Vision Improvement in Keratoconus Patients Trained with Perceptual Learning: A Randomized Controlled Trial.

BACKGROUND: Keratoconus (KC) is a corneal ectasia disease in which the vision of some patients cannot achieve satisfaction by spectacle corrections. However, not everyone can embrace contact lenses to achieve better vision. Perceptual learning (PL) is a potential treatment for vision improvement in such patients. PURPOSE: To investigate the effectiveness and maintenance of PL on vision improvement in KC patients corrected with spectacles. DESIGN: Randomized, double-blind clinical trial. PARTICIPANTS: Thirty-five non-progressive KC patients aged 9 years or older with unsatisfied spectacle-corrected vision were enrolled. METHODS: Non-progressive KC patients with best spectacle-corrected distance visual acuity (CDVA) of 0 to 1.0 logMAR (Snellen equivalent range 20/20 to 20/200) and contact lenses intolerant were enrolled. Eligible subjects were randomized into PL and control groups to receive PL and placebo training for 3 months, respectively. Spectacle-corrected visual acuity, contrast sensitivity function (CSF), stereoacuity, and visual functioning and quality of life questionnaires were measured at baseline, 3 months, and 6 months of follow-up. Statistics were analyzed following the intention-to-treat (ITT) principle. RESULTS: After 3 months of training, the CDVA of patients in the PL group improved as compared to the placebo group (0.17 ± 0.15 logMAR vs. 0.02 ± 0.06 logMAR; P = 0.0006). Eight out of seventeen (47.06 %) patients in the PL group reached CDVA improvement ≥ 2 lines (P=0.0010). This improvement persisted for at least 6 months (from baseline) as compared to the placebo group (0.17 ± 0.17 logMAR vs. 0.01 ± 0.07 logMAR; P = 0.0011). The increase of CSF in the PL group mainly was found for moderate spatial frequency (0.11 ± 0.17 log units at 3 cpd; 0.12 ± 0.19 log units at 6 cpd). Linear regression indicated that patients with worse initial CDVA achieved better gains in CDVA after PL (P = 0.009). No side effects were observed and no subjects quit because of training difficulties. CONCLUSION: Three-month perceptual learning improved vision in KC patients and the improvement maintained after 3 months of treatment cessation. The results indicate that perceptual learning may be a promising therapy for KC patients with unsatisfied spectacle-corrected visual acuity.

Crossmodal to unimodal transfer of temporal perceptual learning.

Subsecond temporal processing is crucial for activities requiring precise timing. Here, we investigated perceptual learning of crossmodal (auditory-visual or visual-auditory) temporal interval discrimination (TID) and its impacts on unimodal (visual or auditory) TID performance. The research purpose was to test whether learning is based on a more abstract and conceptual representation of subsecond time, which would predict crossmodal to unimodal learning transfer. The experiments revealed that learning to discriminate a 200-ms crossmodal temporal interval, defined by a pair of visual and auditory stimuli, significantly reduced crossmodal TID thresholds. Moreover, the crossmodal TID training also minimized unimodal TID thresholds with a pair of visual or auditory stimuli at the same interval, even if crossmodal TID thresholds are multiple times higher than unimodal TID thresholds. Subsequent training on unimodal TID failed to reduce unimodal TID thresholds further. These results indicate that learning of high-threshold crossmodal TID tasks can benefit low-threshold unimodal temporal processing, which may be achieved through training-induced improvement of a conceptual representation of subsecond time in the brain.

Adaptively triggered comparisons enhance perceptual category learning: evidence from face learning.

Categorical learning is important and often challenging in both specialized domains, such as medical image interpretation, and commonplace ones, such as face recognition. Research has shown that comparing items from different categories can enhance the learning of perceptual classifications, particularly when those categories appear highly similar. Here, we developed and tested novel adaptively triggered comparisons (ATCs), in which errors produced during interactive learning dynamically prompted the presentation of active comparison trials. In a facial identity paradigm, undergraduate participants learned to recognize and name varying views of 22 unknown people. In Experiment 1, single-item classification trials were compared to a condition in which ATC trials were generated whenever a participant repeatedly confused two faces. Comparison trials required discrimination between simultaneously presented exemplars from the confused categories. In Experiment 2, an ATC condition was compared to a non-adaptive comparison condition. Participants learned to accuracy and speed criteria, and completed immediate and delayed posttests. ATCs substantially enhanced learning efficiency in both experiments. These studies, using a novel adaptive procedure guided by each learner's performance, show that adaptively triggered comparisons improve category learning.

