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Media type:
E-Article
Title:
Non-invasive electrical brain stimulation for vision restoration after stroke: An exploratory randomized trial (REVIS)
Contributor:
Räty, Silja;
Borrmann, Carolin;
Granata, Giuseppe;
Cárdenas-Morales, Lizbeth;
Schoenfeld, Ariel;
Sailer, Michael;
Silvennoinen, Katri;
Holopainen, Juha;
De Rossi, Francesca;
Antal, Andrea;
Rossini, Paolo M.;
Tatlisumak, Turgut;
Sabel, Bernhard A.
imprint:
IOS Press, 2021
Published in:Restorative Neurology and Neuroscience
Language:
Not determined
DOI:
10.3233/rnn-211198
ISSN:
1878-3627;
0922-6028
Origination:
Footnote:
Description:
<jats:p>Background: Occipital strokes often cause permanent homonymous hemianopia leading to significant disability. In previous studies, non-invasive electrical brain stimulation (NIBS) has improved vision after optic nerve damage and in combination with training after stroke. Objective: We explored different NIBS modalities for rehabilitation of hemianopia after chronic stroke. Methods: In a randomized, double-blinded, sham-controlled, three-armed trial, altogether 56 patients with homonymous hemianopia were recruited. The three experiments were: i) repetitive transorbital alternating current stimulation (rtACS, n = 8) vs. rtACS with prior cathodal transcranial direct current stimulation over the intact visual cortex (tDCS/rtACS, n = 8) vs. sham (n = 8); ii) rtACS (n = 9) vs. sham (n = 9); and iii) tDCS of the visual cortex (n = 7) vs. sham (n = 7). Visual functions were evaluated before and after the intervention, and after eight weeks follow-up. The primary outcome was change in visual field assessed by high-resolution and standard perimetries. The individual modalities were compared within each experimental arm. Results: Primary outcomes in Experiments 1 and 2 were negative. Only significant between-group change was observed in Experiment 3, where tDCS increased visual field of the contralesional eye compared to sham. tDCS/rtACS improved dynamic vision, reading, and visual field of the contralesional eye, but was not superior to other groups. rtACS alone increased foveal sensitivity, but was otherwise ineffective. All trial-related procedures were tolerated well. Conclusions: This exploratory trial showed safety but no main effect of NIBS on vision restoration after stroke. However, tDCS and combined tDCS/rtACS induced improvements in visually guided performance that need to be confirmed in larger-sample trials. NCT01418820 (clinicaltrials.gov)</jats:p>