Case Report: Visual Rehabilitation in Hemianopia Patients. Home-Based Visual Rehabilitation in Patients With Hemianopia Consecutive to Brain Tumor Treatment: Feasibility and Potential Effectiveness

Background/Objectives: Visual field loss is frequent in patients with brain tumors, worsening their daily life and exacerbating the burden of disease, and no supportive care strategies exist. In this case series, we sought to characterize the feasibility and potential effectiveness of a home-based visual rehabilitation program in hemianopia patients using immersive virtual-reality stimulation.Subjects/Methods: Two patients, one with homonymous hemianopia and the other with bitemporal hemianopia, consecutive to pediatric brain tumors, with no prior visual rehabilitation performed 15 min of home-based audiovisual stimulation every 2 days for 6 weeks (case 2) and 7 weeks (case 1) between February and August 2020. Patients used a virtual-reality, stand-alone, and remotely controlled device loaded with a non-commercial audiovisual stimulation program managed in real time from the laboratory. Standard visual outcomes assessed in usual care in visual rehabilitation were measured at the clinic. Following a mixed method approach in this pragmatic study of two cases, we collected quantitative and qualitative data on feasibility and potential effectiveness and compared the results pre- and post-treatment.Results: Implementation and wireless delivery of the audiovisual stimulation, remote data collection, and analysis for cases 1 and 2 who completed 19/20 and 20/20 audiovisual stimulation sessions at home, respectively, altogether indicated feasibility. Contrast sensitivity increased in both eyes for cases 1 and 2. Visual fields, measured by binocular Esterman and monocular Humphrey full-field analyses, improved in case 1. A minor increase was observed in case 2. Cases 1 and 2 enhanced reading speed. Case 2 strongly improved quality of life scores.Conclusion: This is the first report of a home-based virtual-reality visual rehabilitation program for adult patients with hemianopia consecutive to a pediatric brain tumor. We show the feasibility in real-world conditions and potential effectiveness of such technology on visual perception and quality of life.

Naturalistic Audiovisual Stimulation Reveals the Topographic Organization of Human Auditory Cortex

Despite the importance of audition in spatial, semantic, and social function, there is no consensus regarding the detailed organisation of human auditory cortex. Using a novel computational model to analyse a high-powered naturalistic audiovisual movie-watching dataset, we simultaneously estimate spectral tuning properties and category selectivity to reveal the modes of organisation and computational motifs that characterise human auditory cortex. We find that regions more remote from the auditory core exhibit more compressive, non-linear response properties and finely-tuned, speech-selective receptive fields in low frequency portions of the tonotopic map. These patterns of organisation mirror aspects of the visual cortical hierarchy, wherein tuning properties progress from a stimulus category-agnostic front end towards more advanced regions increasingly optimised for behaviorally relevant stimulus categories.

A model of the reference frame of the ventriloquism aftereffect

Background: Ventriloquism aftereffect (VAE), observed as a shift in the perceived locations of sounds after audiovisual stimulation, requires reference frame (RF) alignment since hearing and vision encode space in different RFs (head-centered, HC, vs. eye-centered, EC). Experimental studies examining the RF of VAE found inconsistent results: a mixture of HC and EC RFs was observed for VAE induced in the central region, while a predominantly HC RF was observed in the periphery. Here, a computational model examines these inconsistencies, as well as a newly observed EC adaptation induced by AV-aligned audiovisual stimuli. Methods: The model has two versions, each containing two additively combined components: a saccade-related component characterizing the adaptation in auditory-saccade responses, and auditory space representation adapted by ventriloquism signals either in the HC RF (HC version) or in a combination of HC and EC RFs (HEC version). Results: The HEC model performed better than the HC model in the main simulation considering all the data, while the HC model was more appropriate when only the AV-aligned adaptation data were simulated. Conclusion: Visual signals in a uniform mixed HC+EC RF are likely used to calibrate the auditory spatial representation, even after the EC-referenced auditory-saccade adaptation is accounted for.