Hierarchical Bayesian Augmented Hebbian Reweighting Model of Perceptual Learning.

The Augmented Hebbian Reweighting Model (AHRM) has been effectively utilized to model the collective performance of observers in various perceptual learning studies. In this work, we have introduced a novel hierarchical Bayesian Augmented Hebbian Reweighting Model (HB-AHRM) to simultaneously model the learning curves of individual participants and the entire population within a single framework. We have compared its performance to that of a Bayesian Inference Procedure (BIP), which independently estimates the posterior distributions of model parameters for each individual subject without employing a hierarchical structure. To cope with the substantial computational demands, we developed an approach to approximate the likelihood function in the AHRM with feature engineering and linear regression, increasing the speed of the estimation procedure by 20,000 times. The HB-AHRM has enabled us to compute the joint posterior distribution of hyperparameters and parameters at the population, observer, and test levels, facilitating statistical inferences across these levels. While we have developed this methodology within the context of a single experiment, the HB-AHRM and the associated modeling techniques can be readily applied to analyze data from various perceptual learning experiments and provide predictions of human performance at both the population and individual levels. The likelihood approximation concept introduced in this study may have broader utility in fitting other stochastic models lacking analytic forms.

Distinct Neural Plasticity Enhancing Visual Perception.

The developed human brain shows remarkable plasticity following perceptual learning, resulting in improved visual sensitivity. However, such improvements commonly require extensive stimuli exposure. Here we show that efficiently enhancing visual perception with minimal stimuli exposure recruits distinct neural mechanisms relative to standard repetition-based learning. Participants (n = 20, 12 women, 8 men) encoded a visual discrimination task, followed by brief memory reactivations of only five trials each performed on separate days, demonstrating improvements comparable with standard repetition-based learning (n = 20, 12 women, 8 men). Reactivation-induced learning engaged increased bilateral intraparietal sulcus (IPS) activity relative to repetition-based learning. Complementary evidence for differential learning processes was further provided by temporal-parietal resting functional connectivity changes, which correlated with behavioral improvements. The results suggest that efficiently enhancing visual perception with minimal stimuli exposure recruits distinct neural processes, engaging higher-order control and attentional resources while leading to similar perceptual gains. These unique brain mechanisms underlying improved perceptual learning efficiency may have important implications for daily life and in clinical conditions requiring relearning following brain damage.

Visual Performance of Children with Amblyopia after 6 Weeks of Home-Based Dichoptic Visual Training.

OBJECTIVES: This study was aimed at analyzing the efficacy on the improvement of the visual function of a dichoptic online cloud-based platform for the treatment of amblyopia in anisometropic children. METHODS: A quasi-experimental (pretest-post-test) study was conducted in 23 subjects with ages from 5 to 15 years old with anisometropic amblyopia combined with additional presence (2 subjects) or not (21 subjects) of microtropia. A total of 30 home-based training sessions of 30 min per session with Bynocs® platform were prescribed for 6 weeks. RESULTS: Amblyopic eye logMAR visual acuity (VA) significantly improved from 0.28 ± 0.24 to 0.13 ± 0.20 after the 6-week treatment (p < 0.001). At baseline, 60.9% of participants had VA in amblyopic eye of 0.20 logMAR or worse, whereas this percentage decreased to 21.7% after treatment. Binocular function (BF) significantly improved from 2.82 ± 1.11 to 2.32 ± 0.94 (p < 0.001). Mean compliance was 92%, 87% and 93% at 2, 4 and 6 weeks of treatment, respectively. CONCLUSIONS: In conclusion, home-based dichoptic training with the digital platform evaluated is an effective method to improve amblyopic VA and stereoacuity in children with anisometropic amblyopia combined or not with microtropia.

