Functional MRI of visual cortex predicts training-induced recovery in stroke patients with homonymous visual field defects

Post-chiasmatic damage to the visual system leads homonymous field defects (HVDs), which can severely interfere with daily life activities. Visual Restitution Training (VRT) recover parts of affected in patients chronic HVDs, but training outcome is variable. An untested hypothesis suggests that potential may be largest regions ‘neural reserve’, where cortical responses stimulation do not lead awareness as assessed by Humphrey perimetry—a standard behavioural test. Here, we tested this a sample twenty-seven hemianopic stroke patients, who participated an assiduous 80-hour VRT program. For each patient, collected perimetry and wide-field fMRI-based retinotopic mapping data prior training. In addition, used Goal Attainment Scaling assess whether personal activities living improved. After training, second measurement was improved evaluated goals were attained. Confirming hypothesis, found significantly larger improvements sensitivity at locations neural reserve. These implicated both primary cortex higher order areas. improvement correlated extent enlargement. Our findings are important step toward understanding mechanisms restitution well predicting efficacy hemianopia.