Binocular Approaches to Perceptual Learning in Adult Amblyopia

描述（由申请人提供）：拟定计划的目标是将Cristina莱雷纳Law博士培养为临床科学家和独立的患者研究人员，并开发和评估理论激励的成人弱视双眼治疗的价值。 在出生后的早期，眼睛视觉输入的不对称导致弱视，这是人类单眼视觉障碍的最常见基础。如果不矫正，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到功能性失明的程度。之前在成人弱视患者中恢复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（使双眼的神经元反应正常化）可能会增强学习效果（Hess et al，2010; Ding et al，2006）。使用混合对比度刺激的感知学习程序可能非常适合成人弱视的视觉训练，其中视皮层中突触可塑性的限制可能会阻止传统的单眼训练技术的有效性。 最近的工作已经建立了用于测量眼间对比度（ICR）的新方法，其在双眼视觉期间在双眼之间提供平衡的输入（Mandarin等人，2008; Huang等人，2009）。我们将评估这些已建立的方法的有效性，并设计我们自己的协议来测量这个参数。然后，我们将利用这种对称的感觉输入在成人弱视双眼训练使用新的和建立的知觉学习程序。我们相信，利用双眼和平等的感觉输入之间的技术可以提供增强的恢复成人弱视的视觉功能，这将有望新的非侵入性治疗成人弱视。 拟议的工作将利用脑磁图（MEG）来测量弱视眼的反应，并首次使用类似于以前使用VEP/EEG的刺激的双视混合时间频率刺激来测量双眼相互作用。 莱雷纳Law博士组建了一个由导师、合作者和顾问组成的团队，为她提供最好的工具，使她能够过渡到独立的基于患者的研究。这个团队也被理想地组装起来，为Law博士提供了测试这一假设的资源和技能，使用对视觉功能的全面分析，包括心理物理学和生理学，并在实验过程中的关键里程碑跟踪视觉功能的变化。 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，眼动控制障碍，以及创伤性脑损伤后最佳神经功能的恢复。

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.