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NCT Number: NCT07237412

Neurofeedback-based Visual Restoration Therapy

Visual field defects are a common consequence of acquired brain injuries and affect people of all ages. These vision problems make everyday life more difficult-for example, when reading, driving, or moving around safely. However, there is currently no effective therapy to improve visual field defects.

Previous training methods have focused on maximizing brain activity during a task. However, new findings show that the best performance is achieved when the brain is already in a state of high communication before the task. Our research shows that people can learn to increase communication between brain regions through neurofeedback.

Studies have shown that neurofeedback can help people after a stroke: it improves the coordination of brain areas that are important for movement, thereby helping to increase mobility. Building on these findings, this study investigates whether EEG neurofeedback can support the visual centers in the brain to improve vision in patients with chronic visual field defects. The main objective of the study is to evaluate the effectiveness of neurofeedback in improving visual field defects. More specifically, the investigators are investigating the development of visual ability (expansion of the visual field, contrast sensitivity).

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Key information

Conditions

Visual Field Defect Homonymous Bilateral Blindness Brain Diseases Cardiovascular Diseases Central Nervous System Diseases Cerebrovascular Disorders Eye Diseases Hemianopsia Nervous System Diseases Neurologic Manifestations Pathological Conditions, Signs and Symptoms Sensation Disorders Signs and Symptoms Stroke Vascular Diseases Vision Disorders

Age range

50 year–70 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Inselspital, Bern, Canton of Bern, Switzerland

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Chronic, stable HVFD (homologous lateral quadranopsia or hemianopsia)
  • 12 months or more after stroke
  • Age range 50-70
  • Ability to provide informed consent

Exclusion criteria

  • Inability to concentrate for long treatment sessions
  • Eye disease with impact on visual field or acuity
  • Presence of non-MRI safe metal in the body
  • New stroke during study period
  • Hemispatial neglect

Treatment and study plan

Neurofeedback

Procedure

The proposed neurofeedback approach relies on high-density electroencephalography (EEG) combined with advanced source localization algorithms. Data will be analyzed in real-time and simultaneously recorded for offline analysis. During each update, a data segment will be filtered between 1 and 20 Hz. The beamformer, computed at the beginning of the session, will be used to project the signal to the gray-matter voxels.

The investigators will compute the alpha-band absolute imaginary coherence between a visual target area and the rest of the brain as index of functional connectivity. Global functional connectivity in the alpha band (8-13 Hz) between the voxels in the target region and the rest of the brain will be calculated.

Primary outcomes

  1. Visual field

    Time frame: Change from enrollment to post-test at 3 weeks and follow up at 7 weeks (repeated-measures ANOVA)

    This will be evaluated using the Haag-Streit Octopus 900 perimetry device (Haag-Streit AG, Köniz, Switzerland). The device features advanced gaze-tracking capabilities that effectively control compensatory eye movements, ensuring accurate measurement of visual field improvements. The Central 30-2 protocol will be followed.

    The primary outcome will be the change in the Mean Deviation (MD) score in detection threshold (in dB) from baseline to the end of the intervention period within the target area of affected visual field. The MD score represents the overall deviation of the patient's visual field from age-matched normative data, with more negative values indicating greater visual field loss.

Secondary outcomes

  1. Changes in alpha-band functional connecticity

    Time frame: Change from entrollment to the end of treatment at 3 weeks.

    Neurophysiological changes reflected in alpha-band network communication between targeted area and the rest of the brain, as measured with EEG-based FC. For this, the investigators will record resting state EEG, which, together with individual MRI scans and beamforming techniques, will allow us to estimate FC in source space.

  2. Questionnaire on daily-life impact of the visual impairment

    Time frame: Change from enrollment to treatment end at 3 weeks

    Daily-life impact of the visual impairment (visual function questionnaire, VFQ25). It ranges from 0 (worst visual function) to 100 (best visual function)).

  3. Reading speed

    Time frame: Change from enrollment to treatment end at 3 weeks and follow up at 7 weeks (repeated-measures ANOVA).

    Reading speed (International Reading Speed Test, IReST). It is a continuous variable measured in words per minute with no predefined scale range (higher values indicate better performance).

Other outcomes

  1. Test of Attentional Performance (TAP) Visual Scanning

    Time frame: Change from enrollment to treatment end at 3 weeks

    Reaction time in the TAP Visual Scanning test is a continuous variable with no predefined bounds, with longer reaction times indicating poorer performance; omissions represent the number of missed targets, with higher values also indicating poorer performance.

  2. Test of Attentional Performance (TAP) Sustained Attention

    Time frame: Change from enrollment to treatment end at 3 weeks.

    The reaction time of the TAP Sustained Attention is a continuous variable with no predefined bounds, with longer reaction times indicating poorer performance; omissions represent the number of missed targets, with higher values also indicating poorer performance.

  3. Test of Attentional Performance (TAP) Visual field and Neglect test

    Time frame: Change from enrollment to treatment at 3 weeks.

    The reaction time is a continuous variable with no predefined bounds, with longer reaction times indicating poorer performance; omissions represent the number of missed targets, with higher values also indicating poorer performance.

Study contacts

Contact information is provided by the study sponsor or research team.

Adrian Guggisberg, MD

CONTACT

[email protected]

+41795537291

Sponsors and collaborators

Lead sponsor

Adrian Guggisberg

Other

Registry information

Acronym: ReViseNetFeed

Important dates

Study start
2025
Primary completion
2028
Study completion
2028
First posted
Nov 19, 2025
Registry last updated
Apr 29, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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