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.
研究概览
地位
详细说明
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.
研究类型
注册 (估计的)
阶段
- 不适用
联系人和位置
学习联系方式
- 姓名:Anne-Gaëlle Grosmaire
- 电话号码:+33164715200
- 邮箱:ag.grosmaire@les-trois-soleils.fr
研究联系人备份
- 姓名:Clotilde Guillerot
- 邮箱:c.guillerot@les-trois-soleils.fr
学习地点
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Île-de-France Region
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Boissise-le-Roi、Île-de-France Region、法国、77310
- Clinique Les Trois Soleils
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接触:
- Catherine Maulny
- 电话号码:+33164718000
- 邮箱:c.maulny@les-trois-soleils.fr
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首席研究员:
- Christophe Duret
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
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)
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:交叉作业
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
其他: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. |
|
其他: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. |
研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change in reading speed on paper
大体时间: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
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change in reading accuracy on paper
大体时间: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
大体时间: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
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Change in reading accuracy on screen
大体时间: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
|
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Change in subjective reading abilities
大体时间:Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
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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
大体时间:Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
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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
|
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Change in ocular saccades during reading
大体时间:Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
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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
|
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Change in optokinetic nystagmus
大体时间: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
|
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Change in visual detection during standard perimetry
大体时间: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
|
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Change in visual detection during screen-based perimetry
大体时间:Baseline and end of each 4-week rehabilitation period: Week 0, Week 4, and Week 8
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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
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Tolerability of rehabilitation
大体时间:Before and after each rehabilitation session
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Score of fatigue, stress, and mood induced by the treatment, self-assessed using a numbered visual analogue scale |
Before and after each rehabilitation session
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Motivation for rehabilitation
大体时间:End of each 4-week rehabilitation period: Week 4 and Week 8
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Score obtained on the Situational Motivation Scale |
End of each 4-week rehabilitation period: Week 4 and Week 8
|
合作者和调查者
调查人员
- 首席研究员:Christophe Duret、Clinique Les Trois Soleils, Boissise-le-Roi, France
出版物和有用的链接
一般刊物
- 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.
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- 2026-A00195-46
- 26.02108.000598 (其他标识符:SI (CPP))
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
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