Incidental Learning of Collocations Under Different Input Modes and the Mediating Role of Perceptual Learning Style.

This study investigated how input modes (reading vs. listening) and learners' perceptual learning style (visual vs. auditory) affected the incidental learning of collocations. A total of 182 college students were first assigned to either a visual or auditory group based on their performance on a perceptual learning style questionnaire. Each style group was subsequently subdivided into three groups who were exposed to a series of texts containing unfamiliar collocation items under one of the input conditions: written input, aural input, or no input. Results of the study indicated that both written and aural input led to gains in collocational knowledge, and aural input was more effective than written input. Furthermore, the study provided empirical evidence that there was a moderating role of perceptual learning style on incidental collocation learning. The auditory learners under aural input showed the highest rate of collocation learning among all treatment subgroups.

Glaucoma Rehabilitation using ElectricAI Transcranial Stimulation (GREAT)-study protocol for randomized controlled trial using combined perceptual learning and transcranial electrical stimulation for vision enhancement.

BACKGROUND: Glaucoma patients with irreversible visual field loss often experience decreased quality of life, impaired mobility, and mental health challenges. Perceptual learning (PL) and transcranial electrical stimulation (tES) have emerged as promising interventions for vision rehabilitation, showing potential in restoring residual visual functions. The Glaucoma Rehabilitation using ElectricAI Transcranial stimulation (GREAT) project aims to investigate whether combining PL and tES is more effective than using either method alone in maximizing the visual function of glaucoma patients. Additionally, the study will assess the impact of these interventions on brain neural activity, blood biomarkers, mobility, mental health, quality of life, and fear of falling. METHODS: The study employs a three-arm, double-blind, randomized, superiority-controlled design. Participants are randomly allocated in a 1:1:1 ratio to one of three groups receiving: (1) real PL and real tES, (2) real PL and sham tES, and (3) placebo PL and sham tES. Each participant undergoes 10 sessions per block (~ 1 h each), with a total of three blocks. Assessments are conducted at six time points: baseline, interim 1, interim 2, post-intervention, 1-month post-intervention, and 2-month post-intervention. The primary outcome is the mean deviation of the 24-2 visual field measured by the Humphrey visual field analyzer. Secondary outcomes include detection rate in the suprathreshold visual field, balance and gait functions, and electrophysiological and biological responses. This study also investigates changes in neurotransmitter metabolism, biomarkers, self-perceived quality of life, and psychological status before and after the intervention. DISCUSSION: The GREAT project is the first study to assess the effectiveness of PL and tES in the rehabilitation of glaucoma. Our findings will offer comprehensive assessments of the impact of these treatments on a wide range of brain and vision-related metrics including visual field, neural activity, biomarkers, mobility, mental health, fear of falling, and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT05874258 . Registered on May 15, 2023.

Transcranial direct current stimulation of the prefrontal and visual cortices diversely affects early and late perceptual learning.

BACKGROUND: Research has shown that visual perceptual learning (VPL) is related to modifying neural activity in higher level decision-making regions. However, the causal roles of the prefrontal and visual cortexes in VPL are still unclear. Here, we investigated how anodal transcranial direct current stimulation (tDCS) of the prefrontal and visual cortices modulates VPL in the early and later phases and the role of multiple brain regions. METHODS: Perceptual learning on the coherent motion direction identification task included early and later stages. After early training, participants needed to continuously train to reach a plateau; once the plateau was reached, participants entered a later stage. Sixty participants were randomly divided into five groups. Regardless of the training at the early and later stages, four groups received multitarget tDCS over the right dorsolateral prefrontal cortex (rDLPFC) and right middle temporal area (rMT), single-target tDCS over the rDLPFC, and single-target tDCS over the rMT or sham stimulation, and one group was stimulated at the ipsilateral brain region (i.e., left MT). RESULTS: Compared with sham stimulation, multitarget and two single-target tDCS over the rDLPFC or rMT improved posttest performance and accelerated learning during the early period. However, multitarget tDCS and two single-target tDCS led to equivalent benefits for VPL. Additionally, these beneficial effects were absent when anodal tDCS was applied to the ipsilateral brain region. For the later period, the above facilitating effects on VPL induced by multitarget or single-target tDCS disappeared. CONCLUSIONS: This study suggested the causal role of the prefrontal and visual cortices in visual motion perceptual learning by anodal tDCS but failed to find greater beneficial effects by simultaneously stimulating the prefrontal and visual cortices. Future research should investigate the functional associations between multiple brain regions to further promote VPL.

