Effects of Optokinetic Stimulation Without a Reading Task in Patients With Hemianopic Alexia (OPTO)
The goal of this clinical trial is to investigate whether optokinetic stimulation delivered without a reading task can improve reading performance in adults with post-stroke hemianopic alexia. The main question it aims to answer is: does optokinetic stimulation without a reading task improve reading speed more than optokinetic stimulation with a reading task? Optokinetic stimlation with a reading task is considered the standard rehabilitation. These two conditions will be administered according to a randomized crossover design to determine wether the presence or absence of a reading task influences reading outcomes.
Participants will
- receive 4 weeks of optokinetic stimulation without a reading task and 4 weeks of optokinétic stimulation with a reading task, with the order of these two interventions determined by randomization,
- undergo assesments of reading performance, oculomotor behavior, visual field and rehabilitation tolerability before and after each intervention period,
- undergo a follow-up assesment 1 month after completion of the interventions.
Обзор исследования
Статус
Статус
Условия
Условия
Вмешательство/лечение
Вмешательство/лечение
Подробное описание
Stroke can cause a visual field defect known as homonymous hemianopia (HH). When this visual field loss involves the macula, the central area of vision, it may result in reading difficulties known as hemianopic alexia (HA).
The literature reports improved reading performance in these patients after repeated induction of horizontal optokinetic nystagmus (i.e., an oculomotor reflex consisting of horizontal saccades). To induce this nystagmus, previous studies have used a reading task involving text scrolling from right to left.
However, this type of exercise, which relies on reading, is cognitively demanding and may lead to frustration due to reading difficulties, fatigue, and reduced motivation and potentially the impact of rehabilitation. Therefore, the use of a non-reading task could help overcome these limitations.
The present study aims to compare the efficacy of optokinetic stimulation with reading to optokinetic stimulation without reading in patients with HA.
Тип исследования
Тип исследования
Регистрация (Оцененный)
Регистрация
Фаза
Фаза
- Непригодный
Контакты и местонахождение
Контакты исследования
Контакты исследования
- Имя: Anne-Gaëlle Grosmaire
- Номер телефона: +33164715200
- Электронная почта: ag.grosmaire@les-trois-soleils.fr
Учебное резервное копирование контактов
- Имя: Clotilde Guillerot
- Электронная почта: c.guillerot@les-trois-soleils.fr
Места учебы
-
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Île-de-France Region
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Boissise-le-Roi, Île-de-France Region, Франция, 77310
- Clinique Les Trois Soleils
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Контакт:
- Catherine Maulny
- Номер телефона: +33164718000
- Электронная почта: c.maulny@les-trois-soleils.fr
-
Главный следователь:
- Christophe Duret
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-
Критерии участия
Критерии приемлемости
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
Inclusion Criteria:
- Time since lesion > 1 month
- Diagnosis of homonymous hemianopia post-stroke without macular sparing
- Reading complaint and/or reading impairment
- Proficiency in reading French
- Agreed to give informed consent
- Afiliated with national health insurance
Exclusion Criteria:
- History of neurological or psychiatric disorders
- Visual impairment of peripheral origin (i.e., related to damage to the structures of the eye or the optic nerve)
- Uncorrected visual acuity deficit
- Reading disorder prior to the stroke (dyslexia)
- Instability of reading impairment
- Instability of homonymous hemianopia
- Major cognitive that would limit the ability of the patient to participate in the study (unilateral spatial neglect, simultanagnosia, comprehension disorder, oral expression disorder)
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Уход
- Распределение: Рандомизированный
- Интервенционная модель: Назначение кроссовера
- Маскировка: Одинокий
Количество рук
Оружие и интервенции
Группа участников / АрмияГруппа участников / Армия |
Вмешательство/лечениеВмешательство/лечение |
|---|---|
|
Другой: Group A
Patients receive 15 sessions of optokinetic rehabilitation with a reading task, followed by 15 sessions of optokinetic rehabilitation without an associated reading task. The optokinetic rehabilitation sessions with reading are considered the standard of care, while optokinetic rehabilitation without an associated reading task is the experimental condition. Each patient undergoes both conditions sequentially and serves as their own control. |
Participants are exposed to a horizontally moving optokinetic visual stimulus on a computer screen for 40 minutes per session. The task consists of viewing random sequences of letters scrolling from right to left. The sessions are spread out over 4 weeks, with 3 or 4 sessions per week, to achieve 10 hours (15 sessions) of optokinetic rehabilitation. Participants are exposed to a horizontally moving optokinetic visual stimulus on a computer screen for 40 minutes per session. The task consists of reading aloud sentences scrolling from right to left. The sessions are spread out over 4 weeks, with 3 or 4 sessions per week, to achieve 10 hours (15 sessions) of optokinetic rehabilitation. The scrolling speed ranges from 85 to 275 words per minute, depending on the participant's reading accuracy. |
|
Другой: Group B
Patients receive 15 sessions of optokinetic rehabilitation without an associated reading task, followed by 15 sessions of optokinetic rehabilitation with a reading task. The optokinetic rehabilitation sessions with reading are considered the standard of care, while optokinetic rehabilitation without an associated reading task is the experimental condition. Each patient undergoes both conditions sequentially and serves as their own control. |
Participants are exposed to a horizontally moving optokinetic visual stimulus on a computer screen for 40 minutes per session. The task consists of viewing random sequences of letters scrolling from right to left. The sessions are spread out over 4 weeks, with 3 or 4 sessions per week, to achieve 10 hours (15 sessions) of optokinetic rehabilitation. Participants are exposed to a horizontally moving optokinetic visual stimulus on a computer screen for 40 minutes per session. The task consists of reading aloud sentences scrolling from right to left. The sessions are spread out over 4 weeks, with 3 or 4 sessions per week, to achieve 10 hours (15 sessions) of optokinetic rehabilitation. The scrolling speed ranges from 85 to 275 words per minute, depending on the participant's reading accuracy. |
Что измеряет исследование?
