Very interesting article, thank you Marty.
Sandy
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From: ourplace-bounce@xxxxxxxxxxxxx [mailto:ourplace-bounce@xxxxxxxxxxxxx]
On Behalf Of Marty Rimpau
Sent: August-11-16 4:17 AM
To: our place list
Subject: [ourplace] Current stimulation to the brain partially restores
vision in patients with glaucoma and optic nerve damage: Randomized,
clinical trial shows that modulating brain plasticity offers a promising
avenue for vision restoration and rehabilitation -
Current stimulation to the brain partially restores vision in patients with
glaucoma and optic nerve damage: Randomized, clinical trial shows that
modulating brain plasticity offers a promising avenue for vision restoration
and rehabilitation -- ScienceDaily
Glaucoma slowly and silently clouds vision, without any pain.
Credit: Photo courtesy of NEI
Vision loss due to glaucoma or optic nerve damage is generally considered
irreversible. Now a new prospective, randomized, multi-center clinical trial
demonstrates significant vision improvement in partially blind patients
after 10 days of noninvasive, transorbital alternating current stimulation
(ACS). In addition to activation of their residual vision, patients also
experienced improvement in vision-related quality of life such as acuity,
reading, mobility or orientation. The results are reported in PLOS ONE.
"ACS treatment is a safe and effective means to partially restore vision
after optic nerve damage probably by modulating brain plasticity,
re-synchronizing brain networks, which were desynchronized by vision loss.
This class 1 evidence is the first ever large-scale multi-center clinical
trial in the field of non-invasive brain modulation using electric currents
and suggests that visual fields can be improved in a clinically meaningful
way," commented lead investigator Bernhard A. Sabel, PhD, of the Institute
of Medical Psychology, Medical Faculty, Otto-von-Guericke University of
Magdeburg (Germany).
In a study conducted at three German clinical centers (University of
Göttingen, Charité Berlin, and University of Magdeburg), 82 patients were
enrolled in a double-blind, randomized, sham-controlled clinical trial, 33
with visual deficits caused by glaucoma and 32 with anterior ischemic optic
neuropathy caused by inflammation, optic nerve compression (due to tumors or
intracranial hemorrhage), congenital anomalies, or Leber's hereditary optic
neuropathy. Eight patients had more than one cause of optic nerve atrophy.
The groups were randomized so that 45 patients underwent 10 daily
applications of ACS for up to 50 minutes per day over a two-week period and
37 patients received sham stimulation. The only difference between groups
before treatment was that the stimulation group included more men than the
sham group; no other differences were found, including age of the lesion or
visual field characteristics. ACS was applied with electrodes on the skin
near the eyes. Vision was tested before and 48 hours after completion of
treatment, and then again two months later to check if any changes were
long-lasting.
Patients receiving ACS showed significantly greater improvements in
perceiving objects in the whole visual field than individuals in the
sham-treated group. Specifically, when measuring the visual field, a 24%
improvement was noted after treatment in the ACS group compared to a 2.5%
improvement in the sham group. This was due to significant improvements in
the defective visual field sector of 59% in the ACS group and 34% in the
sham group which received a minimal stimulation protocol. Further analyses
showed improvements in the ACS group at the edges of the visual field. The
benefits of stimulation were found to be stable two months later, as the ACS
group showed a 25% improvement in the visual field compared to negligible
changes (0.28%) in the sham group.
Patient safety measures were maintained at a high level, in line with
previous studies. Current flow was assessed using sophisticated computer
simulation models. No participants reported discomfort during stimulation,
although temporary dizziness and mild headaches were reported in rare cases.
The study results are in line with previous small sample studies in which
efficacy and safety were observed. Those studies revealed that
well-synchronized dynamic brain functional networks are critical for vision
restoration. Although vision loss leads to de-synchronization, these neural
networks can be re-synchronized by ACS via rhythmic firing of the ganglion
cells of the retina, activating or "amplifying" residual vision. Dr. Sabel
added that "while additional studies are needed to further explore the
mechanisms of action, our results warrant the use of ACS treatment in a
clinical setting to activate residual vision by brain network
re-synchronization. This can partially restore vision in patients with
stable vision loss caused by optic nerve damage."
In summary, vision loss, long considered to be irreversible, can be
partially reversed. There is now more light at the end of the tunnel for
patients with low vision or blindness following glaucoma and optic nerve
damage.
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