Restitution of visual functions in cerebrally blind children

Werth, Reinhard; Seelos, Klaus

doi:10.1016/j.neuropsychologia.2005.03.023

Cited by 33 publications

(49 citation statements)

References 33 publications

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“…Interestingly, very similar increases were observed in most of our other investigations, which varied between 2% and 8% (please note that the percentage relates to the size of the visual field, which was investigated with two independent perimetric methods including measurement of both intact and defective visual field areas). On the other hand, the small visual field enlargement we found in our studies contrasts with the training-related increase of intact visual field reported by Zihl et al (Zihl, 1980;Zihl & von Cramon, 1985; up to 48° eccentricity), Kerkhoff et al (1992Kerkhoff et al ( , 1994; up to 24° eccentricity) and Werth et al (Werth & Moehrenschlager, 1997, 1999Werth & Seelos, 2005;up to 90° eccentricity). Furthermore, Balliett, Blood, and Bach-y-Rita (1985) and Reinhard et al (2005) found no significant visual field expansions, but this could be explained by differences in task difficulty .…”

Section: Discussioncontrasting

confidence: 98%

“…Yet there was a small increase of 4.2% in stimulus detection when patients were later tested with high-resolution perimetry and a reduction of the blind field between 3.7% and 4.2% in conventional perimetry on a Tübinger Automatic Perimeter (TAP-2000). This finding is in agreement with earlier reports (e.g., Hyvärinen, Raninen & Näsänen, 2002;Julkunen et al, 2003;Julkunen et al, in press;Kasten et al, 1999;Kasten & Sabel, 1995;Kasten et al, 1998a;Mueller et al, 2003;Poggel, Kasten, Müller-Oehring, Sabel, & Brandt, 2001;Poggel et al, 2004;Potthoff, 1995;Schmielau, 1989;Schmielau, Wong, & Ling, 1998;Werth & Moehrenschlager, 1999;Werth & Seelos, 2005;Wuest, Kasten, & Sabel, 2004). Interestingly, very similar increases were observed in most of our other investigations, which varied between 2% and 8% (please note that the percentage relates to the size of the visual field, which was investigated with two independent perimetric methods including measurement of both intact and defective visual field areas).…”

Section: Discussionsupporting

confidence: 92%

“…Zihl and von Cramon (1985) found a training-related enlargement of the visual field ranging from 10° to 48° eccentricity, while Kerkhoff et al (Kerkhoff, Münßinger, Haaf, EberleStrauss, & Stögerer, 1992;Kerkhoff, Münßinger, & Meier, 1994) found a training related visual field enlargement between 2° and 24°. In cerebrally blind children, a training-related visual field enlargement of up to 90° eccentricity was reported recently (Werth & Seelos, 2005). Furthermore, in our previous studies we found average visual field enlargements in the range of about 5° (e.g., Kasten & Sabel, 1995;Kasten et al, 1999;Kasten et al, 1998a).…”

Section: Introductionsupporting

confidence: 61%

“…Despite the high complexity and specificity of the visual system, patients can recover from visual field defects. As both animal Kasten, Wuest, & Sabel, 1998b;Mueller, Poggel, Kenkel, Kasten, & Sabel, 2003;Sabel, Kenkel, & Kasten, 2004;Werth & Moehrenschlager, 1997, 1999Werth & Seelos, 2005;Zihl, 1980;Zihl, Pöp-pel, & von Cramon, 1977;Zihl & von Cramon, 1985) have shown, training of visual deficits after brain lesions leads to an improvement of visual functions, which is primarily observed by visual field expansions in perimetry. Zihl and von Cramon (1985) found a training-related enlargement of the visual field ranging from 10° to 48° eccentricity, while Kerkhoff et al (Kerkhoff, Münßinger, Haaf, EberleStrauss, & Stögerer, 1992;Kerkhoff, Münßinger, & Meier, 1994) found a training related visual field enlargement between 2° and 24°.…”

Section: Introductionmentioning

confidence: 99%

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Vision restoration therapy does not benefit from costimulation: A pilot study

