Visual field defects (VFD) due to stroke usually do not show improvement beyond 12 weeks from onset. Plasticity is the brain's way to recover lost function and can be achieved by activating dysfunctional regions around the infarcted core. In this article we applied navigated transcranial magnetic stimulation (rTMS) to patients with VFD due to stroke. This was guided by 3D MRI brain to be able to accurately direct the magnetic current to viable areas around the infarction.
This navigated rTMS led to improvement in chronic cortical VFDs as assessed by automated perimetry (an automated measure of visual field) and by functional scale. The degree of improvement was variable and independent of duration and extent of baseline field defect
Confirmation of the efficacy of this technique is needed by further studies. This will open new horizons for post-stroke rehabilitation of VFD which will reduce the direct and indirect costs secondary to such deficit and improve quality of life for those patientsDr Nevine El Nahas, MD