Binocular Approaches to Perceptual Learning in Adult Amblyopia

成人弱视知觉学习的双眼方法

• 批准号: 8518341
• 负责人: Cristina Llerena Law
• 金额: $ 14.43万
• 依托单位: STATE COLLEGE OF OPTOMETRY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8518341
• 关键词: Address; Adult; Affect; Amblyopia; Animal Model; Anisometropia; Attention; Behavior Therapy; Binocular Vision; Blindness; Brain; Candy; Childhood; Clinical; Collaborations; Contrast Sensitivity; Crowding; Data; Depth Perception; Documentation; Effectiveness; Electroencephalography; Equilibrium; Equipment; Etiology; Eye; Eye Movements; Frequencies; Goals; Home environment; Human; Human Development; Infant; Institution; Knowledge; Laws; Lead; Learning; Life; Literature; Magnetoencephalography; Measures; Mentors; Methods; Monitor; Nature; Neurons; Neurophysiology - biologic function; New York City; Nursing Faculty; Optometrist; Patients; Perceptual learning; Physiology; Population; Positioning Attribute; Posture; Procedures; Process; Protocols documentation; Psychophysics; Recovery; Research; Research Personnel; Resources; Scientist; Sensory; Series; Signal Transduction; Site; Sorbus; Staging; Stimulus; Strabismus; Stress; Structure; Synaptic plasticity; Techniques; Testing; Time; Training; Training Programs; Training Technics; Traumatic Brain Injury; Treatment Protocols; Vision; Vision Disparity; Visual; Visual Acuity; Visual Cortex; Visual Pathways; Visual impairment; Visual system structure; Work; base; case-based; common treatment; design; disorder control; experience; improved; improved functioning; innovation; insight; monocular; patient population; postnatal; prevent; receptive field; relating to nervous system; research study; response; restoration; sample fixation; skills; stereoscopic; success; tool

DESCRIPTION (provided by applicant): The goals of the proposed plan are to train Dr. Cristina Llerena Law as a clinician scientist and independent patient based researcher and to develop and assess the value of theoretically motivated binocular treatments for amblyopia in adult humans. An asymmetry in the visual input across the eyes early in postnatal life causes amblyopia, the most common basis of monocular visual impairment in humans. If uncorrected, amblyopia results in the unaffected eye controlling the binocular visual cortex, while the ability f the affected eye to stimulate cortical neurons may weaken to the point of functional blindness. Previous attempts to recover vision in adult amblyopes have had limited success, and recent data suggest that binocular training techniques, which normalize neuronal responses across the two eyes, may enhance learning effects (Hess et al, 2010; Ding et al, 2006). The use of perceptual learning procedures with mixed-contrast stimuli may be ideally suited for vision training in adult amblyopes, where limitations in synaptic plasticity in visual cortex may prevent conventional monocular training techniques from being effective. Recent work has established new methods for measuring inter-ocular contrast ratios (ICR) that provide balanced inputs, between the two eyes, during binocular vision (Mansouri et al, 2008; Huang et al, 2009). We will assess the validity of these established methods and design our own protocols for measuring this parameter. We will then exploit this symmetric sensory input during binocular training in adult amblyopes using both new and established perceptual learning procedures. We believe that techniques which harness the use of binocularity and equal sensory input between the two eyes may provide enhanced recovery of visual function in adult amblyopes, which would promise new non-invasive treatments of adult amblyopia. The proposed work will make use of magnetoencephalography (MEG) both to measure responses from the amblyopic eye, and for the first time, to measure binocular interactions using dichoptic mixed temporal-frequency stimuli similar to stimuli used previously with VEP/EEG. Dr. Llerena Law has assembled a team of mentors, collaborators, and consultants to provide her with the best tools to make a transition into independent patient based research. This team has also been ideally assembled to provide Dr. Law with the resources and skills to test this hypothesis, using a comprehensive analysis of visual functions, including psychophysics and physiology, and to track changes in visual function at key milestones during the experiment. If successful, this work would transform therapy for adult amblyopia, and focus attention on the importance of incorporating methods to reduce suppression. In addition, the insight gained from this work could be extended to strabismus, eye movement control disorders, and the restoration of optimal neural function after damage from traumatic brain injury.

描述（由申请人提供）：拟议计划的目标是将 Cristina Llerena Law 博士培训为临床科学家和独立的患者研究人员，并开发和评估基于理论的双眼治疗成人弱视的价值。 出生后早期眼睛视觉输入的不对称会导致弱视，这是人类单眼视力障碍的最常见原因。如果不加以矫正，弱视会导致未受影响的眼睛控制双眼视觉皮层，而受影响的眼睛刺激皮层神经元的能力可能会减弱至功能性失明的程度。以前恢复成人弱视患者视力的尝试取得了有限的成功，最近的数据表明，双眼训练技术可以使两只眼睛的神经元反应正常化，可以增强学习效果（Hess 等人，2010 年；Ding 等人，2006 年）。使用混合对比刺激的感知学习程序可能非常适合成人弱视患者的视觉训练，其中视觉皮层突触可塑性的限制可能会妨碍传统的单眼训练技术的有效性。 最近的工作建立了测量眼间对比度（ICR）的新方法，该方法在双眼视觉期间提供两只眼睛之间的平衡输入（Mansouri 等人，2008；Huang 等人，2009）。我们将评估这些已建立方法的有效性，并设计我们自己的协议来测量该参数。然后，我们将使用新的和已建立的感知学习程序，在成人弱视患者的双眼训练过程中利用这种对称的感觉输入。我们相信，利用双眼和两眼之间相同的感觉输入的技术可以促进成人弱视视觉功能的恢复，这将有望为成人弱视提供新的非侵入性治疗。 拟议的工作将利用脑磁图 (MEG) 来测量弱视眼的反应，并首次使用类似于之前 VEP/EEG 使用的刺激的二眼混合时频刺激来测量双眼相互作用。 Llerena Law 博士组建了一个由导师、合作者和顾问组成的团队，为她提供最佳工具，帮助她过渡到基于患者的独立研究。该团队的组建也非常理想，可以为劳博士提供资源和技能来检验这一假设，对视觉功能（包括心理物理学和生理学）进行全面分析，并跟踪实验过程中关键里程碑的视觉功能变化。 如果成功，这项工作将改变成人弱视的治疗方法，并将注意力集中在采用减少抑制的方法的重要性上。此外，从这项工作中获得的见解可以扩展到斜视、眼球运动控制障碍以及脑外伤损伤后最佳神经功能的恢复。