Integrating Perceptual Learning Approaches into Effective Therapies for Low Visio

在理解综合进程的复杂相互作用方面存在着根本性的差距， 决定、诱导和调节知觉系统的可塑性。这一差距代表了一个重要问题 因为我们只能对视觉系统的可塑性有一个破碎的理解， 不同的因素对学习起着促进作用，并在学习中相互作用。这限制了我们有效地翻译基础科学的能力 将知觉可塑性的发现转化为治疗方法，可以帮助全世界超过1亿患有 低视力;由于疾病、损伤、中风或衰老导致的视力缺陷， 涉及个人生活各个方面的条约。具体目标是填补知识空白，开发一种新的 一种整合并受益于多种感知学习原则的治疗方法，是由 假设将感知学习原则整合到一个协调的方法中，将通过 多种机制，以改善更广泛的视觉缺陷。我们提出这个假设的基础是 研究表明，刺激强化偶然性，多感官刺激，刺激方案， 从突触可塑性研究中得出的结论，多刺激训练和视频游戏都能增强 和学习质量。然而，现代感知学习研究的一个关键限制是对单一学习的关注。 更大的机制，未能阐明自然环境中多个学习因素的协调相互作用- tings.我们的初步数据表明，一个视频游戏，整合多种方法显着提高 基本视觉能力（例如，敏锐度和对比度），并推广到未经训练的刺激集。的理由 建议的研究是，综合方法将解开自然的学习机制，并改善了- 专门为视力低下的病人设计。在目标1中，我们将研究感知学习方法 相互作用，并确定最有效的综合治疗，在目标2中，我们将把这种治疗应用于低 视力，以了解治疗对影响眼优势的疾病机制的作用机制， 视网膜马赛克的空间畸变以及眼睛中像差的快速变化。我们已经做好充分准备， 进行拟议的研究，因为调查小组结合了经验丰富的视频游戏制作， 管理人员和开发人员与验光师和神经眼科医生谁有经验的治疗低- 视力人群。亚伦塞茨（PI），谁制定了许多原则，这部小说的综合 方法是基础，锚定团队。拟议的研究是创新的，因为它代表了一个新的， 通过整合感知学习的多种原则，从本质上脱离现状。这一控制-- 这是非常重要的，因为开发有效的治疗方法来治疗脑基础方面的低维生素C缺乏症。 锡永可以改变全世界数百万人的生活。我们建议的研究亦应 促进视觉研究领域的范式转变，并为设计有效的治疗方法铺平道路 弱视、老年性黄斑变性和白内障等低视力疾病。

There exists a fundamental gap in understanding of the complex interplay of the integrated processes that de- termine, induce and regulate plasticity in the perceptual systems. This gap represents an important problem because we can only have a fractured understanding of plasticity in the visual system without knowing how different factors contribute to and interact in learning. This limits our ability to effectively translate basic science findings of perceptual plasticity into therapies that could help the over 100 million people worldwide who suffer from low vision; deficits in vision due to disease, injury, stroke or aging that have significant negative im- pacts on all aspects of individuals' lives. The specific objective to fill the knowledge gap and develop a novel therapeutic approach that integrates, and benefits from, multiple perceptual-learning principles, is driven by the hypothesis that integrating perceptual-learning principles into a coordinated approach, will operate through multiple mechanisms to ameliorate a wider range of visual deficits. We formulated this hypothesis based on research showing that stimulus-reinforcement contingencies, multisensory stimulation, stimulation protocols derived from studies of synaptic plasticity, multi-stimulus training, and video games all enhance the magnitude and quality of learning. However, a key limitation of modern perceptual-learning research is the focus on singu- lar mechanisms, which fail to illuminate the coordinated interactions of multiple learning factors in natural set- tings. Our preliminary data show that a video game that integrates multiple approaches dramatically improves basic visual abilities (e.g., acuity and contrast), and generalizes to untrained stimulus sets. The rationale of the proposed research is that integrated approaches will unravel natural learning mechanisms and improve out- comes for the patients afflicted with low vision. In Aim 1, we will examine how perceptual learning approaches interact and determine the most efficacious integrated therapy, and in Aim 2, we will apply that therapy to low vision to understand mechanisms of action of the therapy to disease mechanisms affecting eye-dominance, spatial distortion to the retinal mosaic, and rapid change in aberrations in the eye. We are well prepared to undertake the proposed research because the investigative team combines veteran video game production executives and developers with an optometrist and a neuro-ophthalmologist who have experience treating low- vision populations. Aaron Seitz (PI), who developed many of the principles upon which this novel integrative approach is based, anchors the team. The proposed research is innovative because it represents a new and substantive departure from the status quo by integrating multiple principles of perceptual learning. This contri- bution is significant because the development of effective therapies to treat the brain-based aspect of low vi- sion can lead to life-altering benefits for many millions of people worldwide. Our proposed studies should also catalyze a paradigm shift in the field of vision research, and pave the way for designing efficacious treatments of low vision conditions like amblyopia, age-related macular degeneration and cataracts, in the future.