Kasten

Bunzenthal

Müller‐Oehring

et al. 2007

Journal of Clinical and Experimental Neuropsychology

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Visual field deficits in patients have long been considered to be nontreatable, but in previous studies we have found an enlargement of the intact visual field following vision restoration therapy (VRT). In the present pilot study, we wished to determine whether a double-stimulation approach would facilitate visual field enlargements beyond those achieved by the single-stimulus paradigm used in standard VRT. This was motivated by the findings that following visual cortex injury in animals, the size of receptive fields could be enlarged by systematic costimulation, where two stimuli were used to excite visual cortex neurons (Eysel, Eyding, & Schweigart, 1998). Patients (n = 23) with stable homonymous field deficits after trauma, cerebral ischemia, or hemorrhage (lesion age > 6 months) carried out either (a) standard VRT with a single stimulation (n = 9), or vision therapy with (b) a parallel costimulation (n = 7) or (c) a moving costimulation paradigm (n = 7). Training was carried out twice daily for 30 min over a 3-month period. Before and after therapy, visual fields were tested with 30 degrees and 90 degrees Tübinger automatic perimetry (TAP) and with high-resolution perimetry (HRP). Eye movements were recorded with an eye tracking system. When data of all three types of visual field training were pooled, we found significant improvements of stimulus detection in HRP (4.2%) and fewer misses within the central 30 degrees perimetrically (-3.7% right eye, OD, or -4.4% left eye, OS). However, the type of training did not make any difference such that the three training groups profited equally. A more detailed analysis of trained versus untrained visual field areas in 16 patients revealed a superiority of the trained area of only 1.1% in HRP and between 3.5% (OS) and 4.4% (OD) in TAP. Spatial attention and alertness improved significantly in all three groups and correlated significantly with visual field enlargements. While vision training had no influence on the patient's testimonials concerning their visual abilities, the patients significantly improved in a practical paper-and-pencil number tracking task (Zahlen-Verbindungs Test; ZVT). Visual field enlargement does not benefit from a double-stimulation paradigm, but visual attention seems to play an important role in vision restoration. The improvements in trained as well as in untrained areas are explained by top-down attentional control mechanisms interacting with local visual cortex plasticity.

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Section: Discussioncontrasting

confidence: 98%

Section: Discussionsupporting

confidence: 92%

Section: Introductionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

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Vision restoration therapy does not benefit from costimulation: A pilot study

Kasten

Bunzenthal

Müller‐Oehring

et al. 2007

Journal of Clinical and Experimental Neuropsychology

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“…However, even if the occipital lobe is damaged in early life before the visual field has developed, visual afferents originating in the LGN do not target other areas of the brain and are unable to constitute a new V1. Furthermore, fMRI has demonstrated that visual functions may develop during visual field training if functional tissue is re-established in the occipital lobe (Werth & Seelos, 2005). It was also suggested that the MGCs may be involved, as they have been involved in the steering of axons from the LGN to the occipital target, and that following a lesion the fibres from the LGN trying to make contact with V1 may make contact with remnants of the posterior aspects of the brain and make a substitute for area V1.…”

Section: Mechanisms Of Recovery In Children With Cortical Visual Lesionsmentioning

confidence: 99%

Unravelling the development of the visual cortex: implications for plasticity and repair

Bourne

2010

Journal of Anatomy

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The visual cortex comprises over 50 areas in the human, each with a specified role and distinct physiology, connectivity and cellular morphology. How these individual areas emerge during development still remains something of a mystery and, although much attention has been paid to the initial stages of the development of the visual cortex, especially its lamination, very little is known about the mechanisms responsible for the arealization and functional organization of this region of the brain. In recent years we have started to discover that it is the interplay of intrinsic (molecular) and extrinsic (afferent connections) cues that are responsible for the maturation of individual areas, and that there is a spatiotemporal sequence in the maturation of the primary visual cortex (striate cortex, V1) and the multiple extrastriate ⁄ association areas. Studies in both humans and non-human primates have started to highlight the specific neural underpinnings responsible for the maturation of the visual cortex, and how experience-dependent plasticity and perturbations to the visual system can impact upon its normal development. Furthermore, damage to specific nuclei of the visual cortex, such as the primary visual cortex (V1), is a common occurrence as a result of a stroke, neurotrauma, disease or hypoxia in both neonates and adults alike. However, the consequences of a focal injury differ between the immature and adult brain, with the immature brain demonstrating a higher level of functional resilience. With better techniques for examining specific molecular and connectional changes, we are now starting to uncover the mechanisms responsible for the increased neural plasticity that leads to significant recovery following injury during this early phase of life. Further advances in our understanding of postnatal development ⁄ maturation and plasticity observed during early life could offer new strategies to improve outcomes by recapitulating aspects of the developmental program in the adult brain.

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Intervention

Zihl¹,

Dutton²

2014

Cerebral Visual Impairment in Children

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Restitution of visual functions in cerebrally blind children

Cited by 33 publications

References 33 publications

Vision restoration therapy does not benefit from costimulation: A pilot study

Vision restoration therapy does not benefit from costimulation: A pilot study

Unravelling the development of the visual cortex: implications for plasticity and repair

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