Improvement in activities of daily living after visual training in patients with homonymous visual field defects using Goal Attainment Scaling

Elshout, Joris A.; Bergsma, Douwe; Sibbel, Jacqueline; Baars-Elsinga, Annette; Lubbers, Paula; Asten, Freekje van; Visser-Meily, J. M. A.; Berg, Albert van den

doi:10.3233/rnn-170719

Cited by 11 publications

(7 citation statements)

References 33 publications

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“…We found a relationship between objective visual improvements after training, as assessed by Goldmann perimetry and the GAS scores. Furthermore, for the Humphrey perimetry, we found a linear relationship only between GAS scores and the directed training effects for the full visual field (Elshout et al, 2018). These findings emphasise the value of our quantification of the change in visual field sensitivity, i.e.…”

Section: Discussionsupporting

confidence: 54%

“…A substantial number of studies have reported functional improvements within the VFD measured using either ophthalmic, electrophysiological or psychophysical tests (Bergsma et al, 2012;Bergsma and Van Der Wildt, 2010;Bergsma et al, 2017;Elshout et al, 2018;Elshout et al, 2016;Huxlin and Cavanaugh, 2017;Julkunen et al, 2003;Kasten et al, 1998;Marshall et al, 2010;Mueller et al, 2007;Romano et al, 2008;Sahraie et al, 2006;Jobke et al, 2009) or neuroimaging (Julkunen et al, 2006;Marshall et al, 2010;Raemaekers et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Functional Connectivity of the Precuneus Reflects Effectiveness of Visual Restitution Training in Chronic Hemianopia

Elshout

Bergsma

Norris

et al. 2020

Preprint

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Visual field defects in chronic hemianopia can improve through visual restitution training, yet not all patients benefit equally from this long and exhaustive process. Here, we asked if resting-state functional connectivity prior to visual restitution could predict training success. In two training sessions of eight weeks each, 20 patients with chronic hemianopia performed a visual discrimination task by directing spatial attention towards stimuli presented in either hemifield, while suppressing eye movements. We examined two effects: a sensitivity change in the attended (trained) minus the unattended (control) hemifield (i.e., a training-specific improvement), and an overall improvement (i.e., a total change in sensitivity after both sessions). We then identified five visual resting-state networks and evaluated their functional connectivity in relation to both training effects.We found that the functional connectivity strength between the anterior Precuneus and the Occipital Pole Network was positively related to the attention modulated (i.e., training-specific) improvement. No such relationship was found for the overall improvement or for the other visual networks of interest. Our finding suggests that the anterior Precuneus plays a role in training-induced visual field improvements. The resting-state functional connectivity between the anterior Precuneus and the Occipital Pole Network may thus serve as an imaging-based biomarker that quantifies a patient's potential capacity to direct spatial attention. This may help to identify hemianopia patients that are most likely to benefit from visual restitution training.Abbreviations: FC = functional connectivity, fMRI = functional MRI, FWE = family-wise error, GAS = goal attainment score, GM = grey matter, HFA = Humphreys field analyser, RS = resting-state, VF = visual field, VFD = visual field defect, VRSN = visual resting-state networks, VRT = visual restitution training, WM = white matter

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Section: Discussionsupporting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Functional Connectivity of the Precuneus Reflects Effectiveness of Visual Restitution Training in Chronic Hemianopia

Elshout

Bergsma

Norris

et al. 2020

Preprint

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“…Concerning vision, an improvement in visual acuity was observed between T0 and T1, as well as increased contrast sensitivity and wider visual field as documented by the GAS 41 which highlights an improvement at T1 that affects significantly the activities of daily living (ADL) (see Table 3). Compared to baseline (2/10 for distance, 6 DW for near), the patient achieved a visual acuity of 3/10 for distance and fluctuated between 3 DW and 1 DW for near vision when she was better able to control nystagmus.…”

Section: Visual Functions Assessmentmentioning

confidence: 86%

“…Visual functions assessment was performed with a standard visual acuity test, Goldman kinetic perimetry, 40 and Goal Attainment Scale (GAS). 41 GAS is a sensitive individualized, criterion-referenced method measuring specific outcomes on individual goals after a period of treatment and widely used to supplement standardized measures of outcome that investigated, pre/post treatment and in follow-up, the modification of specific parameters; in our article, we have analyzed compliance with the treatment, visual acuity, visual field, and visual fixation. The assessment of dysarthria was performed by means of dysarthria profile.…”