Первичные показатели результатов
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Change in reading speed on paper
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the number of correctly read words per minute, assessed using the International Reading Speed Texts (IReST). For each participant, the change in reading speed will be calculated separately for the optokinetic rehabilitation condition with a reading task and for the optokinetic rehabilitation condition without a reading task. The within-participant changes obtained after each 4-week period will be pooled across the two randomized sequences and compared between conditions. A higher reading speed indicates better reading performance. |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Вторичные показатели результатов
Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Change in reading accuracy on paper
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the number and type of errors (paralexias, omissions) assessed using the International Reading Speed Texts (IReST). |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in reading speed on screen
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the number of correctly read words per minute, assessed using a screen-based reading task |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in reading accuracy on screen
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the number and type of errors (paralexias, omissions), assessed during a screen-based reading task |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in subjective reading abilities
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the score on the Hemianopia Reading Questionnaire (HRQ) |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in ocular fixations during reading
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the number of fixations and in the mean fixation duration (in ms) during the screen-based reading task, assessed with an eyetracker |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in ocular saccades during reading
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in the number and in the mean amplitude of saccades (in degrees) during the screen-based reading task, assessed with an eyetracker |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in optokinetic nystagmus
Временное ограничение: Baseline and at the end of both rehabilitation: Week 0 and Week 8
|
Change of saccade amplitude and frequency during optokinetic stimulation |
Baseline and at the end of both rehabilitation: Week 0 and Week 8
|
|
Change in visual detection during standard perimetry
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in visual sensitivity (in dB) at each tested visual field location on automated static perimetry (Humphrey or Octopus) |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Change in visual detection during screen-based perimetry
Временное ограничение: Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
Change in number of correctly detected targets and mean reaction time (in ms) at each tested visual field location on screen-based perimetry |
Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
|
|
Tolerability of rehabilitation
Временное ограничение: Before and after each rehabilitation session
|
Score of fatigue, stress, and mood induced by the treatment, self-assessed using a numbered visual analogue scale |
Before and after each rehabilitation session
|
|
Motivation for rehabilitation
Временное ограничение: End of each 4-week rehabilitation period: Week 4 and Week 8
|
Score obtained on the Situational Motivation Scale |
End of each 4-week rehabilitation period: Week 4 and Week 8
|
Соавторы и исследователи
Спонсор
Спонсор
Соавторы
Соавторы
Следователи
Следователи
- Главный следователь: Christophe Duret, Clinique Les Trois Soleils, Boissise-le-Roi, France
Публикации и полезные ссылки
Общие публикации
- Goodwin D. Homonymous hemianopia: challenges and solutions. Clin Ophthalmol. 2014 Sep 22;8:1919-27. doi: 10.2147/OPTH.S59452. eCollection 2014.
- Schuett S, Heywood CA, Kentridge RW, Zihl J. Rehabilitation of hemianopic dyslexia: are words necessary for re-learning oculomotor control? Brain. 2008 Dec;131(Pt 12):3156-68. doi: 10.1093/brain/awn285. Epub 2008 Nov 3.
- Zihl J. Eye movement patterns in hemianopic dyslexia. Brain. 1995 Aug;118 ( Pt 4):891-912. doi: 10.1093/brain/118.4.891.
- Spitzyna GA, Wise RJ, McDonald SA, Plant GT, Kidd D, Crewes H, Leff AP. Optokinetic therapy improves text reading in patients with hemianopic alexia: a controlled trial. Neurology. 2007 May 29;68(22):1922-30. doi: 10.1212/01.wnl.0000264002.30134.2a.
Даты записи исследования
Изучение основных дат
Начало исследования (Оцененный)
Начало исследования
Первичное завершение (Оцененный)
Первичное завершение
Завершение исследования (Оцененный)
Завершение исследования
Даты регистрации исследования
Первый отправленный
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Действительный)
Первый опубликованный
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее опубликованное обновление
Последнее отправленное обновление, отвечающее критериям контроля качества
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
- Неврологические проявления
- Цереброваскулярные расстройства
- Заболевания головного мозга
- Заболевания центральной нервной системы
- Заболевания нервной системы
- Сосудистые заболевания
- Сердечно-сосудистые заболевания
- Глазные болезни
- Нарушения зрения
- Расстройства чувствительности
- Слепота
- Патологические состояния, признаки и симптомы
- Признаки и симптомы
- Инсульт
- Гемианопсия
Другие идентификационные номера исследования
Другие идентификационные номера исследования
- 2026-A00195-46
- 26.02108.000598 (Другой идентификатор: SI (CPP))
Планирование данных отдельных участников (IPD)
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Информация о лекарствах и устройствах, исследовательские документы
Изучает лекарственный продукт, регулируемый FDA США.
Изучает продукт устройства, регулируемый Управлением по санитарному надзору за качеством пищевых продуктов и медикаментов США.
Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .