Targeting residual visual pathways to develop effective rehabilitation for patients with hemianopia (360G-Wellcome-224655_Z_21_Z)

Hemianopia is common following acquired brain injury, and is estimated to affect over 230,000 people living in the UK. Despite its high prevalence and well-described impact on society, it is a neglected clinical problem with no treatments to recover vision. My research shows that patients with hemianopia can show residual vision in their blind field, a phenomenon called 'blindsight'. Patterns of blindsight and one's capacity for visual retraining appear to vary according to the presence of preserved 'secondary' visual pathways. Where pathways remain intact, they represent an important potential target for rehabilitation. I will use cutting-edge neuroimaging techniques in patients and healthy controls to build a normative connectivity atlas of the central visual pathways. I will quantify the relationship between secondary visual pathway integrity and function in patients and controls, to learn how to optimally drive their response. I will use results to develop a novel visual-training protocol targeting the ventral visual stream, and test whether the integrity of ventral and dorsal visual pathways can predict improvement with visual training protocols targeting those two domains in patients with hemianopia. Understanding the secondary visual pathways will expand neural targets and enhance precision through a customised approach to treat hemianopia.