About this trial
The goal of this clinical trial is to investigate whether optokinetic stimulation delivered without a reading task can improve reading performance in adults with post-stroke hemianopic alexia. The main question it aims to answer is: does optokinetic stimulation without a reading task improve reading speed more than optokinetic stimulation with a reading task? Optokinetic stimlation with a reading task is considered the standard rehabilitation. These two conditions will be administered according to a randomized crossover design to determine wether the presence or absence of a reading task influences reading outcomes.
Participants will
* receive 4 weeks of optokinetic stimulation without a reading task and 4 weeks of optokinétic stimulation with a reading task, with the order of these two interventions determined by randomization, * undergo assesments of reading performance, oculomotor behavior, visual field and rehabilitation tolerability before and after each intervention period, * undergo a follow-up assesment 1 month after completion of the interventions.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Time since lesion > 1 month
Diagnosis of homonymous hemianopia post-stroke without macular sparing
Reading complaint and/or reading impairment
Proficiency in reading French
Disqualifiers
History of neurological or psychiatric disorders
Visual impairment of peripheral origin (i.e., related to damage to the structures of the eye or the optic nerve)
Uncorrected visual acuity deficit
Reading disorder prior to the stroke (dyslexia)
Trial design
Crossover
Treatments tested in this trial
Optokinetic stimulation without reading task
Other interventionParticipants are exposed to a horizontally moving optokinetic visual stimulus on a computer screen for 40 minutes per session. The task consists of viewing random sequences of letters scrolling from right to left. The sessions are spread out over 4 weeks, with 3 or 4 sessions per week, to achieve 10 hours (15 sessions) of optokinetic rehabilitation.
Optokinetic stimulation with reading task
Other interventionParticipants are exposed to a horizontally moving optokinetic visual stimulus on a computer screen for 40 minutes per session. The task consists of reading aloud sentences scrolling from right to left. The sessions are spread out over 4 weeks, with 3 or 4 sessions per week, to achieve 10 hours (15 sessions) of optokinetic rehabilitation. The scrolling speed ranges from 85 to 275 words per minute, depending on the participant's reading accuracy.
Treatment groups
Trial outcomes
Primary outcomes
Change in reading speed on paper
Change in the number of correctly read words per minute, assessed using the International Reading Speed Texts (IReST). For each participant, the change in reading speed will be calculated separately for the optokinetic rehabilitation condition with a reading task and for the optokinetic rehabilitation condition without a reading task. The within-participant changes obtained after each 4-week period will be pooled across the two randomized sequences and compared between conditions. A higher reading speed indicates better reading performance.
Secondary outcomes
Change in reading accuracy on paper
Change in the number and type of errors (paralexias, omissions) assessed using the International Reading Speed Texts (IReST).
Change in reading speed on screen
Change in the number of correctly read words per minute, assessed using a screen-based reading task
Change in reading accuracy on screen
Change in the number and type of errors (paralexias, omissions), assessed during a screen-based reading task
Change in subjective reading abilities
Change in the score on the Hemianopia Reading Questionnaire (HRQ)
Sponsors and contacts
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Clinique Les Trois Soleils
Lead sponsor
Laboratoire Mémoire Cerveau et Cognition, Boulogne-Billancourt, France
Collaborator
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