Efficacy and predictors of recovery of function after eye movement training in 296 hemianopic patients

Arash Sahraie* (Corresponding Author), A. Matilda H. Cederblad, Sigrid Kenkel, Jose G. Romano

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Compensatory approaches to rehabilitation of vision loss as a result of brain injury are aimed at improving the efficacy of eye movements, enabling patients to bring the otherwise unseen stimuli into their sighted field. Eye movement training has shown promise in a large number of studies in small clinical populations nevertheless, there remain two problems; standardisation and wide accessibility. NeuroEyeCoach™ (NEC) has been developed to address both. The therapy is based on the visual search approach and is adaptive to the patient’s level of disability and the task difficulty is varied systematically through a combination of set-size and target/distractor similarity. Importantly, the therapy can be accessed online or in clinical settings, to enhance accessibility. Here we have reported on the findings from the first 296 consecutive cases who have accessed and completed NEC online, the largest cohort of patients studied to date. Patients’ performance on two objective (visual search times and errors) and one subjective (self-reported disability) measures of performance were assessed before and after therapy. The findings showed that patients improved in search time, had less errors and improved disability scores in 87% (255/294), 80% (236/294) and 66% (167/254) of all cases respectively. We examined factors age, sex, side of blindness, age at the onset of brain injury, and time elapsed between the brain injury and start of therapy as predictors of both objective and subjective measures of improvements. Age was a significant predictor of improved search errors with older patients showing larger improvements. Time between brain injury and intervention negatively influenced search reaction time, however, none of the factors could predict improved subjective reports of disability.
Original languageEnglish
JournalCortex
Early online date24 Dec 2019
DOIs
Publication statusE-pub ahead of print - 24 Dec 2019

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Recovery of Function
Eye Movements
Brain Injuries
Sex Factors
Age Factors
Blindness
Therapeutics
Age of Onset
Reaction Time
Rehabilitation
Population

Keywords

  • Hemianopia
  • Rehabilitation
  • NeuroEyeCoach™
  • compensatory therapy
  • eye-movement
  • stroke

Cite this

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title = "Efficacy and predictors of recovery of function after eye movement training in 296 hemianopic patients",
abstract = "Compensatory approaches to rehabilitation of vision loss as a result of brain injury are aimed at improving the efficacy of eye movements, enabling patients to bring the otherwise unseen stimuli into their sighted field. Eye movement training has shown promise in a large number of studies in small clinical populations nevertheless, there remain two problems; standardisation and wide accessibility. NeuroEyeCoach™ (NEC) has been developed to address both. The therapy is based on the visual search approach and is adaptive to the patient’s level of disability and the task difficulty is varied systematically through a combination of set-size and target/distractor similarity. Importantly, the therapy can be accessed online or in clinical settings, to enhance accessibility. Here we have reported on the findings from the first 296 consecutive cases who have accessed and completed NEC online, the largest cohort of patients studied to date. Patients’ performance on two objective (visual search times and errors) and one subjective (self-reported disability) measures of performance were assessed before and after therapy. The findings showed that patients improved in search time, had less errors and improved disability scores in 87{\%} (255/294), 80{\%} (236/294) and 66{\%} (167/254) of all cases respectively. We examined factors age, sex, side of blindness, age at the onset of brain injury, and time elapsed between the brain injury and start of therapy as predictors of both objective and subjective measures of improvements. Age was a significant predictor of improved search errors with older patients showing larger improvements. Time between brain injury and intervention negatively influenced search reaction time, however, none of the factors could predict improved subjective reports of disability.",
keywords = "Hemianopia, Rehabilitation, NeuroEyeCoach™, compensatory therapy, eye-movement, stroke",
author = "Arash Sahraie and Cederblad, {A. Matilda H.} and Sigrid Kenkel and Romano, {Jose G.}",
note = "Acknowledgements We would like to acknowledge the help of Insiso Ltd, UK for software support and data download. Funding Development of NeuroEyeCoach™ and completion of regulatory requirements were funded by NovaVision Inc and developed by Arash Sahraie and Josef Zihl with the help of a technical team (Insiso Ltd). Supplementary material Pre-registered data analysis plan and the full dataset reported here can be found on Open Science Framework (Sahraie & Cederblad, 2018)",
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AU - Cederblad, A. Matilda H.

