Matteo Barbara Maria, Viganò Barbara, Cerri Cesare Giuseppe, Meroni Roberto, Cornaggia Cesare Maria, Perin Cecilia
School of Medicine and Surgery, University of Milan-Bicocca: Piazza dell'Ateneo Nuovo, 1, 20126, Milan, Italy.
School of Psychology, University of Milan-Bicocca, Italy.
J Phys Ther Sci. 2017 Sep;29(9):1700-1705. doi: 10.1589/jpts.29.1700. Epub 2017 Sep 15.
[Purpose] Homonymous hemianopia is one of the most common symptoms following neurologic damage leading to impairments of functional abilities and activities of daily living. There are two main types of restorative rehabilitation in hemianopia: "border training" which involves exercising vision at the edge of the damaged visual field, and "blindsight training," which is based on exercising the unconscious perceptual functions deep inside the blind hemifield. Only border effects have been shown to be facilitated by transcranial direct current stimulation (tDCS). This pilot study represents the first attempt to associate the modulatory effects of tDCS over the parieto-occipital cortex to blindsight treatment in the rehabilitation of the homonymous hemianopia. [Subjects and Methods] Patients TA and MR both had chronic hemianopia. TA underwent blindsight treatment which was combined with tDCS followed by blindsight training alone. MR underwent the two training rounds in reverse order. [Results] The patients showed better scores in clinical-instrumental, functional, and ecological assessments after tDCS combined with blindsight rehabilitation rather than rehabilitation alone. [Conclusion] In this two-case report parietal-occipital tDCS modulate the effects induced by blindsight treatment on hemianopia.
[目的] 同向性偏盲是神经损伤后最常见的症状之一，会导致功能能力和日常生活活动受损。偏盲的恢复性康复主要有两种类型：“边界训练”，即在受损视野边缘进行视觉训练；“盲视训练”，即基于对盲半视野深处无意识感知功能的训练。经颅直流电刺激（tDCS）仅被证明能促进边界效应。这项前瞻性研究首次尝试将tDCS对顶枕叶皮质的调节作用与同向性偏盲康复中的盲视治疗联系起来。[对象与方法] 患者TA和MR均患有慢性偏盲。TA接受了与tDCS相结合的盲视治疗，随后仅进行盲视训练。MR则以相反顺序进行了两轮训练。[结果] 与单独康复相比，tDCS联合盲视康复后，患者在临床仪器、功能和生态学评估中得分更高。[结论] 在这份两例报告中，顶枕叶tDCS调节了盲视治疗对偏盲的影响。
