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学术讲座: Brain functional network plasticity and restoration of vision in blindness
日期: 2015/04/09 

Speaker: Prof. Bernhard A. Sabel
               University of Magdeburg, Germany
               Beijing Tongren Hospital, China
Time:     10:00am – 11:30am
Date:     Apr 10 (Fri), 2015
Venue:   心理所南楼8层会议室

Abstract: 
Many visual diseases involve nervous system dysfunction which affects the retina, optic nerve or brain. A typical “eye” disease, glaucoma and some “non-visual” brain diseases, including normal aging and dementia are associated with visual problems. Only by understanding the brain can many ophthalmological diseases be fully grasped. Retinal (“bottom-up”) signals have to be interpreted by higher-level (“top-down”) brain networks for conscious vision to work.
Our preferred method to achieve vision restoration after optic neuropathies is non-invasive alternating current stimulation (ACS) which is known to induce cortical plasticity in normal subject. In two prospective, randomized, sham-controlled clinical trials we studied patients that suffered optic nerve damage, including glaucoma. They were assigned to a group receiving ACS or sham treatment with sub-clinical stimulation. The primary outcome measures were detection performance in visual field testing and acuity. In addition, patient reported vision related quality of life was measured with the NEI-VFQ questionnaire and EEG recordings were collected. Analysing the post-treatment minus baseline differences significant increases were observed in the primary outcome measures (perimetric stimulus detection rates) and several secondary measures, where rtACS significantly improved compared to sham in visual fields, reaction time, and visual acuity. The increase of stimulus detection performance and acuity improvement remained constant at a 2-months follow-up in most but not all patients and it was associated with improved vision related quality of life. Physiological EEG changes were also noticed. We propose that non-invasive electrical stimulation can improve visual fields in patients with visual field defects. Because of the EEG changes we propose that the treatment enhanced neuroplasticity in the brain, activating residual visual capacities by increased neuronal synchronization in higher visual (and non-visual) areas.
Take home message: the brain deserves a better reputation in ophthalmology which will open new paradigms to find novel methods for diagnosis and therapy.

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