AU - Kenkel, Sigrid

AU - Romano, Jose G.

N1 - Acknowledgements We would like to acknowledge the help of Insiso Ltd, UK for software support and data download. Funding Development of NeuroEyeCoach™ and completion of regulatory requirements were funded by NovaVision Inc and developed by Arash Sahraie and Josef Zihl with the help of a technical team (Insiso Ltd). Supplementary material Pre-registered data analysis plan and the full dataset reported here can be found on Open Science Framework (Sahraie & Cederblad, 2018)

PY - 2019/12/24

Y1 - 2019/12/24

N2 - Compensatory approaches to rehabilitation of vision loss as a result of brain injury are aimed at improving the efficacy of eye movements, enabling patients to bring the otherwise unseen stimuli into their sighted field. Eye movement training has shown promise in a large number of studies in small clinical populations nevertheless, there remain two problems; standardisation and wide accessibility. NeuroEyeCoach™ (NEC) has been developed to address both. The therapy is based on the visual search approach and is adaptive to the patient’s level of disability and the task difficulty is varied systematically through a combination of set-size and target/distractor similarity. Importantly, the therapy can be accessed online or in clinical settings, to enhance accessibility. Here we have reported on the findings from the first 296 consecutive cases who have accessed and completed NEC online, the largest cohort of patients studied to date. Patients’ performance on two objective (visual search times and errors) and one subjective (self-reported disability) measures of performance were assessed before and after therapy. The findings showed that patients improved in search time, had less errors and improved disability scores in 87% (255/294), 80% (236/294) and 66% (167/254) of all cases respectively. We examined factors age, sex, side of blindness, age at the onset of brain injury, and time elapsed between the brain injury and start of therapy as predictors of both objective and subjective measures of improvements. Age was a significant predictor of improved search errors with older patients showing larger improvements. Time between brain injury and intervention negatively influenced search reaction time, however, none of the factors could predict improved subjective reports of disability.

AB - Compensatory approaches to rehabilitation of vision loss as a result of brain injury are aimed at improving the efficacy of eye movements, enabling patients to bring the otherwise unseen stimuli into their sighted field. Eye movement training has shown promise in a large number of studies in small clinical populations nevertheless, there remain two problems; standardisation and wide accessibility. NeuroEyeCoach™ (NEC) has been developed to address both. The therapy is based on the visual search approach and is adaptive to the patient’s level of disability and the task difficulty is varied systematically through a combination of set-size and target/distractor similarity. Importantly, the therapy can be accessed online or in clinical settings, to enhance accessibility. Here we have reported on the findings from the first 296 consecutive cases who have accessed and completed NEC online, the largest cohort of patients studied to date. Patients’ performance on two objective (visual search times and errors) and one subjective (self-reported disability) measures of performance were assessed before and after therapy. The findings showed that patients improved in search time, had less errors and improved disability scores in 87% (255/294), 80% (236/294) and 66% (167/254) of all cases respectively. We examined factors age, sex, side of blindness, age at the onset of brain injury, and time elapsed between the brain injury and start of therapy as predictors of both objective and subjective measures of improvements. Age was a significant predictor of improved search errors with older patients showing larger improvements. Time between brain injury and intervention negatively influenced search reaction time, however, none of the factors could predict improved subjective reports of disability.

KW - Hemianopia

KW - Rehabilitation

KW - NeuroEyeCoach™

KW - compensatory therapy

KW - eye-movement

KW - stroke

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DO - 10.1016/j.cortex.2019.12.005

M3 - Article

JO - Cortex

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SN - 0010-9452

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