Audio-visual stimulation improves oculomotor patterns in patients with hemianopia.

Patients with visual field disorders often exhibit impairments in visual exploration and a typical defective oculomotor scanning behaviour. Recent evidence [Bolognini, N., Rasi, F., Coccia, M., & Làdavas, E. (2005b). Visual search improvement in hemianopic patients after audio-visual stimulation. Brain, 128, 2830-2842] suggests that systematic audio-visual stimulation of the blind hemifield can improve accuracy and search times in visual exploration, probably due to the stimulation of Superior Colliculus (SC), an important multisensory structure involved in both the initiation and execution of saccades. The aim of the present study is to verify this hypothesis by studying the effects of multisensory training on oculomotor scanning behaviour. Oculomotor responses during a visual search task and a reading task were studied before and after visual (control) or audio-visual (experimental) training, in a group of 12 patients with chronic visual field defects and 12 controls subjects. Eye movements were recorded using an infra-red technique which measured a range of spatial and temporal variables. Prior to treatment, patients' performance was significantly different from that of controls in relation to fixations and saccade parameters; after Audio-Visual Training, all patients reported an improvement in ocular exploration characterized by fewer fixations and refixations, quicker and larger saccades, and reduced scanpath length. Overall, these improvements led to a reduction of total exploration time. Similarly, reading parameters were significantly affected by the training, with respect to specific impairments observed in both left- and right-hemianopia readers. Our findings provide evidence that Audio-Visual Training, by stimulating the SC, may induce a more organized pattern of visual exploration due to an implementation of efficient oculomotor strategies. Interestingly, the improvement was found to be stable at a 1 year follow-up control session, indicating a long-term persistence of treatment effects on the oculomotor system.