Effects of Visuoauditory Stimuli on the Acoustic Features of Swallowing in the Elderly

Objective: To investigate the effect of audiovisual stimulation on swallowing sounds in the elderly. Method: Mirror therapy (MT) videos were prepared and divided into AMs, LMs, AFs, and LFs. Sixty videos were randomly selected from AMs, LMs, AFs, and LFs. The selected videos were divided into two sections (10 min per section). The control videos were extracted from the film "Le Peuple Migrateur." Finally, the TD (ms), TE (dB), DHE (ms), DHE/TD (%), PI (dB), DPI (ms), FPI (Hz), and PF (Hz) were analyzed. Result: TD of AS was significantly shorter than that of AS. Lower TE and PI were observed in AS compared to those observed in visual and auditory stimuli (VAS). DHE/TD and DPI were longer in AS relative to VAS. In addition, a lower FPI was observed in AS than in VAS. Conclusion: VAS can significantly improve swallowing frequencies, speed up swallowing movements and increase swallowing functional reserve in the elderly. In addition, the decreased swallowing efficacy under auditory stimuli could be reversed by visual stimuli.

M46. THE STUDY OF HEART RATE VARIABILITY AND EMOTIONAL RESPONSE TO POSITIVE AND NEGATIVE AUDIOVISUAL STIMULATION IN PATIENTS WITH SCHIZOPHRENIA

Background This study was to investigate the Heart Rate Variability (HRV) and emotional response to positive and negative audiovisual stimulation in patients with chronic schizophrenia and healthy control group. Methods Among 253 chronic schizophrenic patients, 104 patients were informed about this research and consented. 35 healthy control consisted of peoples that did not have past and present history of mental and physical illness. Positive and negative affect and HRV were compared between chronic schizophrenia and healthy control groups, and positive and negative affect and HRV to positive and negative audiovisual stimulation were measured. Positive and negative audiovisual stimulation was defined by an art therapy professionalist and a psychiatrist as 10 positive and negative pictures. 3 positive and negative musics were shown to two groups for 4 minutes simulta¬neously. Positive and negative audiovisual stimulation were shown to two groups during 1-week intermission. HRV was measured with Ubpulse H3, an equipment for autonomic nervous system test made by Laxtha company and also analyzed by frequency domain analysis. Emotional Empathy Scale(EES) and Positive Affect and Negative Affect Schedule (PANAS) of two groups were measured at baseline and after positive and negative audiovisual stimulation. Global Assessment of Functioning Scale(GAF) and Positive and Negative Syndrome Scale(PANSS) of chronic schizophrenia group were measured by a psychiatrist. Results Positive affect of patients group were significantly lower than control group, negative affect of patients group were significantly higher than control group. Low Frequency (LF), High Frequency (HF), and Total Power (TP) of HRV in patients group were significantly lowered than control group at baseline. 7 subscales of emotional empathy scale were lowered in patients group compared to control group. Positive affect of patients group was significantly less increased compared to the control group after positive audiovisual stimulation, negative affect of patients group was significantly less decreased to the control group after positive audiovisual stimulation. Positive affect of patients group was increased after negative audiovisual stimulation, but positive affect of control group was significantly decreased compared to the patients group after negative audiovisual stimulation. There was no significant difference in negative affect between two groups after audiovisual stimulation. LF of patients group was significantly higher than control group after positive audiovisual stimulation, HF and TP of patients group were significantly lowered than control group after positive audiovisual stimulation. LF of patients group was significantly higher than control group after negative audiovisual stimulation, HF and PT of patients were significantly lowered than control group after negative audiovisual stimulation. Discussion Audiovisual stimulation in integrative arts therapy program for schizophrenia might have avoid overactive sympathetic stimulation and recommend activate parasympathetic stimulation. Integrative art therapy for schizophrenia must be sufficiently relaxed, empathetic, and promote positive affect during therapeutic process.