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      The Effects of Short-Lasting Anti-Saccade Training in Homonymous Hemianopia with and without Saccadic Adaptation


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          Homonymous Visual Field Defects (HVFD) are common following stroke and can be highly debilitating for visual perception and higher level cognitive functions such as exploring visual scene or reading a text. Rehabilitation using oculomotor compensatory methods with automatic training over a short duration (~15 days) have been shown as efficient as longer voluntary training methods (>1 month). Here, we propose to evaluate and compare the effect of an original HVFD rehabilitation method based on a single 15 min voluntary anti-saccades task (AS) toward the blind hemifield, with automatic sensorimotor adaptation to increase AS amplitude. In order to distinguish between adaptation and training effect, 14 left- or right-HVFD patients were exposed, 1 month apart, to three trainings, two isolated AS task (Delayed-shift and No-shift paradigm), and one combined with AS adaptation (Adaptation paradigm). A quality of life questionnaire (NEI-VFQ 25) and functional measurements (reading speed, visual exploration time in pop-out and serial tasks) as well as oculomotor measurements were assessed before and after each training. We could not demonstrate significant adaptation at the group level, but we identified a group of nine adapted patients. While AS training itself proved to demonstrate significant functional improvements in the overall patient group, we could also demonstrate in the sub-group of adapted patients and specifically following the adaptation training, an increase of saccade amplitude during the reading task (left-HVFD patients) and the Serial exploration task, and improvement of the visual quality of life. We conclude that short-lasting AS training combined with adaptation could be implemented in rehabilitation methods of cognitive dysfunctions following HVFD. Indeed, both voluntary and automatic processes have shown interesting effects on the control of visually guided saccades in different cognitive tasks.

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          Most cited references43

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          Eye movement control by the cerebral cortex.

          This review focuses on eye movement control by the cerebral cortex, mainly in humans. Data have emerged based on the important contribution of recent techniques such as transcranial magnetic stimulation and functional magnetic resonance imaging, which provide complementary results to those of the classical lesion and electrical stimulation studies. The location of the human frontal eye field and its role in pursuit eye movement control were recently detailed. Cumulative evidence for the role of the dorsolateral prefrontal cortex in unwanted reflexive saccade inhibition, short-term spatial memory and prediction suggests that this area controls decisional processes governing ocular motor behaviour. The organization of spatial memory in the dorsolateral prefrontal cortex (short-term), the parahippocampal cortex (medium-term) and the hippocampal formation (long-term) is also reviewed with the results of recent transcranial magnetic stimulation studies. The relatively complicated anatomy of the posterior parietal cortex in humans is briefly described followed by some additional results concerning the location of the parietal eye field - within the posterior half of the intraparietal sulcus - and its role in visuo-spatial integration and attention. The other areas involved in spatial attention are also examined in the light of several recent contributing reports. Lastly, there are also new functional magnetic resonance imaging findings concerning the posterior cingulate cortex, which appears to be mainly involved in the control of externally guided eye movements and attentional mechanisms. Many new findings on the organization of saccades and pursuit eye movements at the cortical level have recently been reported. Furthermore, eye movements are increasingly used as a tool to elucidate relatively complex neuropsychological processes such as attention, spatial memory, motivation and decisional processes, and a considerable number of reports dealing with these questions have been observed.
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            Neuronal correlates for preparatory set associated with pro-saccades and anti-saccades in the primate frontal eye field.

            Diversity in behavioral responses to sensory stimuli has been attributed to variations in preparatory set. Variability in oculomotor responses toward identical visual stimuli has been well documented, but the neuronal processes underlying this variability are poorly understood. Here, we report evidence for set-related activity for saccadic eye movements in single neurons in the frontal eye field (FEF) in monkeys trained on a task in which they either had to look toward a visual stimulus (pro-saccade) or away from the stimulus (anti-saccade) depending on a previous instruction. A portion of FEF neurons were identified as neurons projecting directly to the superior colliculus (SC) with antidromic activation techniques. Saccade-related neurons in the FEF had lower prestimulus and stimulus-related activity on anti-saccade trials compared with pro-saccade trials. The level of prestimulus activity correlated with saccadic reaction times, express saccade occurrence, and errors in the anti-saccade task. In addition, saccade-related activity in the FEF was higher for pro-saccades than for anti-saccades. These results demonstrate that the direct descending pathway from the FEF to the SC carries preparatory set-related activity for pro-saccades and anti-saccades. The results also provide insights into the neuronal basis of variations in saccadic reaction times and in the control of the prepotent response to glance to a flashed stimulus.
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              Parametric adjustment in saccadic eye movements


                Author and article information

                Front Behav Neurosci
                Front Behav Neurosci
                Front. Behav. Neurosci.
                Frontiers in Behavioral Neuroscience
                Frontiers Media S.A.
                05 January 2016
                : 9
                : 332
                [1] 1Neuroscience Research Center – Institut National de la Santé et de la Recherche Médicale U 1028 – Centre National de la Recherche Scientifique UMR 5292 Bron, France
                [2] 2Unité de Neuro-ophtalmologie, Hospices Civils de Lyon, Hôpital Neurologique Pierre Wertheimer Bron, France
                [3] 3University Lyon 1 Lyon, France
                [4] 4Hospices Civils de Lyon, Hôpital Henry Gabrielle Saint Genis-Laval, France
                Author notes

                Edited by: Katiuscia Sacco, University of Turin, Italy

                Reviewed by: Radek Ptak, University Hospital Geneva, Switzerland; Olivier A. Coubard, CNS-Fed, France

                *Correspondence: Caroline Tilikete caroline.tilikete@ 123456inserm.fr

                †Present Address: Delphine Lévy-Bencheton, Queensland Brain Institute, The University of Queensland, St. Lucia, QLD, Australia

                Copyright © 2016 Lévy-Bencheton, Pélisson, Prost, Jacquin-Courtois, Salemme, Pisella and Tilikete.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                : 16 March 2015
                : 19 November 2015
                Page count
                Figures: 7, Tables: 4, Equations: 0, References: 48, Pages: 14, Words: 9896
                Funded by: Agence Nationale de la Recherche 10.13039/501100001665
                Case Report

                compensatory training,lateral homonymous hemianopia,reading,saccadic adaptation,visual exploration


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