Influence of spatial orientation training in a centrifuge on the ability of fighter pilots to assess the bank angle during flight without visual references.

Without visual references, nonpilots exposed to coordinated flight turns underestimate the bank angle, because of discordant information of the roll-angular displacement from the otoliths, consistently signaling vertical position, versus the semicircular canals, enabling detection of the displacement. Pilots may also use their ability to perceive the G load and knowledge of the relation between load and angle to assess the bank angle. Our aim was to investigate whether the perception of bank angle can be improved by spatial orientation training in a centrifuge. Sixteen pilots/pilot students assessed their roll tilt, in complete darkness, during both real coordinated flight turns and gondola centrifugation, at roll tilts of 30° and 60°. The experiments were repeated after a 3-wk period, during which eight of the subjects performed nine training sessions in the centrifuge, comprising feedback on roll angle vs. G load, and on indicating requested angles. Before training, the subjects perceived in the aircraft and centrifuge, respectively: 37 (17)°, 38 (14)° during 60° turns and 19 (12)°, 20 (10)° during 30° turns. Training improved the perception of angle during the 60° [to 60 (7)°, 55 (10)°; P ≤ 0.04] but not the 30° [21 (10)°, 15 (9)°; P ≥ 0.30] turns; the improvement disappeared within 2 yr after training. Angle assessments did not change in the untrained group. The results suggest that it is possible to, in a centrifuge, train a pilot's ability to perceive large but not discrete-to-moderate roll-angular displacements. The transient training effect is attributable to improved capacity to perceive and translate G load into roll angle and/or to increased reliance on semicircular canal signals.NEW & NOTEWORTHY Spatial disorientation is a major problem in aviation. When performing coordinated flight turns without external visual cues (e.g., flying in clouds or darkness), the pilot underestimates the aircraft bank angle because the vestibular system provides unreliable information of roll tilt. The present study demonstrates that it is possible to, in a long-arm centrifuge, train a pilot's ability to perceive large but not discrete-to-moderate roll-angular displacements.

Enhancing Intraoperative Cholangiography Interpretation Skills: A Perceptual Learning Approach for Surgical Residents.

OBJECTIVE: Laparoscopic cholecystectomy is a commonly performed surgery with risk of serious complications. Intraoperative cholangiography (IOC) can mitigate these risks by clarifying the anatomy of the biliary tree and detecting common bile duct injuries. However, mastering IOC interpretation is largely through experience, and studies have shown that even expert surgeons often struggle with this skill. Since no formal curriculum exists for surgical residents to learn IOC interpretation, we developed a perceptual learning (PL)-based training module aimed at improving surgical residents' IOC interpretation skills. DESIGN: Surgical residents were assessed on their ability to identify IOC characteristics and provide clinical recommendations using an online training module based on PL principles. This research had 2 phases. The first phase involved pre/post assessments of residents trained via the online IOC interpretation module, measuring their IOC image recognition and clinical management accuracy (percentage of correct responses), response time and confidence. During the second phase, we explored the impact of combining simulator-based IOC training with the online interpretation module on same measures as used in the first phase (accuracy, response time, and confidence). SETTING: The study was conducted at Rush University Medical College in Chicago. The participants consisted of surgical residents from each postgraduate year (PGY). Residents participated in this study during their scheduled monthly rotation through Rush's surgical simulation center. RESULTS: Total 23 surgical residents participated in the first phase. A majority (95.7%) found the module helpful. Residents significantly increased confidence levels in various aspects of IOC interpretation, such as identifying complete IOCs and detecting abnormal findings. Their accuracy in making clinical management decisions significantly improved from pretraining (mean accuracy 68.1 +/- 17.3%) to post-training (mean accuracy 82.3 +/- 10.4%, p < 0.001). Furthermore, their response time per question decreased significantly from 25 +/- 12 seconds to 17 +/- 12 seconds (p < 0.001). In the second phase, we combined procedural simulator training with the online interpretation module. The 20, first year residents participated and 88% found the training helpful. The training group exhibited significant confidence improvements compared to the control group in various aspects of IOC interpretation with observed nonsignificant accuracy improvements related to clinical management questions. Both groups demonstrated reduced response times, with the training group showing a more substantial, though nonsignificant, reduction. CONCLUSION: This study demonstrated the effectiveness of a PL-based training module for improving aspects of surgical residents' IOC interpretation skills. The module, found helpful by a majority of participants, led to significant enhancements in clinical management accuracy, confidence levels, and decreased response time. Incorporating simulator-based training further reinforced these improvements, highlighting the potential of our approach to address the lack of formal curriculum for IOC interpretation in surgical education.

