- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06121219
Effect of Visual Retraining After Stroke (urochester)
Effect of Visual Retraining on Visual Loss Following Cortical Damage
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Chrys Callan
- Phone Number: 585-276-3426
- Email: Christine_Callan@URMC.Rochester.Edu
Study Locations
-
-
New York
-
Rochester, New York, United States, 14642
- University of Rochester Medical Center
-
Contact:
- Chrys Callan
- Phone Number: 585-276-3426
- Email: Christine_Callan@URMC.Rochester.Edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Cortically Blind Subjects
Inclusion:
- Between 21 and 75 years of age
- Residents of the United States or Canada
- Unilateral stroke or stroke-like damage to primary visual cortex or its immediate afferent white matter sustained within the specified age range (21-75 years)
- Reliable visual field defects in both eyes as measured by Humphrey, MAIA, Goldmann, and/or equivalent perimetry, large enough to enclose a 5-deg diameter visual stimulus.
- Able to fixate on visual targets reliably for 1000ms
- Willing, able, and competent to provide informed consent
- Normal cognitive abilities, able to understand written and oral instructions in English, and competent and responsible adults in order to complete the visual training at home, independently, as instructed, for several months.
Exclusion:
- Past or present eye disease interfering with visual acuity
- BCVA worse than 20/40 in either eye
- Damage to the dorsal Lateral Geniculate Nucleus
- Diffuse whole brain degenerative processes
- History of traumatic brain injury
- Any other brain damage deemed by study staff to potentially interfere with training ability or outcome measures
- Documented history of drug/alcohol abuse
- Currently taking neuroactive medications which would impact training, as determined by PI
- Presence of cognitive or seizure disorders
- One-sided attentional neglect
- Subjects who lack the competence or are otherwise unable to perform the visual training exercises as directed.
Control Subjects (n = 50)
Inclusion:
- Between 21 and 75 years of age
- Report no history of neurological disorder.
- Competent and responsible, as determined by the Principal Investigator.
Exclusion:
- Presence of damage to the visual system
- Presence of an active disease process involving their nervous system.
- Cognitive or seizure disorders
- Best corrected visual acuity worse than 20/40 in either eye
- Presence of vision field loss from ocular disease or disorder
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Experimental: Cortically Blind (CB) Subjects
Cortically Blind subjects will be enrolled to perform a daily home visual training task.
|
A computer software and chin-rest necessary to perform visual training will be loaned to each subject to be used at home.
Subjects will perform one to two daily training sessions in their home, consisting of 200-300 trials each.
The visual task performed repetitively will involve discriminating the direction of motion, the presence of motion, or the orientation of a visual stimulus (either a small cloud of dots or bars) located at a predetermined location in the blind field.
The computer program will automatically create a record of patient performance during each home training session.
Subjects will train daily (about 40-60 minutes total), 5 to 7 days per week for at least 3 and up to 12 months at a time.
|
No Intervention: Normative Comparator: Control Subjects
Healthy control subjects will be recruited to collect normative data by which to compare test results from CB subjects.
No home training will be asked.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Mean Direction Discrimination Threshold
Time Frame: Baseline to 4-6 months
|
For each subject, the investigators will measure the change in ability to detect differences in the motion direction of visual stimuli relative to horizontal, measured in degrees of visual angle with respect to the stimulus. These assessments will be based on what can be reliably detected at a 72-75% correct level of performance on our 2AFC task, with task difficulty adjusted on a 3:1 staircase. The degrees of visual angle for the stimulus vary from 90 degrees (fully vertical) to 0.1 degrees (virtually overlapping the horizontal axis). These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training |
Baseline to 4-6 months
|
Change in Mean Direction Discrimination Threshold
Time Frame: Baseline to 8-12 months
|
For each subject, the investigators will measure the change in ability to detect differences in the motion direction of visual stimuli relative to horizontal, measured in degrees of visual angle with respect to the stimulus. These assessments will be based on what can be reliably detected at a 72-75% correct level of performance on our 2AFC task, with task difficulty adjusted on a 3:1 staircase. The degrees of visual angle for the stimulus vary from 90 degrees (fully vertical) to 0.1 degrees (virtually overlapping the horizontal axis). These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training |
Baseline to 8-12 months
|
Change in Mean Direction Integration Threshold
Time Frame: Baseline to 4-6 months
|
