ARBi - Assessment and Rehabilitation of Binocular Sensorimotor Disorders

ARBi - 双眼感觉运动障碍的评估和康复

• 批准号: 10366392
• 负责人: MARTIN S BANKS
• 金额: $ 59.49万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-01 至 2026-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10366392
• 关键词: 3-Dimensional; Address; Adult; Affect; Amblyopia; Asthenopia; Attention; Basic Science; Behavior; Behavioral; Binocular Vision; Blindness; Clutterings; Complex; Custom; Data; Depth Perception; Development; Devices; Diplopia; Disease; Education; Effectiveness; Environment; Esotropia; Evaluation; Exotropia; Eye; Eye Movements; Failure; Feedback; Foundations; Gait; Goals; Head; Head Movements; Health; Image; Impairment; Intervention; Laboratories; Lead; Life; Maintenance; Measurement; Measures; Methodology; Methods; Monitor; Monocular Vision; Motor; Occupations; Operative Surgical Procedures; Outcome; Patients; Perception; Performance; Persons; Posture; Prevalence; Psychophysics; Public Health; Quality of life; Reading; Rehabilitation therapy; Research; Retina; Risk; Sensorimotor functions; Sensory; Sports; Stimulus; Stimulus Deprivation-Induced Amblyopia; Strabismus; Structure; Syndrome; System; Technology; Therapeutic; Time; Training; Translating; Vision; Visual; Visual Fields; Visual impairment; Visual system structure; Walking; base; clinical practice; commercialization; computer framework; critical period; digital; evidence base; gaze; grasp; improved; innovation; monocular; motor control; motor deficit; motor impairment; motor rehabilitation; movie; novel; oculomotor; oculomotor behavior; personalized medicine; preservation; prevent; recidivism; remediation; sample fixation; sensory input; sensory mechanism; sensory system; side effect; socioeconomics; standard care; statistics; stereoscopic; success; synergism; targeted treatment; treatment response; virtual; virtual reality; visual dysfunction; visual performance; visual tracking

PROJECT SUMMARY Binocular vision relies on a synergy between sensory and motor fusional mechanisms that jointly construct a single percept of the environment from the differing images formed on the two retinae. A stereoscopic sensory representation of the environment is required for accurate binocular eye movements, which in turn are required for stereoscopic sensory vision. A failure in either component of this system, especially during development, can lead to permanent binocular vision impairment. Sensory impairments can include amblyopia, diplopia and suppression, oculomotor impairments can include strabismus and vergence insufficiency, while socio-economic sequelae include lost education, sport and job opportunities and elevated adverse health risks. The current treatments for amblyopia (occlusion and penalization) are primarily monocular and do not promote binocular perception or eye movement coordination. Similarly, treatments for strabismus do not typically address binocular perception. These limitations are at least partly due to a lack of practical methodologies for the assessment of sensory-motor function and partly due to a lack of coordinated sensory-motor therapies. Recent data show that there is significant plasticity in both sensory systems and motor systems, even in adults. Many groups are now exploring methods to promote sensory plasticity with digitally modified images in dichoptic games and movies, but considerably less attention has been directed to motor plasticity or sensory and motor plasticity together. We hypothesize that additional therapeutic gains and a lower risk of adverse side effects may be achieved with a combined sensory-motor therapeutic approach that is monitored by effective sensory-motor endpoints. We argue i) that the pace of commercialization of virtual reality therapies for anisometropic amblyopia intensifies the need simultaneously to understand sensory and oculomotor deficits in strabismic amblyopia and ii) that the high levels of recidivism following surgical intervention may benefit from combined sensorimotor rehabilitation. In Aim 1, we develop and evaluate efficient methods to measure sensory and motor deficits in people with binocular vision impairment and to provide a quantitative framework for evidence-based assessment of sensory-motor therapy. In Aim 2, we measure the impact across the visual field of strabismus on the three-dimensional representation of virtual and natural environments to understand how the distribution of naturally occurring depth statistics across the visual field may impact the development of binocular sensory and motor deficits and moderate their response to treatment. In Aim 3, we develop and evaluate feedback-based methods that aim to facilitate and maintain ocular alignment and examine the potential benefit of simultaneous sensory and motor interventions for binocular visual function. In each Aim, we employ both laboratory stimuli, because of their high level of control, and natural and virtual 3D scenes, because of their rich structure and relevance to real-world deficits. The overall goal is to demonstrate the theoretical foundation for combined sensory and motor therapeutic approaches to binocular visual dysfunction.

项目概要 双目视觉依赖于感觉和运动融合机制之间的协同作用，共同构建一个 通过两个视网膜上形成的不同图像对环境进行单一感知。立体感 准确的双眼眼球运动需要对环境的表征，而双眼眼球运动又是必需的 用于立体感官视觉。该系统任何一个组件的故障，尤其是在开发过程中，都可能导致 导致永久性双眼视力损伤。感觉障碍包括弱视、复视和 抑制，动眼神经障碍可能包括斜视和聚散不足，而社会经济 后遗症包括失去教育、体育和工作机会以及增加不良健康风险。目前的 弱视的治疗（遮挡和惩罚）主要是单眼治疗，不提倡双眼治疗 感知或眼动协调。同样，斜视的治疗通常不能解决双眼问题 洞察力。这些限制至少部分是由于缺乏评估的实用方法 感觉运动功能，部分原因是缺乏协调的感觉运动疗法。 最近的数据表明，即使在成年人中，感觉系统和运动系统都具有显着的可塑性。 许多团体现在正在探索通过数字修改图像来促进感官可塑性的方法。 二视游戏和电影，但对运动可塑性或感觉的关注要少得多 和运动可塑性在一起。我们假设额外的治疗收益和较低的不良反应风险 可以通过联合感觉运动治疗方法来实现效果，该方法通过有效的监测 感觉运动终点。我们认为 i) 虚拟现实疗法商业化的步伐 屈光参差性弱视加强了同时了解感觉和动眼神经缺陷的需要 斜视性弱视和 ii) 手术干预后的高复发率可能受益 联合感觉运动康复。在目标 1 中，我们开发并评估测量感官的有效方法 和双眼视力障碍患者的运动缺陷，并提供一个定量框架 感觉运动疗法的循证评估。在目标 2 中，我们测量整个视野的影响 斜视对虚拟和自然环境的三维表示的影响，以了解如何 自然发生的深度统计在整个视野中的分布可能会影响 双眼感觉和运动缺陷并减轻他们对治疗的反应。在目标 3 中，我们开发并 评估旨在促进和维持眼部对准的基于反馈的方法，并检查 同时感觉和运动干预对双眼视觉功能的潜在益处。在每个目标中，我们 采用实验室刺激（由于其高水平的控制）以及自然和虚拟 3D 场景， 因为它们的丰富结构以及与现实世界赤字的相关性。总体目标是展示 双眼视觉功能障碍的感觉和运动联合治疗方法的理论基础。