Every year, over 12 million people worldwide suffer from stroke, affecting one in four adults over the age of 25 at some point in their lives. It is estimated that approximately 30% of all stroke survivors suffer from post-stroke visual impairment, which can severely reduce the quality of life of stroke survivors. Current treatments remain limited largely due to a lack of mechanistic understanding of how the adult brain reorganizes after visual system injury to compensate for lost function and which types of visual training stimuli (low-level versus high-level vision) are most effective in driving recovery. The VIBRANT (Vision Improvement through Behavioral Rehabilitation And Neuroplasticity Training) study integrates visual behavior (psychophysics, eye-tracking), neuroimaging (structural and functional MRI), and neurorehabilitation (transcranial random noise stimulation, tRNS) with the long-term goal of achieving precision vision recovery in these patients. Here, we report multimodal results from the first stroke patient enrolled in VIBRANT. First, perceptual learning performance on a motion discrimination task improved as a function of training sessions, with a steeper learning slope in the tRNS compared to sham condition, suggesting efficacy and efficiency of neurorehabilitation. Second, a comparison of Humphrey Visual Field before and after neurorehabilitation revealed improved accuracy specifically in the trained blind-field location, suggesting generalization from motion discrimination to luminance-based perception task. Third, patient-reported outcomes on the NEI Visual Function Questionnaire demonstrated improvements in the domain of vision specific mental health, indicating correspondence between objective measures and subjective visual experience. These converging results highlight the potential of the VIBRANT protocol in promoting functional visual recovery following brain lesions. Ongoing work will evaluate the VIBRANT protocols in a larger and more diverse patient cohort. This research will help determine the effectiveness of the perceptual learning tasks and inform the development of individualized interventions, including tailored brain stimulation protocols guided by neuroimaging.
(Research Poster) Perceptual Learning Paired with tRNS for a Stroke Patient: A VIBRANT Study Case Report
The VIBRANT (Vision Improvement through Behavioral Rehabilitation And Neuroplasticity Training) study integrates visual behavior, neuroimaging, and neurorehabilitation, with the long-term goal of achieving precision vision recovery in patients.