviewed by the responsible MD and a decision about inclusion will be made based on the following: The patient's past medical history, drug dose, history of recent medication changes or duration of treatment, and combination of CNS (central nervous system) active drugs.
- All female participants that are pre-menopausal will be required to have a pregnancy test; any participant who is pregnant or breastfeeding will not be enrolled in the study.
- Subjects who, in the investigator's opinion, might not be suitable for the study
- A hair style or head dress that prevents electrode contact with the scalp or would interfere with the stimulation (for example: thick braids, hair weave, afro, wig)
Sites / Locations
- Beth Israel Deaconess Medical CenterRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Sham Comparator
Visual Training with Noninvasive Brain Stimulation
Visual Training with Sham Stimulation
Noninvasive Brain Stimulation without visual training
Sham Stimulation without visual training
10 daily (Monday-Friday) 20-30 minute sessions of tRNS with visual training on the computer
10 daily (Monday-Friday) 20-30 minute sessions of sham stimulation with visual training on the computer
10 daily (Monday-Friday) 20-30 minute sessions of tRNS alone
Placebo control. Simulation of tRNS without receiving any actual stimulation