Functional connectivity of the Precuneus reflects effectiveness of visual restitution training in chronic hemianopia

Neuroimage Clin. 2020;27:102292. doi: 10.1016/j.nicl.2020.102292. Epub 2020 May 26.


Visual field defects in chronic hemianopia can improve through visual restitution training, yet not all patients benefit equally from this long and exhaustive procedure. Here, we asked if resting-state functional connectivity prior to visual restitution could predict training success. In two training sessions of eight weeks each, 20 patients with chronic hemianopia performed a visual discrimination task by directing spatial selective attention towards stimuli presented in either hemifield, while suppressing eye movements. We examined two effects: a sensitivity change in the attended (trained) minus the unattended (control) hemifield (i.e., a training-specific improvement), and an overall improvement (i.e., a total change in sensitivity after both sessions). We then identified five visual resting-state networks and evaluated their functional connectivity in relation to both training effects. We found that the functional connectivity strength between the anterior Precuneus and the Occipital Pole Network was positively related to the attention modulated (i.e., training-specific) improvement. No such relationship was found for the overall improvement or for the other visual networks of interest. Our finding suggests that the anterior Precuneus plays a role in attention-modulated visual field improvements. The resting-state functional connectivity between the anterior Precuneus and the Occipital Pole Network may thus serve as an imaging-based biomarker that quantifies a patient's potential capacity to direct spatial attention. This may help to identify hemianopia patients that are most likely to benefit from visual restitution training.

Keywords: Functional connectivity; Hemianopia; Precuneus; Resting-state; Spatial attention; Visual restitution training.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attention / physiology
  • Brain / physiopathology*
  • Brain Mapping / methods
  • Female
  • Hemianopsia / pathology
  • Hemianopsia / physiopathology*
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Nerve Net / physiopathology
  • Neural Pathways / pathology
  • Neural Pathways / physiopathology*
  • Parietal Lobe / physiology
  • Parietal Lobe / physiopathology*
  • Rest / physiology
  • Visual Perception / physiology*