An interventional study of neurofeedback in Visual Field Defect Homonymous Bilateral, sponsored by Adrian Guggisberg. Recruiting at 2 sites in Switzerland. Open to participants aged 50 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-04-29.
Sponsored by Adrian Guggisberg · Not applicable, Interventional, and Treatment
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).
63 studies on the registry are indexed under Hemianopsia; 24 are open to participants now.
This study's planned enrollment of 14 is below the median of 32 across 53 interventional studies indexed under Hemianopsia.
Browse Hemianopsia studies →Adrian Guggisberg is the lead sponsor of 5 studies on the registry; 2 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
During the active phase, patients will receive real-time audio feedback on spontaneous alpha-band functional connectivity between ipsilesional associative visual areas and the rest of the brain. This will allow them to learn to improve their pathological brain interactions. The neurofeedback training will last about 40 minutes, with frequent breaks. It will be followed by visual stimulation of the affected visual field according to recommendations for inducing steady-state visual evoked potentials.
Procedure: neurofeedback
The control phase is structured identically to the active period, except that the acoustic neurofeedback is synthetically generated and not linked to the subject's actual functional connectivity, while still resembling its dynamic characteristics to ensure effective blinding. The training will last about 40 minutes, with frequent breaks. The training will be followed by visual stimulation of the affected visual field, just as in the active condition.
Procedure: neurofeedback
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.
Visual field
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.
Time frame: Change from enrollment to post-test at 3 weeks and follow up at 7 weeks (repeated-measures ANOVA)
Changes in alpha-band functional connecticity
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.
Time frame: Change from entrollment to the end of treatment at 3 weeks.
Questionnaire on daily-life impact of the visual impairment
Daily-life impact of the visual impairment (visual function questionnaire, VFQ25). It ranges from 0 (worst visual function) to 100 (best visual function)).
Time frame: Change from enrollment to treatment end at 3 weeks
Reading speed
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).
Time frame: Change from enrollment to treatment end at 3 weeks and follow up at 7 weeks (repeated-measures ANOVA).
Test of Attentional Performance (TAP) Visual Scanning
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.
Time frame: Change from enrollment to treatment end at 3 weeks
Test of Attentional Performance (TAP) Sustained Attention
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.
Time frame: Change from enrollment to treatment end at 3 weeks.
Test of Attentional Performance (TAP) Visual field and Neglect test
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.
Time frame: Change from enrollment to treatment at 3 weeks.
Plan to share: Undecided
Started Nov 2025 (actual). Primary completion is estimated for Apr 2028, 29 months after the start.
Of 36 interventional studies with no phase under Hemianopsia, half reached primary completion within 47 months of starting (the median), counting those still running; a quarter within 21 and three quarters within 95. This study's planned 29 months is below that.
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Adrian Guggisberg