This will measure the change in ability of subjects to integrate across a range of motion directions measured in degrees of visual angle, with respect to the stimulus. These assessments will be based on what range of motion directions can be reliably integrated at a 72-75% correct level of performance on our 2AFC task, with task difficulty adjusted on a 3:1 staircase. The degrees of visual angle for the stimulus vary from 90 degrees (fully vertical) to 0.1 degrees (virtually overlapping the horizontal axis) . These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 4-6 months
|
Change in Mean Direction Integration Threshold
Time Frame: Baseline to 8-12 months
|
This will measure the change in ability of subjects to integrate across a range of motion directions measured in degrees of visual angle, with respect to the stimulus. These assessments will be based on what range of motion directions can be reliably integrated at a 72-75% correct level of performance on our 2AFC task, with task difficulty adjusted on a 3:1 staircase. The degrees of visual angle for the stimulus vary from 90 degrees (fully vertical) to 0.1 degrees (virtually overlapping the horizontal axis) . These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 8-12 months
|
Change in Mean Contrast Sensitivity for Direction
Time Frame: Baseline to 4-6 months
|
Assessment of visual perception transfer to untrained psychophysical tasks of contrast sensitivity for direction discrimination. This is a change metric as transfer must be compared from pre- to post- each course of training. For each subject, the investigators will measure the ability to correctly detect the motion direction of visual stimuli that are also varying in contrast against a grey background. The investigators will measure the luminance contrast, measured in percentage of contrast with respect to the stimulus, that can be reliably detected at a 72-75% correct level of performance. Contrast will vary between 100% (maximum contrast of black on grey) and 0.1% (minimum contrast visible of grey-on-grey) based on subject performance and a 3:1 staircase. These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 4-6 months
|
Change in Mean Contrast Sensitivity for Direction
Time Frame: Baseline to 8-12 months
|
Assessment of visual perception transfer to untrained psychophysical tasks of contrast sensitivity for direction discrimination. This is a change metric as transfer must be compared from pre- to post- each course of training. For each subject, the investigators will measure the ability to correctly detect the motion direction of visual stimuli that are also varying in contrast against a grey background. The investigators will measure the luminance contrast, measured in percentage of contrast with respect to the stimulus, that can be reliably detected at a 72-75% correct level of performance. Contrast will vary between 100% (maximum contrast of black on grey) and 0.1% (minimum contrast visible of grey-on-grey) based on subject performance and a 3:1 staircase. These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 8-12 months
|
Change in Mean Contrast Sensitivity for Static Orientation
Time Frame: Baseline to 4-6 months
|
Assessment of visual perception transfer to untrained psychophysical tasks of contrast sensitivity for static orientation discrimination. This is a change metric as transfer must be compared from pre- to post- each course of training. For each subject, the investigators will measure the ability to correctly detect the orientation of non-moving visual stimuli that vary in contrast against a grey background. The investigators will measure the luminance contrast, measured in percentage of contrast with respect to the stimulus, that can be reliably detected at a 72-75% correct level of performance. Contrast will vary between 100% (maximum contrast of black on grey) and 0.1% (minimum contrast visible of grey-on-grey) based on subject performance and a 3:1 staircase. These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 4-6 months
|
Change in Mean Contrast Sensitivity for Static Orientation
Time Frame: Baseline to 8-12 months
|
Assessment of visual perception transfer to untrained psychophysical tasks of contrast sensitivity for static orientation discrimination. This is a change metric as transfer must be compared from pre- to post- each course of training. For each subject, the investigators will measure the ability to correctly detect the orientation of non-moving visual stimuli that vary in contrast against a grey background. The investigators will measure the luminance contrast, measured in percentage of contrast with respect to the stimulus, that can be reliably detected at a 72-75% correct level of performance. Contrast will vary between 100% (maximum contrast of black on grey) and 0.1% (minimum contrast visible of grey-on-grey) based on subject performance and a 3:1 staircase. These measures of change will be evaluated baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 8-12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Humphrey 10-2 and 24-2 perimetry
Time Frame: Baseline to 4-6 months
|
The investigators will measure the change in visual sensitivity (measured in decibels) at all locations tested by the system. These measures will be evaluated at baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 4-6 months
|
Humphrey 10-2 and 24-2 perimetry
