| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Institute of Medical Psychology (Drs. Poggel, Kasten, and Sabel), Otto von Guericke University of Magdeburg, Germany; and Center for Innovative Visual Rehabilitation (Dr. Poggel), Boston VA Medical Center, MA.
Address correspondence and reprint requests to Dr. B.A. Sabel, Institute of Medical Psychology, Otto von Guericke University of Magdeburg, Leipziger Str. 44, 39120 Magdeburg, Germany; e-mail: bernhard.sabel{at}medizin.uni-magdeburg.de
Background: In patients with postgenicular lesions of the visual system, areas of residual vision (ARVs) are the main predictor of recovery induced by vision restoration therapy (VRT). In these partially defective regions, the elevated perceptual thresholds can be acutely reduced by attentional cueing.
Objective: To examine whether directing attention to ARVs using a visuospatial cue also increases long-term neural plasticity and thus enhances permanent training outcome.
Methods: In a prospective, randomized clinical trial, treatment outcome was compared in patients with postgenicular visual system lesions who received either standard VRT (control group [CG]; n = 10) or VRT with attentional cueing (experimental group [EG]; n = 9). Visual field size was determined before and after a 6-month treatment period using Tübingen Automated Perimetry and computer-based high-resolution perimetry (HRP) and in regular intervals throughout this period by HRP and detection performance in VRT.
Results: In the area of the cue, restoration of vision was significantly greater than during VRT without cueing: cued patients showed a much more pronounced shift of the visual field border toward the blind area than that observed in the CG or in uncued regions of the EG. Focusing attention at ARVs during treatment changed topographic and temporal patterns of recovery as compared with uncued regions of the visual field.
Conclusions: Use of a visuospatial cue to focus attention at areas of residual vision amplifies long-term neuronal plasticity. The authors propose that top-down signals preactivate partially damaged areas of V1, thus linking visual and attentional neuronal networks, with the effect of permanently increasing conscious visual perception.
Received March 30, 2004. Accepted in final form August 10, 2004.
B.A. Sabel and E. Kasten are inventors. B.A. Sabel is a consultant and shareholder of NovaVision, Inc., and has equity in excess of $10,000.
This article has been cited by other articles:
|
|
 |
|
  F. Rowe, D. Brand, C. A. Jackson, A. Price, L. Walker, S. Harrison, C. Eccleston, C. Scott, N. Akerman, C. Dodridge, et al. Visual impairment following stroke: do stroke patients require vision assessment? Age Ageing, March 1, 2009; 38(2): 188 - 193. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Brodtmann, A. Puce, D. Darby, and G. Donnan Serial Functional Imaging Poststroke Reveals Visual Cortex Reorganization Neurorehabil Neural Repair, February 1, 2009; 23(2): 150 - 159. [Abstract] [PDF]
|
|
|
|
 |
|
 A Raninen, S Vanni, L Hyvarinen, and R Nasanen Temporal sensitivity in a hemianopic visual field can be improved by long-term training using flicker stimulation J. Neurol. Neurosurg. Psychiatry, January 1, 2007; 78(1): 66 - 73. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. Jones and R. A. Shinton Improving outcome in stroke patients with visual problems Age Ageing, November 1, 2006; 35(6): 560 - 565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A Sabel Vision restoration therapy and raising red flags too early Br J Ophthalmol, May 1, 2006; 90(5): 659 - 660. [Full Text] [PDF]
|
|
|
|
|
|
B A Sabel, S Kenkel, and E Kasten Vision restoration therapy Br J Ophthalmol, May 1, 2005; 89(5): 522 - 524. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
