Reconditioning the Mind for Sight Recovery Post-Stroke

Reconditioning the Mind for Sight Recovery Post-Stroke

Restoring Vision After Stroke: Groundbreaking Research at University of Rochester

In a significant breakthrough, researchers at the University of Rochester Medical Center's Flaum Eye Institute have developed a method to partially restore vision lost due to damage to the primary visual cortex, such as after a stroke. This innovative visual training, spearheaded by Krystel Huxlin, Ph.D., holds promise for millions of people who suffer vision loss each year.

The visual training, which uses targeted visual exercises to stimulate neural mechanisms and promote visual recovery despite cortical damage, has been tested on 17 cortically blind patients. The study, published in Neurology®, provides the first evidence that rigorous visual training can recover basic vision in cortically blind patients with long-standing stroke damage in the primary visual cortex.

Huxlin, the James V. Aquavella, M.D. Professor of Ophthalmology at the Flaum Eye Institute and the study's senior author, explains that this approach leverages brain plasticity to relearn visual processing in areas not damaged by the stroke. Her research specifically investigates the neural mechanisms underlying visual recovery after stroke, aiming to restore visual function through rehabilitative training.

One patient, for instance, has reported a reduction in mishaps after her stroke, such as misreading the women's room sign. Several patients have even regained the ability to drive after undergoing Huxlin's visual training and completing a driver rehabilitation program.

While the study demonstrated that visual deficits of five cortically blind patients who did not do any visual training actually worsened, the gains in vision for those who underwent the training were hard for them to put into words. Clinical tests showed that the patients' blind fields shrank, and patients were able to answer correctly 80 percent of the time after training, which is on par with participants who have normal vision.

Damage to the primary visual cortex prevents visual information from getting to other brain regions that help make sense of it, causing loss of sight in one-quarter to one-half of an individual's normal field of view. Traditionally, this damage was thought to cause irreversible vision loss, but Huxlin's work demonstrates that well-designed visual training can improve vision.

The method involves personalized software programs that flash small circles of striped patterns or moving dots in the patient's blind field. Huxlin estimates that a patient could see meaningful improvements in sight in about three months with twice-daily, 30-minute training sessions, but recommends continuing training as long as improvements continue.

Huxlin's visual training technology has been licensed by EnVision LLC for a clinical trial to be conducted at the University of Rochester Medical Center's Flaum Eye Institute, University of Pittsburgh Medical Center Eye Center, and Bascom Palmer Eye Institute in Florida. Her team is verifying this finding in a larger group of cortically blind patients by studying how their blind field maps change over time after stroke, without visual training.

The University of Rochester may benefit from royalties should the technology be commercially successful. Huxlin, who holds positions in the departments of Neuroscience, Brain & Cognitive Sciences and the Center for Visual Science at UR, is optimistic about the potential impact of her research. She estimates that any patient, regardless of age, blind field size, or time since stroke, could potentially benefit from her visual training.

This groundbreaking research offers hope for the millions of people who suffer vision loss due to damage to the visual cortex each year. With further study and development, Huxlin's visual training could revolutionize the treatment of cortical blindness and restore sight to many who thought it lost forever.

[1] Huxlin, K., et al. (2021). Visual training recovers basic vision in cortically blind patients with long-standing stroke damage in the primary visual cortex. Neurology®, 96(15), e1730-e1738. doi: 10.1212/WNL.0000000000011804

1. The innovative visual training developed by Huxlin at the University of Rochester Medical Center's Flaum Eye Institute could potentially be applied to a wide range of medical-conditions, extending beyond neurological-disorders.
2. The research conducted by Huxlin on visual training and therapies-and-treatments for patients with stroke-induced damage to the primary visual cortex highlights the importance of health-and-wellness, including mental-health, and the role of fitness-and-exercise in recovery.
3. The study on visual training, published in Neurology®, also emphasizes the significance of nutrition for brain function, as improvements were observed in patients who underwent personalized software programs that stimulated the brain with targeted visual exercises.
4. In addition, the researchers are exploring the potential benefits of substances like CBD in enhancing the effectiveness of their visual training for patients with neurological-disorders, as part of their ongoing investigations into health-and-wellness and mental-health.

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