Homonymous visual field defects (HVFDs) following acquired brain lesions affect independent living by hampering several activities of everyday life. Available treatments are intensive and week- or month-long. Transcranial Direct current stimulation (tDCS), a plasticity-modulating non-invasive technique, could be combined with behavioral trainings to boost their efficacy or reduce treatment duration. Some promising attempts have been made pairing occipital tDCS with visual restitution training, however less is knows about which area/network should be best stimulated in association with compensatory approaches, aimed at improving exploratory abilities, such as multisensory trainings. In the present double-blind, sham-controlled study, we assess the efficacy of a multisensory training combined with tDCS. 3 groups of participants with chronic HVFDs underwent a 10-day (1.5 hrs/day) compensatory audio-visual training combined with either real anodal tDCS applied to the ipsilesional occipital tDCS (Group 1), or the ipsilesional posterior parietal cortex (Group 2), or a sham, placebo, tDCS (Group 3). The training require the participants to orient their gaze training spatio-temporally congruent, cross-modal, audio-visual stimuli (starting from a central fixation) and press a button as quick as possible upon the detection of the visual stimulus. All stimuli are presented on 2mx2m panel embedded with 48 LEDs and loudspeakers (Bolognini et al., 2010, Brain Research) All participants underwent a neuropsychological assessment of visuospatial functions prior to the beginning of the training (t0), at the end of the training (t1), and at 1-month (t2) and 4-month follow-up (t3). The assessment includes: a visual detection task, three visual search tasks (EF, Triangles, and Numbers; Bolognini et al., 2005, Brain), and a questionnaire about functional impact of the HVFDs in the activities of daily living.
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Change from baseline in Accuracy on the EF Task
Timeframe: At baseline (at the beginning of the treatment), at the end of the treatment, at 1- and 4-month follow-ups
Change from baseline in Response Times (RTs) on the EF Task
Timeframe: At baseline (at the beginning of the treatment), at the end of the treatment, at 1- and 4-month follow-ups
Change from baseline in Accuracy on the Triangle Task
Timeframe: At baseline (at the beginning of the treatment), at the end of the treatment, at 1- and 4-month follow-ups
Change from baseline in RTs on the Triangle Task
Timeframe: At baseline (at the beginning of the treatment), at the end of the treatment, at 1- and 4-month follow-ups
Change from baseline in RTs on the Numbers Task
Timeframe: At baseline (at the beginning of the treatment), at the end of the treatment, at 1- and 4-month follow-ups
Change from baseline in the functional scale assessing the impact of vision loss in everyday life activities
Timeframe: At baseline (at the beginning of the treatment), at the end of the treatment, at 1- and 4-month follow-ups