Improvement in reading performance through training with simulated thalamic visual prostheses

Simulations of artificial vision are used to provide the researcher an opportunity to explore different aspects of visual prosthesis device design by observing subject performance on various tasks viewed through the simulation. Such studies typically use normal, sighted subjects to measure performance at a given point in time. Relatively few studies examine performance changes longitudinally to quantitatively assess the benefits from a training plan that would be akin to post-implantation rehabilitation. Here, we had six normal, sighted subjects use a standard reading task with daily practice over eight weeks to understand the effects of an intensive training schedule on adaptation to artificial sight. Subjects read 40 MNREAD-style sentences per session, with a new set each session, that were presented at five font sizes (logMAR 1.0–1.4) and through three center-weighted phosphene patterns (2,000, 1,000, 500 phosphenes). We found that subjects improved their reading accuracy across sessions, and that the training lead to an increase of reading speed that was equivalent to a doubling of available phosphenes. Most importantly, the hardest condition, while initially illegible, supported functional reading after training. Consistent with experience-driven neuroplastic changes, gaps in the training schedule lead to transient decreases in reading speed, but, surprisingly, not reading accuracy. Our findings contribute to our larger project of developing a thalamic visual prosthesis and to post-implant rehabilitation strategies.