Non-symbolic estimation of big and small ratios with accurate and noisy feedback.

The ratio of two magnitudes can take one of two values depending on the order they are operated on: a 'big' ratio of the larger to smaller magnitude, or a 'small' ratio of the smaller to larger. Although big and small ratio scales have different metric properties and carry divergent predictions for perceptual comparison tasks, no psychophysical studies have directly compared them. Two experiments are reported in which subjects implicitly learned to compare pairs of brightnesses and line lengths by non-symbolic feedback based on the scaled big ratio, small ratio or difference of the magnitudes presented. Results of Experiment 1 showed all three operations were learned quickly and estimated with a high degree of accuracy that did not significantly differ across groups or between intensive and extensive modalities, though regressions on individual data suggested an overall predisposition towards differences. Experiment 2 tested whether subjects learned to estimate the operation trained or to associate stimulus pairs with correct responses. For each operation, Gaussian noise was added to the feedback that was constant for repetitions of each pair. For all subjects, coefficients for the added noise component were negative when entered in a regression model alongside the trained differences or ratios, and were statistically significant in 80% of individual cases. Thus, subjects learned to estimate the comparative operations and effectively ignored or suppressed the added noise. These results suggest the perceptual system is highly flexible in its capacity for non-symbolic computation, which may reflect a deeper connection between perceptual structure and mathematics.

Pretraining alpha rhythm enhancement by neurofeedback facilitates short-term perceptual learning and improves visual acuity by facilitated consolidation.

Introduction: Learning through perceptual training using the Gabor patch (GP) has attracted attention as a new vision restoration technique for myopia and age-related deterioration of visual acuity (VA). However, the task itself is monotonous and painful and requires numerous training sessions and some time before being effective, which has been a challenge for its widespread application. One effective means of facilitating perceptual learning is the empowerment of EEG alpha rhythm in the sensory cortex before neurofeedback (NF) training; however, there is a lack of evidence for VA. Methods: We investigated whether four 30-min sessions of GP training, conducted over 2 weeks with/without EEG NF to increase alpha power (NF and control group, respectively), can improve vision in myopic subjects. Contrast sensitivity (CS) and VA were measured before and after each GP training. Results: The NF group showed an improvement in CS at the fourth training session, not observed in the control group. In addition, VA improved only in the NF group at the third and fourth training sessions, this appears as a consolidation effect (maintenance of the previous training effect). Participants who produced stronger alpha power during the third training session showed greater VA recovery during the fourth training session. Discussion: These results indicate that enhanced pretraining alpha empowerment strengthens the subsequent consolidation of perceptual learning and that even a short period of GP training can have a positive effect on VA recovery. This simple protocol may facilitate use of a training method to easily recover vision.

Improving iconic memory through contrast detection training with HOA-corrected vision.

