This research will explore if brain stimulation combined with virtual reality therapy improves visual impairment. The stimulation technique is called low-intensity focused ultrasound stimulation (LIFUS). The treatment uses ultrasound to stimulate vision specific parts of the brain. Before this therapy, the participants will get structural brain imaging. Functional brain imaging will be performed before and after the study's completion to measure brain activity response to therapy. The purpose of this research study is to evaluate patients who have had a stroke between 6 and 24 months ago with a visual field impairment. The duration of active participation in the study is 1.5 months.
Randomization visit and 1st Intervention visit: The randomization visit and 1st intervention vision will be on the same day. Participants will be "randomized" into one of the study groups described below. * Group 1 (Sham Group): Inactive LIFU + VR * Group 2 (Active Group): LIFU + VR Neither the subject nor the researcher conducting this study will know which group participants are in. Sham LIFU: The setup is similar for the active stimulation group, except that a high acoustic impedance disk will be placed between the LIFU probe and the scalp that mimics the audible sensation of a slight buzzing but attenuates more than 95% of the energy into the brain. The audible sound is nearly identical for both the sham and active stimulation. Intervention visits (9 sessions over 21 days, about 2.5 hours per visit): At these visits, participants will undergo the investigational study interventions. There will be 30 minutes of a VR session and 20 minutes of active LIFU or inactive LIFU treatments.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
28
Low-intensity focused Ultrasound (LIFU) is a noninvasive brain stimulation technique that uses low-intensity ultrasound to stimulate specific parts of the brain.
IVR is a noninvasive, computer-based audiovisual therapy designed to enhance visual function. Using a VR headset, the system delivers targeted visual stimulation through an interactive game that the participant engages with during each session.
High acoustic impedance disk placed between LIFU and scalp that mimics the audible sensation of a slight buzzing but attenuates more than 95% of the energy into the brain.
Duke University Health System
Durham, North Carolina, United States
Visual Field Change
Change of the blind area in the visual fields as measured by visual perimetry implemented in a virtual reality (VR) headset
Time frame: From enrollment to the 30 days after the end of treatment.
Quality of Life Change
Change as assessed by the National Eye Institute 25 Item Visual Function Questionnaire (NEI-VFQ 25). The NEI-VFQ is a vision based questionnaire which evaluates quality of life with respect to vision in everyday life. The NEI-VFQ has multiple sub-scales for different areas of life, such as Near-Vision, General Health, or Ocular Pain. Each scale is scored from 0 to 100 with 100 representing the best possible score (perfect health or ability)
Time frame: From enrollment to the 30 days after the end of treatment.
Hemodynamic response change
Change in oxygenated hemoglobin concentration or blood-oxygen-level-dependent (BOLD) signal response from baseline and after intervention
Time frame: From enrollment to the 30 days after the end of treatment.
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