Time Frame: Baseline to 8-12 months
|
The investigators will measure the change in visual sensitivity (measured in decibels) at all locations tested by the system. These measures will be evaluated at baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 8-12 months
|
Goldmann perimetry
Time Frame: Baseline to 4-6 months
|
The investigators will measure the change in area of vision (degrees squared) as encompassed by each isopter, measured by one of 3 different light stimuli. The 3 isopters which will be compared are: I2e 1asb, 0.25 mm^2 I4e 10asb, 0.25 mm^2 V4e 1000asb, 64 mm^2 These measures will be evaluated at baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 4-6 months
|
Goldmann perimetry
Time Frame: Baseline to 8-12 months
|
The investigators will measure the change in area of vision (degrees squared) as encompassed by each isopter, measured by one of 3 different light stimuli. The 3 isopters which will be compared are: I2e 1asb, 0.25 mm^2 I4e 10asb, 0.25 mm^2 V4e 1000asb, 64 mm^2 These measures will be evaluated at baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 8-12 months
|
MAIA Visual Field Perimetry
Time Frame: Baseline to 4-6 months
|
The investigators will measure the change in visual sensitivity (measured in decibels) at all locations tested by the system. These measures will be evaluated at baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 4-6 months
|
MAIA Visual Field Perimetry
Time Frame: Baseline to 8-12 months
|
The investigators will measure the change in visual sensitivity (measured in decibels) at all locations tested by the system. These measures will be evaluated at baseline and at each subsequent visit to the laboratory; minimally from baseline to 4-6 months, then baseline to 8-12 months from start of training. |
Baseline to 8-12 months
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Ischemia
- Pathologic Processes
- Necrosis
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Eye Diseases
- Neurologic Manifestations
- Sensation Disorders
- Vision Disorders
- Infarction
- Stroke
- Ischemic Stroke
- Blindness
- Hemianopsia
- Blindness, Cortical
Other Study ID Numbers
- STUDY00008697
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Stroke, Ischemic
-
Nordsjaellands HospitalRigshospitalet, Denmark; Metropolitan University CollegeCompletedTransient Ischemic Attack | Stroke, Ischemic | Stroke HemorrhagicDenmark
-
University of CalgaryThe George Institute for Global Health, AustraliaNot yet recruitingAcute Ischemic Stroke AIS | Stroke, Acute, Stroke Ischemic | Stroke AcuteCanada, Australia
-
Second Affiliated Hospital, School of Medicine,...Shanghai Zhongshan Hospital; First Affiliated Hospital of Wenzhou Medical University and other collaboratorsRecruitingAcute Ischemic Stroke and Transient Ischemic AttacksChina
-
Medtronic Cardiac Rhythm and Heart FailureMedtronic Bakken Research CenterCompletedCryptogenic Symptomatic Transient Ischemic Attack | Cryptogenic Ischemic StrokeNetherlands, United States, France, Belgium, Germany, Sweden, Italy, Austria, Canada, Denmark, Finland, Greece, Slovakia, Spain
-
University Hospital, BrestCompletedStroke, Ischemic | Stroke HemorrhagicFrance
-
Umbria Bioengineering TechnologiesRecruitingStroke, Ischemic | Stroke HemorrhagicItaly
-
Sheffield Teaching Hospitals NHS Foundation TrustUnknownFatigue | Stroke, Ischemic | Stroke HemorrhagicUnited Kingdom
-
BayerRecruitingAcute Non-cardioembolic Ischemic Stroke | Prevention of Ischemic Stroke | High-risk Transient Ischemic AttackUnited States, Switzerland, Belgium, Sweden, Canada, Australia, Taiwan, Spain, Korea, Republic of, Latvia, Israel, Malaysia, Greece, Japan, Turkey, Netherlands, Romania, China, United Kingdom, Portugal, Italy, Brazil, France, Slovakia, ... and more
-
University of AlbertaCompletedTransient Ischemic Attack | Minor Ischemic StrokeCanada
-
Stephanie HarrisonActive, not recruitingTransient Ischemic Attack | Stroke, IschemicUnited Kingdom
Clinical Trials on Training in the Blind Field
-
University of RochesterNational Institutes of Health (NIH)RecruitingStroke, Ischemic | Stroke Hemorrhagic | Visual Field Defect, Peripheral | Hemianopsia | Hemianopia | Quadrantanopia | Homonymous Hemianopia | Occipital Lobe Infarct | Visual Fields Hemianopsia | Vision Loss Partial | Peripheral Visual Field Defect of Both Eyes | Peripheral Visual Field Defect | Homonymous Hemianopsia and other conditionsUnited States
-
University of RochesterNational Eye Institute (NEI)Active, not recruitingStroke, Ischemic | Hemianopia | Quadrantanopia | Vision Loss Partial | Hemianopia HomonymousUnited States
-
University of RochesterEnvision Solutions, LLCCompletedHemianopia | Quadrantanopia | Stroke Induced Vision LossUnited States
-
University of OxfordUniversity of Rochester; University of Turin, Italy; University of Texas at AustinRecruitingHemianopsia | Hemianopia | Quadrantanopia | Stroke Induced Vision LossUnited Kingdom
-
Fondation Ophtalmologique Adolphe de RothschildTerminated
-
Medipol UniversityNot yet recruiting
-
University of VirginiaCompleted
-
Kubota Vision Inc.Completed
-
Manchester Metropolitan UniversityEuropean Society for Clinical Nutrition and MetabolismRecruitingCardiovascular Diseases | Obesity | Diabetes Mellitus, Type 2United Kingdom
-
Kubota Vision Inc.Completed