Iconic memory and short-term memory are not only crucial for perception and cognition, but also of great importance to mental health. Here, we first showed that both types of memory could be improved by improving limiting processes in visual processing through perceptual learning. Normal adults were trained in a contrast detection task for ten days, with their higher-order aberrations (HOA) corrected in real-time. We found that the training improved not only their contrast sensitivity function (CSF), but also their iconic memory and baseline information maintenance for short-term memory, and the relationship between memory and CSF improvements could be well-predicted by an observer model. These results suggest that training the limiting component of a cognitive task with visual perceptual learning could improve visual cognition. They may also provide an empirical foundation for new therapies to treat people with poor sensory memory.

Transfer of Tactile Learning to Untrained Body Parts: Emerging Cortical Mechanisms.

Pioneering investigations in the mid-19th century revealed that the perception of tactile cues presented to the surface of the skin improves with training, which is referred to as tactile learning. Surprisingly, tactile learning also occurs for body parts and skin locations that are not physically involved in the training. For example, after training of a finger, tactile learning transfers to adjacent untrained fingers. This suggests that the transfer of tactile learning follows a somatotopic pattern and involves brain regions such as the primary somatosensory cortex (S1), in which the trained and untrained body parts and skin locations are represented close to each other. However, other results showed that transfer occurs between body parts that are not represented close to each other in S1-for example, between the hand and the foot. These and similar findings have led to the suggestion of additional cortical mechanisms to explain the transfer of tactile learning. Here, different mechanisms are reviewed, and the extent to which they can explain the transfer of tactile learning is discussed. What all of these mechanisms have in common is that they assume a representational or functional relationship between the trained and untrained body parts and skin locations. However, none of these mechanisms alone can explain the complex pattern of transfer results, and it is likely that different mechanisms interact to enable transfer, perhaps in concert with higher somatosensory and decision-making areas.

Learning of the same task subserved by substantially different mechanisms between patients with body dysmorphic disorder and healthy individuals.

It has remained unclear whether individuals with psychiatric disorders involving altered visual processing employ similar neuronal mechanisms during perceptual learning of a visual task. We investigated this question by training patients with body dysmorphic disorder, a psychiatric disorder characterized by distressing or impairing preoccupation with nonexistent or slight defects in one's physical appearance, and healthy controls on a visual detection task for human faces with low spatial frequency components. Brain activation during task performance was measured with functional magnetic resonance imaging before the beginning and after the end of behavioral training. Both groups of participants improved performance on the trained task to a similar extent. However, neuronal changes in the fusiform face area were substantially different between groups such that activation for low spatial frequency faces in the right fusiform face area increased after training in body dysmorphic disorder patients but decreased in controls. Moreover, functional connectivity between left and right fusiform face area decreased after training in patients but increased in controls. Our results indicate that neuronal mechanisms involved in perceptual learning of a face detection task differ fundamentally between body dysmorphic disorder patients and controls. Such different neuronal mechanisms in body dysmorphic disorder patients might reflect the brain's adaptations to altered functions imposed by the psychiatric disorder.

Visual perceptual learning is enhanced by training in the illusory far space.

Visual objects in the peripersonal space (PPS) are perceived faster than farther ones appearing in the extrapersonal space (EPS). This shows preferential processing for visual stimuli near our body. Such an advantage should favour visual perceptual learning occurring near, as compared with far from observers, but opposite evidence has been recently provided from online testing protocols, showing larger perceptual learning in the far space. Here, we ran two laboratory-based experiments investigating whether visual training in PPS and EPS has different effects. We used the horizontal Ponzo Illusion to create a lateralized depth perspective while participants completed a visual search task in which they reported whether or not a specific target object orientation (e.g., a triangle pointing upwards) was present among distractors. This task was completed before and after a training phase in either the (illusory) near or far space for 1 h. In Experiment 1, the near space was in the left hemispace, whereas in Experiment 2, it was in the right. Results showed that, in both experiments, participants were more accurate after training in the far space, whereas training in the near space led to either improvement in the far space (Experiment 1), or no change (Experiment 2). Moreover, we found a larger visual perceptual learning when stimuli were presented in the left compared with the right hemispace. Differently from visual processing, visual perceptual learning is more effective in the far space. We propose that depth is a key dimension that can be used to improve human visual learning.

