Effectiveness of tDCS in Paediatric Amblyopia.
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: tDCS.
- Who it may be relevant to
- Registry conditions: Amblyopia, Amblyopia Strabismic, Visual Acuity, Stereoscopic Vision. Basic parameters: 4 years — 14 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Spain
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Overview
The goal of this randomized, double-blind clinical trial is to determine whether transcranial direct current stimulation (tDCS) can effectively and safely improve vision in children aged 4-14 years with strabismic or anisometropic amblyopia that has not responded to conventional patching therapy. The main questions it aims to answer are: Does tDCS produce significant and sustained improvements in visual acuity, contrast sensitivity, and stereopsis in children with amblyopia? Is tDCS a safe, well-tolerated, and faster alternative or complementary treatment compared with standard occlusion therapy? Does tDCS induce functional and structural changes in the visual cortex associated with increased neuroplasticity, including modulation of GABAergic activity? If there is a comparison group: Researchers will compare active tDCS with sham (placebo) stimulation to see if active treatment leads to greater visual recovery and cortical changes than placebo. Participants will: Receive several sessions of active or sham tDCS using low-intensity electrical stimulation applied to visual brain areas. Undergo standard visual assessments, including visual acuity, contrast sensitivity, and stereopsis. Complete neurophysiological and neuroimaging evaluations (EEG, pattern visual evoked potentials, and functional MRI). Provide biochemical measures related to GABA levels. This study aims to validate tDCS as a non-invasive, child-friendly, and effective therapy that may overcome the limitations of patching and support its inclusion in paediatric clinical practice.
Detailed description
Amblyopia is a neurodevelopmental visual disorder characterised by reduced visual performance despite optimal optical correction and the absence of ocular pathology. It affects up to 2-4% of children and is the leading cause of visual impairment in this population. Conventional treatment involves optical correction and patching of the contralateral (non-amblyopic) eye, which usually produces limited improvement, low therapeutic compliance and frequent relapses, highlighting the need for new approaches based on neuroplasticity.
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique that can modify cortical excitability by regulating GABAergic inhibition in the primary visual cortex (V1). It has been safely used in children with attention deficit disorder, schizophrenia, epilepsy or cerebral palsy.
Preliminary data from our group show that after three sessions of tDCS on paediatric strabismic amblyopia, there are significant and sustained improvements in visual acuity, contrast sensitivity, and stereopsis at 3 months.
This project proposes a randomised, double-blind clinical trial to evaluate the efficacy, safety and optimal dosage regimen of tDCS in children aged 4 to 14 years with strabismic or anisometropic amblyopia classified as non-responsive to occlusion therapy, according to the criteria established by the Pediatric Eye Disease Investigation Group (PEDIG). Objective biomarkers will be included using electroencephalogram, visual evoked potentials (pattern) and functional magnetic resonance imaging to explore cortical functional and structural changes, together with biochemical assessment of GABA levels.
The expected outcome is to validate tDCS as an effective, rapid, and safe alternative or complementary therapy for amblyopia. Demonstrating sustained visual and cortical improvements would support its inclusion in paediatric clinical protocols and promote translational neuro-ophthalmological rehabilitation
Interventions
- Device tDCS
The direct current is gradually increased over 34 seconds until it reaches 2 mA, remains constant for 15 minutes, and then is gradually reduced to zero using NIC2® v2.1.2.0 software (Neuroelectrics®, Barcelona, Spain). The stimulating current is applied using two rubber electrodes housed in circular sponge pockets (8 cm² each) soaked in saline solution. The electrodes are placed at Oz (active/stimulating electrode, located in the visual cortex) and Cz (reference electrode). This includes a total
Primary outcome measures
- Visual Acuity [Time frame: 3 months]
- Stereoscopic visual acuity [Time frame: 3 months]
- Contrast sensitivity [Time frame: 3 months]
- Eye Fixation [Time frame: 3 months]
Eligibility criteria
Inclusion criteria
- Children aged 4-14 years.
- Strabismic amblyopia resistant to patching (PEDIG criteria).
- Anisometropic amblyopia resistant to patching (PEDIG criteria).
Exclusion criteria
- Ocular pathology.
- Nystagmus.
- Mental disability.
- Cognitive delay.
- Neurological problems incompatible with treatment.
- Pacemakers.
- Intracranial electrodes.
- Implanted defibrillators.
- Cranial pathologies.
- Cranial lesions.
- Withdrawal will occur upon adverse events, protocol deviation, refusal, or loss to follow-up.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Triple blind
- Primary purpose
- Treatment
Study locations
Spain · 1 center
- University of Murcia — Murcia
Identifiers
NCT: NCT07547670 · T-TDCS-PJY