Sahraie Arash, Cederblad A Matilda H, Kenkel Sigrid, Romano Jose G
School of Psychology, University of Aberdeen, UK.
School of Psychology, University of Aberdeen, UK.
Cortex. 2020 Apr;125:149-160. doi: 10.1016/j.cortex.2019.12.005. Epub 2019 Dec 24.
Compensatory approaches to rehabilitation of vision loss as a result of brain injury are aimed at improving the efficacy of eye movements, enabling patients to bring the otherwise unseen stimuli into their sighted field. Eye movement training has shown promise in a large number of studies in small clinical populations. Nevertheless, there remain two problems; standardisation and wide accessibility. NeuroEyeCoach™ (NEC) has been developed to address both. The therapy is based on the visual search approach and is adaptive to the patient's level of disability and the task difficulty is varied systematically through a combination of set-size and target/distractor similarity. Importantly, the therapy can be accessed online or in clinical settings, to enhance accessibility. Here we have reported on the findings from the first 296 consecutive cases who have accessed and completed NEC online, the largest cohort of patients studied to date. Patients' performance on two objective (visual search times and errors) and one subjective (self-reported disability) measures of performance were assessed before and after therapy. The findings showed that patients improved in search time, had less errors and improved disability scores in 87% (255/294), 80% (236/294) and 66% (167/254) of all cases respectively. We examined factors age, sex, side of blindness, age at the onset of brain injury, and time elapsed between the brain injury and start of therapy as predictors of both objective and subjective measures of improvements. Age was a significant predictor of improved search errors with older patients showing larger improvements. Time between brain injury and intervention negatively influenced search reaction time, however, none of the factors could predict improved subjective reports of disability.
针对脑损伤导致的视力丧失的康复补偿方法旨在提高眼球运动的功效，使患者能够将原本看不见的刺激物纳入其可见视野。眼球运动训练在针对少量临床人群的大量研究中显示出了前景。然而，仍然存在两个问题：标准化和广泛可及性。NeuroEyeCoach™（NEC）就是为解决这两个问题而开发的。该疗法基于视觉搜索方法，并能适应患者的残疾程度，通过结合集合大小和目标/干扰物相似度来系统地改变任务难度。重要的是，该疗法可以通过在线或临床环境使用，以提高可及性。在此，我们报告了首批296例连续在线使用并完成NEC治疗的患者的研究结果，这是迄今为止研究的最大患者队列。在治疗前后，对患者在两项客观指标（视觉搜索时间和错误率）和一项主观指标（自我报告的残疾程度）上的表现进行了评估。结果显示，在所有病例中，分别有87%（255/294）、80%（236/294）和66%（167/254）的患者在搜索时间上有所改善、错误减少且残疾评分提高。我们研究了年龄、性别、失明侧、脑损伤发病年龄以及脑损伤与治疗开始之间的时间间隔等因素，作为客观和主观改善指标的预测因素。年龄是搜索错误改善的显著预测因素，年龄较大的患者改善更为明显。脑损伤与干预之间的时间对搜索反应时间有负面影响，然而，没有任何一个因素能够预测残疾主观报告的改善情况。