Section: Methodsmentioning

confidence: 99%

Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study

Errante

Saviola

Fasano

et al. 2019

J Cent Nerv Syst Dis

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Late recovery of consciousness in vegetative state is considered as an exceptional outcome and has been reported prevalently in patients who suffered a traumatic brain injury. In these patients, the benefits of prolonging the rehabilitation, aimed at the recovery of autonomy in basic everyday activities, has been demonstrated. Here, we describe the application of an intensive multi-professional rehabilitation program carried out on a young female patient, with exceptionally late recovery of consciousness, specifically, after 7 years of vegetative state due to severe brain hemorrhage. Neuropsychological and functional assessment was conducted before and after the end of the rehabilitation program. In addition, functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI)-based probabilistic tractography were performed. Two follow-up neuropsychological and functional assessments were also conducted 6 and 29 months after the conclusion of the program. Functional results showed an improvement, maintained over time, in walking with assistance, cognitive efficiency, visual acuity and visual field, dysarthria, and execution of activities of daily living. Moreover, functional and structural magnetic resonance imaging (MRI) data documented the existence of preserved neural networks involved in sensory, motor, and linguistic tasks, which in all likelihood support the recovery process. This report suggests the possibility of undertaking an intensive rehabilitation program in patients who remain for long periods in altered states of consciousness, in spite of early negative prognosis.

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“…In order to relate perimetry results with personal improvement in daily life activities, GAS was applied by three independent occupational therapists, who were blinded to training outcome. A more detailed description about how GAS was applied can be found in 20. In brief, each patient sets three SMART (Specific, Measurable, Achievable, Realistic, Time orientated) goals prior to training under supervision of the therapist 19.…”

Section: Goal Attainment Scalingmentioning

confidence: 99%

Functional MRI of visual cortex predicts training-induced recovery in stroke patients with homonymous visual field defects

Elshout¹,

Bergsma²,

Berg³

et al. 2020

Preprint

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Post-chiasmatic damage to the visual system leads to homonymous visual field defects (HVDs), which can severely interfere with daily life activities. Visual Restitution Training (VRT) can recover parts of the affected visual field in patients with chronic HVDs, but training outcome is variable. An untested hypothesis suggests that training potential may be largest in regions with ‘neural reserve’, where cortical responses to visual stimulation do not lead to visual awareness as assessed by Humphrey perimetry—a standard behavioural visual field test. Here, we tested this hypothesis in a sample of twenty-seven hemianopic stroke patients, who participated in an assiduous 80-hour VRT program. For each patient, we collected Humphrey perimetry and wide-field fMRI-based retinotopic mapping data prior to training. In addition, we used Goal Attainment Scaling to assess whether personal activities in daily living improved. After training, we assessed with a second Humphrey perimetry measurement whether the visual field was improved and evaluated which personal goals were attained. Confirming the hypothesis, we found significantly larger improvements of visual sensitivity at field locations with neural reserve. These visual field improvements implicated both regions in primary visual cortex and higher order visual areas. In addition, improvement in daily life activities correlated with the extent of visual field enlargement but not sensitivity gain. Our findings are an important step toward understanding the mechanisms of visual restitution as well as predicting training efficacy in stroke patients with chronic hemianopia.

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Improvement in activities of daily living after visual training in patients with homonymous visual field defects using Goal Attainment Scaling

Cited by 11 publications

References 33 publications

Functional Connectivity of the Precuneus Reflects Effectiveness of Visual Restitution Training in Chronic Hemianopia

Functional Connectivity of the Precuneus Reflects Effectiveness of Visual Restitution Training in Chronic Hemianopia

Application of an Intensive Rehabilitation Program After Very Late Recovery of Consciousness: A Single-Case Neurorehabilitation and Neuroimaging Study

Functional MRI of visual cortex predicts training-induced recovery in stroke patients with homonymous visual field defects

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