Spatial Cognitive Training

Study Overview
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Brief Summary
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This study is designed to see if doing regular training on a spatial imagery task leads to improvements in the ability to do the trained spatial imagery task and in the ability to get around in everyday activities.

Detailed Description
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The investigators will recruit 40 blind participants, randomized by the investigators' CVNR statistician into two groups. One group will undergo the experimental intervention (spatial cognitive training) and the other will undergo a control intervention involving letter-number matching. The participants will include women and minorities in proportion to the demographics of the Veteran population attending the Atlanta VA.

Official Title
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Spatial Cognitive Training in Visual Impairment

Conditions
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Blind

Intervention / Treatment
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* Other: Spatial Training
* Other: Letter number matching


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Inability to perceive visual stimuli, i.e. no light perception, with stable visual loss over the past year The investigators anticipate that causes of blindness will be ocular, including: glaucoma diabetic retinopathy and macular degeneration the most common causes of blindness in Veterans as well as possibly late-onset Leber's optic atrophy and ocular trauma (in the absence of TBI) To minimize heterogeneity due to variations in age and the duration of visual loss, the investigators will restrict enrollment to Veterans and Non-Veterans over the age of 50 who lost light perception within the last 5 years, and who have completed standard O&M training. From a practical standpoint, this also enables the investigators to focus on participants who can potentially benefit most from the proposed intervention. Exclusion Criteria: Participants will be excluded if they have any neurological condition, such as: TBI history of blast exposure stroke brain tumors epilepsy, etc. Participants will also be excluded if MRI scanning is contra-indicated, e.g.: due to an implanted device such as a pacemaker or foreign bodies of ferromagnetic nature Cognitive screening will be performed using the Repeatable Battery for Assessment of Neuropsychological Status (RBANS, Randolph, 1998) and participants with cognitive impairment will be excluded based on a score of 1.5 SD below the mean for the Verbal Memory Index. The investigators will test participants' hearing using a validated screening questionnaire (Screening Version of the Hearing Handicap Inventory for the Elderly, HHIE-S, Wentry & Weinstein, 1983, Lichtenstein et al., 1988) followed by assessment of audiometric pure tone (0.5, 1.0, 2.0, 4.0 KHz) hearing thresholds in the CVNR sound booth. Participants with more than mild hearing loss (HHIE score >8 or audiometric thresholds >40dB) will be excluded (Wentry & Weinstein, 1983; Wilson, 2009), given that the investigators are relying on audio cues. The investigators will also exclude visually impaired Veterans who are dependent on a wheelchair or scooter for mobility, as they will not be able to take part in the real-world task.

Ages Eligible for Study
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Minimum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Spatial Training group and Control group
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Training Group<br>Spatial training | Other: Spatial Training<br>* Spatial Training using a 5x5 grid<br>|
| Other: Control Group<br>Letter number matching | Other: Letter number matching<br>* Letter number matching<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Spatial Ability | Ability to orient to where participants began at the beginning of task. Using a 5x5 grid on testing device, a 5x5 grid that the participant will have to walk, and a 5x5 grid during task in MRI. | 1 month |