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: 10559543
• 负责人: Peter John Bex
• 金额: $ 52.61万
• 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/10559543
• 关键词: 3-Dimensional; Address; Adult; Affect; Agreement; Amblyopia; Asthenopia; Attention; Basic Science; Behavior; Behavioral; Binocular Vision; Blindness; Clutterings; Complex; Custom; Data; Depth Perception; Development; Devices; Diplopia; Disease; Disparity; Education; Effectiveness; Environment; Esotropia; Evaluation; Exotropia; Eye; Eye Movements; Failure; Feedback; Foundations; Gait; Goals; Head; Head Movements; Health; Image; Impairment; Intervention; Laboratories; 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 System; Visual impairment; Walking; 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.

项目摘要 双眼视力依赖于共同构建A的感觉和运动融合机制之间的协同作用 从两个视网膜上形成的不同图像对环境的单一感知。立体感觉 准确的双眼眼动作需要环境的代表，这又需要 用于立体感官视觉。该系统的任何一个组件，尤其是在开发过程中的失败都可以 导致永久性双眼视力障碍。感觉障碍可能包括弱视，复视和 抑制，动眼障碍可能包括斜视和遗传不足，而社会经济 后遗症包括失去的教育，体育和工作机会以及升高的不良健康风险。电流 弱视治疗（遮挡和处罚）主要是单眼的，不会促进双目 感知或眼动协调。同样，斜视的治疗通常不会解决双目 洞察力。这些限制至少部分是由于缺乏评估的实际方法。 感觉运动功能，部分是由于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，甚至在感觉系统和运动系统中都有明显的可塑性。 现在，许多小组正在探索使用数字修改图像来促进感觉可塑性的方法 二分游戏和电影，但关注的关注程度要少得多。 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风险 可以通过有效监测的合并感觉运动治疗方法来实现效果 感觉运动端点。我们认为I）虚拟现实疗法的商业化步伐 Anisometropic amblyopia同时加强了对感觉和动眼缺陷的需求 斜视amblyopia和ii），手术干预后的高水平累犯可能会受益 合并的感觉运动康复。在AIM 1中，我们开发和评估有效的方法来测量感觉 双眼视力障碍者的运动不足，并为定量框架提供 基于证据的感觉运动疗法评估。在AIM 2中，我们测量了视野的影响 斜视在虚拟和自然环境的三维表示上，以了解如何 整个视野中自然发生的深度统计数据的分布可能会影响 双眼感觉和运动缺陷，并适应其对治疗的反应。在AIM 3中，我们发展并 评估旨在促进和维持眼对准并检查的基于反馈的方法 同时感觉和运动干预措施对双眼视觉功能的潜在优势。在每个目标中，我们 由于其高水平的控制以及自然和虚拟的3D场景，都采用了实验室刺激 因为它们的结构丰富，并且与现实世界的赤字相关。总体目标是证明 双眼视觉功能障碍的感觉和运动治疗方法结合的理论基础。