The aim of this study is to develop a computer-aided diagnosis system to identify subjects at differing stages of development of multiple sclerosis (MS) using multifocal visual-evoked potentials (mfVEPs). Using an automatic classifier, diagnosis is performed first on the eyes and then on the subjects. MfVEP signals were obtained from patients with Radiologically Isolated Syndrome (RIS) (n = 30 eyes), patients with Clinically Isolated Syndrome (CIS) (n = 62 eyes), patients with definite MS (n = 56 eyes) and 22 control subjects (n = 44 eyes). The CIS and MS groups were divided into two subgroups: those with eyes affected by optic neuritis (ON) and those without (non-ON). For individual eye diagnosis, a feature vector was formed with information about the intensity, latency and singular values of the mfVEP signals. A flat multiclass classifier (FMC) and a hierarchical classifier (HC) were tested and both were implemented using the k-Nearest Neighbour (k-NN) algorithm. The output of the best eye classifier was used to classify the subjects. In the event of divergence, the eye with the best mfVEP recording was selected. In the eye classifier, the HC performed better than the FMC (accuracy = 0.74 and extended Matthew Correlation Coefficient (MCC) = 0.68). In the subject classification, accuracy = 0.95 and MCC = 0.93, confirming that it may be a promising tool for MS diagnosis. In addition to amplitude (axonal loss) and latency (demyelination), it has shown that the singular values of the mfVEP signals provide discriminatory information that may be used to identify subjects with differing degrees of the disease.

Las interfaces cerebro-computadora (BCIs) se han consolidado como una herramienta prometedora para la neurorrehabilitación. Entre los paradigmas de control más utilizados en este contexto se encuentra la imaginación motora, debido a su capacidad para activar áreas corticales relacionadas con el movimiento. No obstante, el entrenamiento previo del usuario y el coste asociado pueden dificultar su aplicación clínica. Con esto en mente, se ha desarrollado un sistema de bajo coste basado en un videojuego controlado por imaginación motora, diseñado para ser utilizado de forma autónoma en el hogar y así fomentar la participación activa en la rehabilitación. El sistema fue validado experimentalmente con dos sujetos de control: el primero alcanzó una exactitud media de 0.69~$\pm$0.04 y el segundo, de 0.80$\pm$~0.01. Ambos completaron con éxito las partidas, lo que sugiere que el uso del videojuego puede contribuir positivamente al proceso de rehabilitación, ofreciendo un apoyo accesible y motivador a las rutinas clínicas.

The objective of this study was to evaluate the efficacy of a novel digital platform (Visitrain VG, Alicante, Spain) as a visual rehabilitation tool for patients with convergence insufficiency (CI), in comparison with conventional in-office vision therapy (VT) supplemented with home reinforcement exercises. A retrospective comparative study was conducted comprising 33 patients diagnosed with CI, allocated into two groups: a digital group (DG; n = 16) receiving treatment with the aforementioned digital platform and a conventional group (CG; n = 17) undergoing conventional vision therapy. Binocular vision clinical parameters were assessed at baseline, one month, and three months of follow-up, including near point of convergence (NPC), positive fusional vergence (PFV), and binocular accommodative facility (BAF). Both groups demonstrated significant improvements following three months (p < 0.050). At the one-month evaluation, the CG showed a more rapid clinical response, with statistically significant between-group differences being observed in the NPC (p = 0.004) and near PFV (p = 0.040) compared with the DG. Nevertheless, at the three-month follow-up, no significant differences were found between the groups (p ≥ 0.060). The digital platform under investigation appears to constitute an effective therapeutic alternative to conventional vision therapy, albeit with a comparatively slower initial clinical response rate. It may be particularly indicated for patients requiring greater scheduling flexibility or those with limited access to in-office clinical care. Prospective controlled clinical trials are warranted to corroborate these preliminary outcomes.

Rationale and objectives: Parkinson’s disease (PD) significantly affects visual function, especially convergence and eye movements, impacting tasks such as reading. The objective was to investigate preliminarily the impact of the use of digital visual training in PD patients with associated convergence insufficiency (CI). Materials and methods: Pre–post pseudo-experimental pilot study to evaluate the impact of a novel digital therapy system (video game for use on a mobile phone or tablet) in 13 patients with PD and CI, with a mean age of 67 years. A comprehensive visual assessment was performed before and after a 6-week home-based visual rehabilitation, including measurement of near point of convergence (NPC), near positive fusional vergence (PFV), oculomotor tests (NSUCO and King-Devick tests), and symptom assessments with two validated questionnaires (CISS and SQVD). Results: Treatment adherence was variable, ranging from 0.8% to 124.7%. Despite this, significant improvements were found after therapy in break (p = 0.022) and recovery points of the NPC (p = 0.007), as well as break (p = 0.003) and recovery points in near PFV (p < 0.001). In the NSUCO test, the total score improved significantly from 23.9 ± 4.2 to 26.2 ± 3.7 after therapy (p = 0.003). Furthermore, a significant reduction in the total King-Devick test time was observed, decreasing from 79.4 ± 28.8 s to 69.0 ± 21.5 s with therapy (p = 0.034). Finally, symptom questionnaire scores also decreased significantly with therapy (CISS p = 0.037, SQVD p < 0.001). Conclusions: The digital vision therapy system evaluated seems to improve oculomotor control and reduce visual symptoms associated with CI in PD patients. Studies with larger sample sizes and a control group are needed to fully validate the therapeutic effectiveness of this tool.