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Advanced Spatiomotor Rehabilitation for Navigation in Blindness & Visual Impairment

NCT ID: NCT05377853

Last Updated: 2023-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-02-15

Study Completion Date

2024-02-29

Brief Summary

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One of the most challenging tasks for blind and visually impaired individuals is navigation through a complex environment. The goal of the present multidisciplinary study is to increase spatial-cognition abilities in people who are blind or visually impaired through training with the previously-developed Cognitive-Kinesthetic Rehabilitation Training to improve navigation, and to investigate the resultant neuroplastic brain reorganization through multimodal brain imaging.

In accordance with National Eye Institute (NEI) strategic goals, this multidisciplinary project will promote the development of well-informed new approaches to navigational rehabilitation, memory enhancement and cross-modal brain plasticity to benefit 'cutting edge' fields of mobile assistive technologies, vision restoration and memory facilitation for the aging brain.

Detailed Description

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The investigators propose a radical new multidisciplinary approach to navigation training in blindness and visual impairment. Successful navigation requires the development of an accurate and flexible mental, or cognitive, map of the navigational space and of the route trajectory required to travel from the current to the target location. The Cognitive-Kinesthetic (C-K) Rehabilitation Training that the PI has developed in the preceding period utilizes a unique form of blind memory-guided drawing to develop cognitive mapping to a high level of proficiency. Particular reliance must be placed on such mental maps (supported only by tactile and auditory inputs), and on the ability to use them effectively for spatiomotor control, when vision with its built-in spatial functionality is lost. There is, however, a fundamental gap in the practice of Orientation and Mobility (O\&M), which is the lack of a specific emphasis on enhancement of these cognitive roots of spatiomotor activity, despite their known importance for navigation in the visually impaired.

The investigators therefore propose a rigorous multidisciplinary approach to this issue, which lies at the intersection of the fields of spatiomotor rehabilitation, blindness assessment technologies, and brain function, each a focus of one Specific Aim. To train the spatial cognition abilities underlying successful navigation, the current proposal aims to translate the power of the C-K Rehabilitation Training to the domain of navigation. The blind and visually impaired trainees will quickly learn how to generate precise and stable cognitive maps of haptically explored raised-line images or tactile maps, and how to use the formed cognitive maps to confidently guide both drawing 'hand navigation' on a map-scale, and whole-body blind navigation on the macro-scale. Once translated to navigation, the preliminary data show that this efficient and enjoyable training will rapidly and sustainably enhance spatial cognition functions both for improved navigation performance and for enhancement of more general spatial cognitive skills. Beyond its practical advantages, the rapid and effective training protocol will also serve as an efficient tool to drive and study training-based neuroplasticity mechanisms through a comprehensive whole-brain multimodal brain imaging platform.

Conditions

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Blindness Blindness, Acquired Low Vision Blindness, Complete

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Multiple regression analyses with life history and vision-related clinical factors as covariates
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Blindness history

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Group Type EXPERIMENTAL

Cognitive-Kinesthetic Navigational Training

Intervention Type BEHAVIORAL

Training with tactile maps to improve spatial memory capability for enhanced navigational capabilities.

Interventions

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Cognitive-Kinesthetic Navigational Training

Training with tactile maps to improve spatial memory capability for enhanced navigational capabilities.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

Behavioral Studies:

* Vision from \< 20/500 to NLP (No Light Perception)

Brain Imaging Studies:

* Vision from \< 20/500 to NLP
* Within average gender range for height +/-1 standard deviation
* Within average gender range for weight +/-1 standard deviation
* Comfortable with MRI procedures

Exclusion Criteria

Behavioral Studies:

* Neurological deficits
* Inability to normally control lower or upper extremities
* Inability to hear and understand instructions.

Brain Imaging Studies:
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Smith-Kettlewell Eye Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lora T Likova

Role: PRINCIPAL_INVESTIGATOR

Senior Scientist

Locations

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Smith-Kettlewell Eye Research Institute

San Francisco, California, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Lora T Likova

Role: CONTACT

[email protected]
415 345 2066

Christopher W Tyler

Role: CONTACT

[email protected]
415 345 2020

Facility Contacts

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Lora T Likova, PhD

Role: primary

[email protected]
415-345-2066

Christopher W Tyler, PhD

Role: backup

[email protected]
415 345 2020

References

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Likova LT, Cacciamani L. Transfer of Learning in People Who Are Blind: Enhancement of Spatial-Cognitive Abilities Through Drawing. J Vis Impair Blind. 2018 Jul 1;112(4):385-397. doi: 10.1177/0145482x1811200405.

Reference Type RESULT
PMID: 33223582 (View on PubMed)

Likova LT, Mineff KN, Nicholas SC. Mental Visualization in the Cerebellum: Rapid Non-motor Learning at Sub-Lobular and Causal Network Levels. Front Syst Neurosci. 2021 Sep 10;15:655514. doi: 10.3389/fnsys.2021.655514. eCollection 2021.

Reference Type RESULT
PMID: 34566588 (View on PubMed)

Likova LT. A Cross-Modal Perspective on the Relationships between Imagery and Working Memory. Front Psychol. 2013 Jan 18;3:561. doi: 10.3389/fpsyg.2012.00561. eCollection 2012.

Reference Type RESULT
PMID: 23346061 (View on PubMed)

Likova LT, Tyler CW, Cacciamani L, Mineff K, Nicholas S. The Cortical Network for Braille Writing in the Blind. IS&T Int Symp Electron Imaging. 2016;2016:10.2352/ISSN.2470-1173.2016.16.HVEI-095. doi: 10.2352/ISSN.2470-1173.2016.16.HVEI-095. Epub 2016 Feb 14.

Reference Type RESULT
PMID: 28890944 (View on PubMed)

Cacciamani L, Likova LT. Memory-guided drawing training increases Granger causal influences from the perirhinal cortex to V1 in the blind. Neurobiol Learn Mem. 2017 May;141:101-107. doi: 10.1016/j.nlm.2017.03.013. Epub 2017 Mar 24.

Reference Type RESULT
PMID: 28347878 (View on PubMed)

Likova LT, Mei M, Mineff KN, Nicholas SC. Learning face perception without vision: Rebound learning effect and hemispheric differences in congenital vs late-onset blindness. IS&T Int Symp Electron Imaging. 2019 Jan 13;2019:2371-23713. doi: 10.2352/ISSN.2470-1173.2019.12.HVEI-237.

Reference Type RESULT
PMID: 31633079 (View on PubMed)

Likova LT. Drawing enhances cross-modal memory plasticity in the human brain: a case study in a totally blind adult. Front Hum Neurosci. 2012 May 14;6:44. doi: 10.3389/fnhum.2012.00044. eCollection 2012.

Reference Type RESULT
PMID: 22593738 (View on PubMed)

Other Identifiers

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EY024056

Identifier Type: -

Identifier Source: org_study_id