Neuroplasticity – the Key to Stroke and Traumatic Brain Injury Vision Rehabilitation
Neuroplasticity is the term used to describe the brain’s ability to form neural connections in response to new information, sensory stimulation, development, dysfunction, or damage. In general neuroplasticity is often associated with learning that takes place during infancy. Research has shown that this type of change in neural connections takes place throughout a person’s life. In short, neuroplasticity is the rewiring of the brain. The ability for the brain to form new neural connections in response to damage caused by a brain injury is the basis of Vision Restoration Therapy. Vision Restoration Therapy (VRT) is a daily method of stroke and traumatic brain injury vision rehabilitation. Vision Restoration Therapy attempts to leverage the process of neuroplasticity through non-invasive light stimulation to the visual center of the brain. The therapy, performed on an FDA-cleared medical device, is customized for each patient’s vision deficit and is updated on a monthly basis for optimal results.
- Physical Changes
- About Visual Neuroplaticity
- Neuroplasticity and Attention
- Neuroplasticity-based Therapy for Vision Loss
- The Pillars of Vision Restoration Therapy
- Evidence That Eye Movement Is Not Rresponsible For Patient Recovery Through VRT
Physical Changes
Neuroplasticity is a complex activity that can involve multiple levels of brain organization. It is also a physical process. Thinking, learning, and environmental stimuli actually change both the brain’s physical structure, and functional organization. These physical changes in the brain translate to changes in our abilities – the ability to perform a new dance step, to recall the name of a new acquaintance, and so on. A recent neuro imaging study using an fMRI - a type of specialized MRI scan used to study activity in the brain based on blood flow - showed changes in brain activity after VRT was performed. This study suggested that cerebral reorganization does occur1.
About Visual Neuroplasticity
People suffering from a variety of conditions like visual field defects may be able to stimulate their brains and restore proper function by undergoing neuroplasticity-based therapies. While neuroscientists have not yet uncovered the exact mechanisms of recovery, they have seen cortical reorganization or remapping in the brain through imaging such as fMRI. In response to stimulation, the formation of new neural connections in the visual cortex of the brain can bypass areas damaged by stroke or brain injury. NovaVision® Vision Restoration Therapy is updated and customized to provide the survivors of stroke and traumatic brain injury with effective vision rehabilitation.
Neuroplasticity and Attention
As with any type of therapy, the key to success is determination and attention. Neuroplasticity has been shown to have its greatest impact during periods of attentiveness. With Vision Restoration Therapy, the more a patient focuses during treatment the greater the chances for successful results.
Neuroplasticity-based Therapy for Vision Loss
Vision Restoration Therapy induces neuroplasticity by non-invasively stimulating the visual cortex of the brain through the retinato treat vision loss after stroke or brain injury. The first step in Vision Restoration Therapy is the diagnosis and evaluation of the patient’s visual field deficit. Next, customized therapy is created to stimulate the border of the blind area, thereby encouraging neuroplasticity. The therapy routine is completed at home in two 30-minute sessions per day for approximately six months. The vision therapy program is analyzed and updated as the patient improves.
The Pillars of Vision Restoration Therapy
Research has shown that three factors must be present for neuroplasticity-based therapies to be effective: environmental stimuli, frequent and consistent stimulation for the proper amount of time, and motivation and attention on the part of patients. VRT was designed with these fundamentals in mind. In developing the therapy, NovaVision focused on ease of use and the effective, ongoing stimulation of the brain’s self-repair mechanisms.
Evidence That Eye Movement Is Not Responsible For Patient Recovery Through VRT
Some physicians question the mechanisms of recovery with VRT. They believe that scanning (moving the eyes) – is responsible for patient improvement, not the engagement of the brain through neuroplasticity. However, increasingly research supports that VRT’s effects are not due solely to eye movements:
- Eye movements are controlled by having patients respond to isoluminant color change of the fixation target which is difficult to detect if eyes stray from that point. The lack of response to the central fixation target is tracked by the device. Studies have reported excellent fixation performance in patients undergoing VRT2.
- A study that monitored eye movements with an eye tracker has shown that patients keep their eyes within 2 degrees to either side of the fixation point 99% of the time after VRT, which is actually improved compared to prior to therapy2.
- Many of the changes in visual fields achieved with VRT would be impossible to explain solely by eye movements. If that was the case, one would expect that the edge of the blind field would shift to the same degree all along the border, which clearly does not occur in many patients.
- Neuroimaging has shown changes in brain activity after VRT suggesting that cerebral reorganization occurs. This was demonstrated by a study conducted at Columbia University Medical Center and published in Neurorehabilitation and Neural Repair3.
While NovaVision continues to actively study the mechanisms of recovery and remaining questions about how neuroplasticity works on a cellular level, the important fact is that the majority of patients do improve their vision, and more importantly, have meaningful changes in their activities of daily living.
Learn More about Neuroplasticity and Vision Restoration Therapy
To learn more about neuroplasticity and neuroplasticity-based therapies for vision loss, please explore our pages on vision rehabilitation after stroke or brain injury, how vision rehabilitation works, or VRT success stories. If you are interested in stroke or traumatic brain injury vision rehabilitation, please contact NovaVision by email, call Patient Services at 1.866.414.0009, or visit the VRT Directory to find someone who can assist with the diagnosis of your condition.
- Marshall RS, Ferrera JJ, Barnes A, Zhang X, O’Brien KA, Chmayssani M, Hirsch J and Lazar, RM. Brain Activity Associated With Stimulation Therapy of the Visual Borderzone in Hemianopic Stroke Patients. Neurorehabil Neural Repair. 2008 22(2):136-44. Epub 2007 Aug 14.
- Chmayssani M, Minzer B, Saxena N, Arogyasami R, Lazar R, Greenstein VC and Marshall R. Retinal Microperimetry as a Means to Assess Visual Field Expansion in Visual Restoration Therapy. Poster presented at the American Academy of Neurology Conference in Chicago in April 2008
- Romano JG. et al. Visual field changes after a rehabilitation intervention: vision restoration therapy, J Neurol Sci(2008), doi: 10.1016/j.jns.2008.06.026