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PLoS One. 2016 Jun 29;11(6):e0156134. doi: 10.1371/journal.pone.0156134. eCollection 2016.

Alternating Current Stimulation for Vision Restoration after Optic Nerve Damage: A Randomized Clinical Trial.

Author information

1
Institute of Medical Psychology, Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.
2
Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
3
Department of Ophthalmology, University Medical Center, Georg-August University of Goettingen, Goettingen, Germany.
4
Department of Clinical Neurophysiology, University Medical Center, Georg-August University, Goettingen, Germany.
5
Center for Integrative Biomedical Computing and the Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, United States of America.
6
Institute for Biometry and Medical Informatics, Otto-von-Guericke University Magdeburg, Magdeburg, Germany.

Abstract

BACKGROUND:

Vision loss after optic neuropathy is considered irreversible. Here, repetitive transorbital alternating current stimulation (rtACS) was applied in partially blind patients with the goal of activating their residual vision.

METHODS:

We conducted a multicenter, prospective, randomized, double-blind, sham-controlled trial in an ambulatory setting with daily application of rtACS (n = 45) or sham-stimulation (n = 37) for 50 min for a duration of 10 week days. A volunteer sample of patients with optic nerve damage (mean age 59.1 yrs) was recruited. The primary outcome measure for efficacy was super-threshold visual fields with 48 hrs after the last treatment day and at 2-months follow-up. Secondary outcome measures were near-threshold visual fields, reaction time, visual acuity, and resting-state EEGs to assess changes in brain physiology.

RESULTS:

The rtACS-treated group had a mean improvement in visual field of 24.0% which was significantly greater than after sham-stimulation (2.5%). This improvement persisted for at least 2 months in terms of both within- and between-group comparisons. Secondary analyses revealed improvements of near-threshold visual fields in the central 5° and increased thresholds in static perimetry after rtACS and improved reaction times, but visual acuity did not change compared to shams. Visual field improvement induced by rtACS was associated with EEG power-spectra and coherence alterations in visual cortical networks which are interpreted as signs of neuromodulation. Current flow simulation indicates current in the frontal cortex, eye, and optic nerve and in the subcortical but not in the cortical regions.

CONCLUSION:

rtACS treatment is a safe and effective means to partially restore vision after optic nerve damage probably by modulating brain plasticity. This class 1 evidence suggests that visual fields can be improved in a clinically meaningful way.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01280877.

PMID:
27355577
PMCID:
PMC4927182
DOI:
10.1371/journal.pone.0156134
[Indexed for MEDLINE]
Free PMC Article

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