Article

Vision Restoration Therapy (VRT) aims to improve visual field
function by systematically training regions of residual vision associated with
the activity of suboptimal firing neurons within the occipital cortex.
Transcranial direct current stimulation (tDCS) has been shown to modulate
cortical excitability. OBJECTIVE: Assess the possible efficacy of tDCS combined
with VRT. METHODS: The authors conducted a randomized, double-blind,
demonstration-of-concept pilot study where participants were assigned to either
VRT and tDCS or VRT and sham. The anode was placed over the occipital pole to
target both affected and unaffected lobes. One hour training sessions were
carried out 3 times per week for 3 months in a laboratory. Outcome measures
included objective and subjective changes in visual field, recording of visual
fixation performance, and vision-related activities of daily living (ADLs) and
quality of life (QOL). RESULTS: Although 12 participants were enrolled, only 8
could be analyzed. The VRT and tDCS group demonstrated significantly greater
expansion in visual field and improvement on ADLs compared with the VRT and sham
group. Contrary to expectations, subjective perception of visual field change was
greater in the VRT and sham group. QOL did not change for either group. The
observed changes in visual field were unrelated to compensatory eye movements, as
shown with fixation monitoring. CONCLUSIONS: The combination of occipital
cortical tDCS with visual field rehabilitation appears to enhance visual
functional outcomes compared with visual rehabilitation alone. TDCS may enhance
inherent mechanisms of plasticity associated with training.

Langue : ANGLAIS