Multisensory Rehabilitation for Hemianopia

Recruiting in Palo Alto (17 mi)

Overseen by Benjamin A Rowland, PhD

Age: 18+

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Wake Forest University Health Sciences

Disqualifiers: Age over 85, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial aims to help people who are blind in one half of their visual field by using training sessions with matching sights and sounds. The goal is to see if this can help their brains re-learn how to process visual information.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Multisensory Rehabilitation Paradigm, Multisensory Training Paradigm, Visual-Auditory Stimulation Therapy for hemianopia?

Research shows that visual-auditory stimulation therapy can help people with hemianopia (blindness on one side) regain their ability to see in their blind field. In studies, patients who received this therapy were able to detect and describe visual stimuli in their previously blind areas, and improvements were seen quickly and lasted over time. ^{1 2 3 4 5}

Is multisensory rehabilitation for hemianopia safe for humans?

The studies on multisensory rehabilitation for hemianopia, including visual-auditory stimulation therapy, have shown no reported safety concerns in human participants. The therapy was tested on patients with hemianopia and showed improvements in visual function without any adverse effects mentioned. ^{1 2 3 5 6}

How is the Multisensory Rehabilitation Paradigm treatment different from other treatments for hemianopia?

The Multisensory Rehabilitation Paradigm is unique because it uses a combination of visual and auditory stimuli to engage the brain's multisensory pathways, which can help restore vision in areas affected by hemianopia. Unlike other treatments that may focus solely on visual exercises, this approach leverages the brain's ability to integrate different sensory inputs, leading to rapid and effective improvements in visual function. ^{1 2 4 7 8}

Research Team

Benjamin A Rowland, PhD

Principal Investigator

Wake Forest Health Sciences

Eligibility Criteria

This trial is for adults under 85 years old with a stable condition called hemianopia, where half of the visual field is lost. Participants should not have attention deficits related to vision (hemineglect) and must be able to see well enough in their unaffected field to do certain visual tasks.

Inclusion Criteria

I am willing to join the three-month program.

I am under 85 years old.

I can see clearly with my unaffected eye.

Exclusion Criteria

I am over 85 years old.

I cannot see differences in shapes or colors correctly.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in weekly multisensory training sessions with visual-auditory stimulation

12 weeks

12 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

• Multisensory Rehabilitation Paradigm (Behavioural Intervention)

Trial Overview The study tests a new way to help people with hemianopia, which involves using multiple senses in therapy. The goal is to show that this approach can improve vision problems caused by damage to the primary visual cortex while leaving other brain areas intact.

Participant Groups

Group I: Unilaterally blind Subjects will be exposed to visual-auditory stimulation Experimental Treatment 1 Intervention

The over-arching objective is to evaluate the functional recovery of vision in hemianopic patients engaged with a multisensory training paradigm. Unilaterally blind participants will participate in weekly training sessions in which they are exposed to high-density spatiotemporally congruent and consistent visual-auditory stimulation. The participants will be tested on a battery of visual tasks probing different levels of function in different environments in a longitudinal study to track recovery.

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials

1,432

Recruited

2,506,000+

Dr. L. Ebony Boulware

Wake Forest University Health Sciences

Chief Medical Officer since 2022

MD from Duke University School of Medicine, MPH from Johns Hopkins Bloomberg School of Public Health

Dr. Julie Ann Freischlag

Wake Forest University Health Sciences

Chief Executive Officer since 2020

BS from University of Illinois, MD from Rush University

Neuroscience Clinical Trial and Innovation Center (NCTIC)

Collaborator

Trials

1

Recruited

6+

Findings from Research

Visual-auditory stimulation therapy has shown promising results in restoring visual sensitivity in two male patients with hemianopia, a condition typically considered permanent after stroke, with significant improvements observed within a few weeks.

Both patients were able to detect, describe, and localize visual stimuli in their previously blind field, demonstrating that this multisensory approach can effectively enhance visual function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ameliorating Hemianopia with Multisensory Training. Rowland, BA., Bushnell, CD., Duncan, PW., et al.[2023]

A novel approach using passive auditory stimulation significantly improved visual detection in patients with hemianopia, showing nearly a 100% increase in performance shortly after stimulation on the blind side.

The improvement in visual detection was temporary, lasting about 1.5 hours, suggesting that auditory stimulation may activate residual visual pathways, highlighting a potential new method for rehabilitation of visual field disorders.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Passive auditory stimulation improves vision in hemianopia. Lewald, J., Tegenthoff, M., Peters, S., et al.[2021]

Multisensory stimulation methods, such as motor imagery and music therapy, are currently used in stroke rehabilitation and can enhance the brain's ability to process and integrate sensory information, which is crucial for recovery.

Future stroke rehabilitation studies should focus on patient characteristics like age and gender, and utilize advanced neuroimaging techniques to better tailor interventions and improve outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Multisensory stimulation in stroke rehabilitation. Johansson, BB.[2021]

A new rehabilitation approach using audio-visual stimulation showed promising results in improving visual field defects in 8 patients, with training sessions lasting 4 hours daily over nearly 2 weeks.

Patients demonstrated significant improvements in visual detection and oculomotor exploration, which translated to better performance in daily activities, with benefits lasting up to one month after treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Visual search improvement in hemianopic patients after audio-visual stimulation. Bolognini, N., Rasi, F., Coccia, M., et al.[2019]

This study will assess the effects of multisensory virtual reality (VR) training on various aspects of recovery in 224 acute stroke patients over a 6-year period, focusing on gait speed and limb function.

The trial aims to provide clearer evidence on the efficacy of VR training compared to conventional therapy, addressing previous limitations in sample size and long-term evaluation of outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Prospective clinical study of rehabilitation interventions with multisensory interactive training in patients with cerebral infarction: study protocol for a randomised controlled trial. Lo, WL., Mao, YR., Li, L., et al.[2019]

A novel rehabilitation tool for patients with homonymous hemianopia showed significant improvements in visual search efficiency after 20 training sessions, with patients achieving shorter response times and faster performance in daily living tasks.

While there was no significant enlargement of the visual field, patients experienced a small increase in visual search fields, indicating that training can enhance overall visual function through compensatory eye movement strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Saccadic visual search training: a treatment for patients with homonymous hemianopia. Pambakian, AL., Mannan, SK., Hodgson, TL., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Ameliorating Hemianopia with Multisensory Training. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Passive auditory stimulation improves vision in hemianopia. [2021]

3. Switzerland pubmed.ncbi.nlm.nih.gov

Multisensory stimulation in stroke rehabilitation. [2021]

4. England pubmed.ncbi.nlm.nih.gov

Visual search improvement in hemianopic patients after audio-visual stimulation. [2019]

5. England pubmed.ncbi.nlm.nih.gov

Behavioural and functional changes in neglect after multisensory stimulation. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Prospective clinical study of rehabilitation interventions with multisensory interactive training in patients with cerebral infarction: study protocol for a randomised controlled trial. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Using the Principles of Multisensory Integration to Reverse Hemianopia. [2021]

8. England pubmed.ncbi.nlm.nih.gov

Saccadic visual search training: a treatment for patients with homonymous hemianopia. [2022]