Neuroplasticity in Blind Subjects After Repetitive Tactile Stimulation

Brain plasticity of cortical activity caused by repetitive tactile stimulation could have a progressive development that was from primary parietal areas, passing over parieto-occipital areas and came secondary to primary occipital areas. This process allows to understand the existence of neurons in the brain and specific areas for certain functions independent of the type of stimulation is performed.

By performing repetitive tactile stimulation over a period of 3 months,using a tactile stimulator, our group will try to prove several that repetitive tactile stimulation can create cross-modality and improve recognition and localization of patterns in blind people.

Study Overview

• Status: Unknown
• Conditions: Blindness
• Intervention / Treatment: Other: Tactile Training

Detailed Description

The investigators will use passive repetitive tactile stimulation over a period of 3 months, one hour a day for five days a week, with vertical, horizontal and oblique lines generated randomly by a tactile stimulator. Our aim is (a) to study if repetitive tactile stimulation can create cross-modality and improve recognition and localization of patterns in blind people, (b) to evaluate the impact of this training on brain activity the investigators performed high-density scalp EEG recording during the initial stimulation session and in the last one. And (c) measure the functional connectivity of the brain with resting state MRI pre and post training. The resting state MRI protocol consist on one run of T1WI and three bold runs (TE=30ms,TR=3000ms, flip angle 90º,voxel size 3mm, 124 time points, 0 gap).

Cross-modality sensory stimulation may offer a good opportunity to improve recognition, localization and navigation in blind people. Although the neural substrate of this multimodality integration is not fully understood yet. Some areas of the brain, mainly the lateral occipital cortex, are specialized for visual object recognition and they can be activated by tactile stimuli. This activation of the visual cortex might lead to visual-like perception, regardless of the sensory input modality.

In the blind the high demand required by object recognition appears to recruit also ventral and dorsal occipital areas. Blindness modifies neocortical processing of non-visual tasks, including frontoparietal and visual regions during tactile stimulation. It is also known that people with blindness proficient in the use of a visuo-tactile sensory substitution device that presents visual images as patterns of electric stimuli to the subject's tongue, like Bach-y-Rita and Ptito said, show occipital cortex activation in an orientation-discrimination task.

As far as the investigators know there are no studies aimed at understanding the relationship between activation of lateral occipital cortex and the ability to recognize objects presented to the hand along time. In particular, the investigators tested if repetitive passive tactile stimulation leads to activation of visual areas and recognition of spatial patterns in people with blindness.

• Study Type: Interventional
• Enrollment (Anticipated): 24
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Tomas Ortiz Alonso, MD, PhD; Phone Number: +34 91 394 1495; Email: tortiz@med.ucm.es
• Study Contact Backup: Name: Laura Ortiz Teran, MD, PhD; Email: teran@nmr.mgh.harvard.edu

Study Locations

• Spain
  • Madrid, Spain, 28040
    • Recruiting
    • Universidad Complutense de Madrid
    • Contact: Tomas Ortiz Alonso, MD,PhD; Phone Number: 1495 +34 91 394 1495; Email: tortiz@med.ucm.es
    • Contact: Laura Ortiz Teran, MD, PhD; Phone Number: +1 617 945 3384; Email: teran@nmr.mgh.harvard.edu
    • Principal Investigator: Tomas Ortiz Alonso, MD, PhD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 7 years to 70 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Clinical Diagnosis: Different Causes of blindness were diverse: congenital nystagmus, glaucoma, retinopathy, congenital cataracts, lenticular fibroplasia, macular degeneration, optic atrophy, Peter's anomaly with microphthalmia, retinal detachment, retina necrosis, retinitis pigmentosa and uveitis

Exclusion Criteria:

• No history of neurological, psychiatric, cognitive or sensorimotor deficits other than blindness.

Study Plan

How is the study designed?

Design Details

• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Functional Connectivity MRI; Functional Connectivity will be measured by MRI, we will perform one T1WI run as well as three resting state bold based runs. Bold runs parameters: TE 30ms, TR 3000ms, flip angle 90º, gap 0mm, 124 time points, voxel size 3mm, duration 6min18s each, FOV 240x240x141.	Other: Tactile Training; Tactile Training to induce neuroplasticity in the visual pathway, measured with functional connectivity MRI

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
MRI Functional Connectivity of the visual pathway	Functional Connectivity analysis (fcMRI) is a tool that allows functionally associated brain regions to be identified. fcMRI takes advantage of the observation that the brain regions exhibit spontaneous, low frequency variations as measured using blood oxygenation level-dependent (BOLD) imaging.	1 year

Collaborators and Investigators

• Sponsor: Universidad Complutense de Madrid
• Collaborators: Harvard University
• Investigators: Principal Investigator: Tomás Ortiz Alonso, MD PhD, Universidad Complutense de Madrid

Publications and helpful links

General Publications

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Study record dates

Study Major Dates

• Study Start: January 1, 2012
• Primary Completion (Anticipated): September 1, 2013
• Study Completion (Anticipated): December 1, 2014

Study Registration Dates

• First Submitted: July 2, 2012
• First Submitted That Met QC Criteria: December 17, 2012
• First Posted (Estimate): December 21, 2012

Study Record Updates

• Last Update Posted (Estimate): December 21, 2012
• Last Update Submitted That Met QC Criteria: December 17, 2012
• Last Verified: December 1, 2012

More Information

Terms related to this study

• Keywords: neuroplasticity; functional connectivity; blind; tactile stimulation; resting state MRI; cross-modality; visual qualia
• Additional Relevant MeSH Terms: Nervous System Diseases; Eye Diseases; Neurologic Manifestations; Sensation Disorders; Vision Disorders; Blindness
• Other Study ID Numbers: VISION TACTIL