A Virtual Reality Oculomotor Exercise for Restoring Functional Vision After Head Trauma
Abstract
The proposed study aligns with the Vision Research Program s priority on restoration of visual function after trauma-related vision loss or severe visual impairment. Brain injuries caused by battlefield head trauma can have significant impact on vision even when there is no injury to the eye. This is a pressing problem because as many as 75% of Service Members and 80% of civilians who had suffered a brain injury have visual dysfunction. The proposed study is focused on visual neglect. Affected individuals lost the ability to explore the full extent of their surroundings, and they have difficulty in reading, locating objects and personal belongings, finding ways to reach their destination, and many other daily activities. Because of impaired visual attention, they are at a high risk of falls and injuries. This visual neglect is caused by disconnected neural networks and has been studied extensively in stroke but remains largely unexplored in other types of brain injury. We propose to fill this knowledge gap by studying visual neglect in traumatic brain injury (TBI) and developing a new treatment modality to facilitate intensive smooth eye pursuit exercise for this population. The rationale is that, assuming a similar neural basis of visual neglect in TBI and stroke, the smooth eye pursuit exercise, which is found effective in ameliorating visual neglect after stroke, has great potential for addressing visual neglect in TBI. Before examining the effectiveness of the treatment, we propose to conduct an observational, clinical research study to fully characterize visual neglect after TBI. The result of the proposed study will inform the study design of the subsequent clinical trial. Our objectives in the proposed study are to explore the neural basis of visual neglect after TBI, at rest and during smooth eye pursuit exercise, and to identify facilitators and barriers to implementing the smooth eye pursuit exercise in virtual reality (VR). Specifically, we aim (1) to identify the neural basis of visual neglect due to TBI, (2) to determine the neural mechanisms of smooth eye pursuits in individuals with TBI, (3) to modernize the smooth eye pursuit exercise, using VR technology combining with eye-tracking technology, and (4) to reveal the feasibility and self-perceived benefits of implementing the VR equipment that eliminates direct supervision from therapists. The proposed project is at the forefront of neurorehabilitation using immersive technology as the VR industry continues to mature and VR hardware becomes even more affordable and ubiquitous. We have designed the proposed research with the short-term and long-term outcomes in mind, which are results of the proposed study and results of the subsequent clinical trial, respectively. These outcomes will lead to new avenues of research, such as broadening the understanding of spatial processing and visual cognition as functions of brain connectivity, advancing vision sciences in the field of neurorehabilitation, and encouraging innovative development that leverages state-of-the-art technology. We will identify the neural mechanisms of visual neglect and smooth eye pursuits in individuals with TBI (short-term outcomes) and the neuro-rehabilitative mechanisms underlying the improved visual function after the treatment of smooth eye pursuit exercise (long-term outcome). We will develop the VR treatment program as a vehicle to deliver and facilitate intensive smooth eye pursuit exercises while promoting therapy engagement and compliance with the treatment protocol (short-term outcome). Results of the subsequent clinical trial will optimize self-initiated VR-based interventions that can be implemented in a variety of settings in different physical environments (long-term outcome). We will reveal the feasibility and self-perceived benefits of implementing the VR equipment that eliminates direct supervision from therapists (short-term outcome) and the benefits of havin
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Dec 05, 2021
- Source ID
- W81XWH2110746
Entities
People
- Peii Chen
Organizations
- Kessler Foundation
- United States Army