Non-invasive electrical brain stimulation for vision restoration after stroke : An exploratory randomized trial (REVIS)

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Räty , S , Borrmann , C , Granata , G , Cardenas-Morales , L , Schoenfeld , A , Sailer , M , Silvennoinen , K , Holopainen , J , De Rossi , F , Antal , A , Rossini , P M , Tatlisumak , T & Sabel , B A 2021 , ' Non-invasive electrical brain stimulation for vision restoration after stroke : An exploratory randomized trial (REVIS) ' , Restorative Neurology and Neuroscience , vol. 39 , no. 3 , pp. 221-235 . https://doi.org/10.3233/RNN-211198

Title: Non-invasive electrical brain stimulation for vision restoration after stroke : An exploratory randomized trial (REVIS)
Author: Räty, Silja; Borrmann, Carolin; Granata, Giuseppe; Cardenas-Morales, Lizbeth; Schoenfeld, Ariel; Sailer, Michael; Silvennoinen, Katri; Holopainen, Juha; De Rossi, Francesca; Antal, Andrea; Rossini, Paolo M.; Tatlisumak, Turgut; Sabel, Bernhard A.
Contributor organization: HUS Neurocenter
Neurologian yksikkö
University of Helsinki
HUS Head and Neck Center
Department of Ophthalmology and Otorhinolaryngology
Silmäklinikka
Date: 2021
Language: eng
Number of pages: 15
Belongs to series: Restorative Neurology and Neuroscience
ISSN: 0922-6028
DOI: https://doi.org/10.3233/RNN-211198
URI: http://hdl.handle.net/10138/334644
Abstract: 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.
Subject: Electrical stimulation
homonymous hemianopia
randomized controlled trial
rehabilitation
occipital stroke
vision restoration
ALTERNATING-CURRENT STIMULATION
VISUAL FUNCTION
HEMIANOPIA
RECOVERY
FIELD
SENSITIVITY
PLASTICITY
3112 Neurosciences
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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