Background:Visual field defects (VFD) usually do not show improvement beyond 12 weeks from their onset. It has been shown that repetitive presentation of a stimulus to areas of residual vision in cases of visual field defect can improve vision. The counterpart of these areas in the brain are the partially damaged brain regions at the perilesional areas where plasticity can be enhanced. Objective:We aimed to study the effect of navigated repetitive transcranial magnetic stimulation (rTMS) applied to perilesional areas on the recovery of patients with cortical VFD. Methods:Thirty-two patients with cortical VFD secondary to stroke of more than 3 months duration received 16 sessions of either active or sham high frequency navigated perilesional rTMS. Automated perimetry and visual functioning questionnaire (VFQ-25) were performed at baseline and after completion of the sessions. Results:The active group showed significant improvement after intervention, compared to the sham group, in both mean deviation (MD), visual field index (VFI) and in the VFQ-25 scores. Conclusions:Navigated rTMS is a new treatment option for post-stroke VFD as it can selectively stimulate areas of residual vision around the infarcted tissue, improving the threshold of visual stimulus detection which could be used alone or in combination with existing therapies.

中文翻译：

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导航病灶周围经颅磁刺激可改善卒中后视野缺损：一项双盲假对照研究

背景：视野缺损 (VFD) 通常在发病后 12 周内不会出现改善。已经表明，在视野缺损的情况下，对残余视力区域重复呈现刺激可以改善视力。大脑中这些区域的对应物是可以增强可塑性的病灶周围区域部分受损的大脑区域。目的：我们旨在研究导航重复经颅磁刺激（rTMS）应用于病灶周围区域对皮质 VFD 患者康复的影响。方法：32 例脑卒中继发于 3 个月以上的皮质 VFD 患者接受了 16 次主动或假高频导航病灶周围 rTMS。自动视野检查和视觉功能问卷 (VFQ-25) 在基线和完成会议后进行。结果：与假手术组相比，活动组干预后在平均偏差（MD）、视野指数（VFI）和VFQ-25评分方面均有显着改善。结论：导航 rTMS 是卒中后 VFD 的一种新的治疗选择，因为它可以选择性地刺激梗死组织周围的残余视力区域，提高视觉刺激检测的阈值，可以单独使用或与现有疗法结合使用。