Abstract
Neuropsychological training methods of visual rehabilitation for homonymous vision loss caused by postchiasmatic damage fall into two fundamental paradigms: “compensation” and “restoration”. Existing methods can be classified into three groups: Visual Scanning Training (VST), Audio-Visual Scanning Training (AViST) and Vision Restoration Training (VRT). VST and AViST aim at compensating vision loss by training eye scanning movements, whereas VRT aims at improving lost vision by activating residual visual functions by training light detection and discrimination of visual stimuli. This review discusses the rationale underlying these paradigms and summarizes the available evidence with respect to treatment efficacy. The issues raised in our review should help guide clinical care and stimulate new ideas for future research uncovering the underlying neural correlates of the different treatment paradigms. We propose that both local “within-system” interactions (i.e., relying on plasticity within peri-lesional spared tissue) and changes in more global “between-system” networks (i.e., recruiting alternative visual pathways) contribute to both vision restoration and compensatory rehabilitation, which ultimately have implications for the rehabilitation of cognitive functions.
Highlights
Homonymous visual field defects (HVFD) are among the most serious deficits after cerebral artery stroke and traumatic brain injury (TBI) in adults (Bouwmeester et al, 2007)
The evidence presented in this review supports the idea that visual rehabilitation, defined as the promotion of improvements in independent living and quality of life, can be achieved with adult HVFD patients using either Visual Scanning Training (VST), Audio-Visual Scanning Training (AViST) or Vision Restoration Training (VRT) (Kerkhoff, 2000; Pambakian et al, 2005; Schofield and Leff, 2009; Zihl, 2010; Trauzettel-Klosinski, 2011; de Haan et al, 2014; Goodwin, 2014)
The reviewed studies suggest that VST and AViST induce long term improvements in patients’ visual exploration abilities, promoting a more organized pattern of fixations and refixations and increasing the amplitude of the saccades (Zihl, 1995; Nelles et al, 2001; Bolognini et al, 2005b; Passamonti et al, 2009)
Summary
Homonymous visual field defects (HVFD) are among the most serious deficits after cerebral artery stroke and traumatic brain injury (TBI) in adults (Bouwmeester et al, 2007). Restoration methods aim at increasing the sensitivity of residual tissue and expanding the visual field itself, by activating residual structures of the damaged visual field to strengthen their neuronal activity and synaptic plasticity The latter can be accomplished by vision training of areas of residual vision (ARV) or by applying non-invasive brain current stimulation (reviewed by Sabel et al, 2011b). We will discuss emergent neuroimaging and electroencephalographic data which are beginning to uncover the neural mechanisms underlying these treatment approaches
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