Digital therapeutics using virtual reality-based visual perceptual learning for visual field defects in stroke: A double-blind randomized trial.

INTRODUCTION: Visual field defects (VFDs) represent a debilitating poststroke complication, characterized by unseen parts of the visual field. Visual perceptual learning (VPL), involving repetitive visual training in blind visual fields, may effectively restore visual field sensitivity in cortical blindness. This current multicenter, double-blind, randomized, controlled clinical trial investigated the efficacy and safety of VPL-based digital therapeutics (Nunap Vision [NV]) for treating poststroke VFDs. METHODS: Stroke outpatients with VFDs (>6 months after stroke onset) were randomized into NV (defective field training) or Nunap Vision-Control (NV-C, central field training) groups. Both interventions provided visual perceptual training, consisting of orientation, rotation, and depth discrimination, through a virtual reality head-mounted display device 5 days a week for 12 weeks. The two groups received VFD assessments using Humphrey visual field (HVF) tests at baseline and 12-week follow-up. The final analysis included those completed the study (NV, n = 40; NV-C, n = 35). Efficacy measures included improved visual area (sensitivity ≥6 dB) and changes in the HVF scores during the 12-week period. RESULTS: With a high compliance rate, NV and NV-C training improved the visual areas in the defective hemifield (>72 degrees2) and the whole field (>108 degrees2), which are clinically meaningful improvements despite no significant between-group differences. According to within-group analyses, mean total deviation scores in the defective hemifield improved after NV training (p = .03) but not after NV-C training (p = .12). CONCLUSIONS: The current trial suggests that VPL-based digital therapeutics may induce clinically meaningful visual improvements in patients with poststroke VFDs. Yet, between-group differences in therapeutic efficacy were not found as NV-C training exhibited unexpected improvement comparable to NV training, possibly due to learning transfer effects.

Bias in perceptual learning.

Perceptual learning is commonly understood as conferring some benefit to the learner, such as allowing for the extraction of more information from the environment. However, perceptual learning can be biased in several different ways, some of which do not appear to provide such a benefit. Here we outline a systematic framework for thinking about bias in perceptual learning and discuss how several cases fit into this framework. We argue these biases are compatible with an understanding in which perceptual learning is beneficial, but that its benefits are tied to both a person's narrow interests and the training environment or domain, and so if there are changes to either of these, then benefits can turn into liabilities, though these are often temporary. This article is categorized under: Psychology > Learning Philosophy > Value Linguistics > Language Acquisition.

What do you learn from a single cue? Dimensional reweighting and cue reassociation from experience with a newly unreliable phonetic cue.

In language comprehension, we use perceptual cues to infer meanings. Some of these cues reside on perceptual dimensions. For example, the difference between bear and pear is cued by a difference in voice onset time (VOT), which is a continuous perceptual dimension. The present paper asks whether, and when, experience with a single value on a dimension behaving unexpectedly is used by the learner to reweight the whole dimension. We show that learners reweight the whole VOT dimension when exposed to a single VOT value (e.g., 45 ms) and provided with feedback indicating that the speaker intended to produce a /b/ 50% of the time and a /p/ the other 50% of the time. Importantly, dimensional reweighting occurs only if 1) the 50/50 feedback is unexpected for the VOT value, and 2) there is another dimension that is predictive of feedback. When no predictive dimension is available, listeners reassociate the experienced VOT value with the more surprising outcome but do not downweight the entire VOT dimension. These results provide support for perceptual representations of speech sounds that combine cues and dimensions, for viewing perceptual learning in speech as a combination of error-driven cue reassociation and dimensional reweighting, and for considering dimensional reweighting to be reallocation of attention that occurs only when there is evidence that reallocating attention would improve prediction accuracy (Harmon, Z., Idemaru, K., & Kapatsinski, V. 2019. Learning mechanisms in cue reweighting. Cognition, 189, 76-88.).