Benjamin Thompson

Sun Yat-Sen University, Guangzhou, Guangdong Sheng, China

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Publications (67)189.17 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Occlusion therapy for amblyopia is predicated on the idea that amblyopia is primarily a disorder of monocular vision; however, there is growing evidence that patients with amblyopia have a structurally intact binocular visual system that is rendered functionally monocular due to suppression. Furthermore, we have found that a dichoptic treatment intervention designed to directly target suppression can result in clinically significant improvement in both binocular and monocular visual function in adult patients with amblyopia. The fact that monocular improvement occurs in the absence of any fellow eye occlusion suggests that amblyopia is, in part, due to chronic suppression. Previously the treatment has been administered as a psychophysical task and more recently as a video game that can be played on video goggles or an iPod device equipped with a lenticular screen. The aim of this case-series study of 14 amblyopes (six strabismics, six anisometropes and two mixed) ages 13 to 50 years was to investigate: 1. whether the portable video game treatment is suitable for at-home use and 2. whether an anaglyphic version of the iPod-based video game, which is more convenient for at-home use, has comparable effects to the lenticular version.
    Clinical and Experimental Optometry 08/2014; · 0.92 Impact Factor
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    ABSTRACT: ABSTRACT BODY: Purpose: The selective serotonin reuptake inhibitor (SSRI) fluoxetine has been shown to significantly enhance visual cortex plasticity in adult animals. This effect was blocked by administration of a benzodiazepine. The aim of this study was to assess whether fluoxetine would enhance visual perceptual learning in healthy adults and whether the benzodiazepine Lorazepam would reverse this effect. Methods: 20 male participants were randomized to a 3 week course of fluoxetine (20mg per day) or placebo. Psychometric functions of performance on a motion direction discrimination task were measured for two different motion directions at baseline and at weekly intervals for 4 weeks after the first drug dose. Transcranial magnetic stimulation was also used to measure phosphene thresholds, an index of visual cortex excitability, at weekly intervals. During the final 5 days of drug administration, participants were trained extensively on the motion discrimination task at a fixed motion direction. Psychometric functions were re-measured the day after training and the following day 2 hours after a single dose of Lorazepam (0.0625 mg). A final set of measurements were made one week after training. Results: There were no significant differences between the placebo and fluoxetine groups in the amount of perceptual learning, the rate of learning or the transfer of learning to the untrained motion direction. However fluoxetine did tend to reduce phosphene thresholds. Lorazepam significantly impaired task performance for the untrained motion direction but not the trained motion direction (F = 3.3, p = 0.04). Conclusions: Fluoxetine did not enhance perceptual learning; however the fluoxetine group did show a tendency for increased visual cortex excitability. Learning due to transfer was vulnerable to Lorazepam whereas learning due to training was not. This suggests the existence of separate neural mechanisms for learning and transfer within perceptual learning paradigms.
    The Association for Research in Vision and Opthalmology, Orlando, Florida, USA; 05/2014
  • Robert F Hess, Benjamin Thompson, Daniel H Baker
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    ABSTRACT: The amblyopic visual system was once considered to be structurally monocular. However, it now evident that the capacity for binocular vision is present in many observers with amblyopia. This has led to new techniques for quantifying suppression that have provided insights into the relationship between suppression and the monocular and binocular visual deficits experienced by amblyopes. Furthermore, new treatments are emerging that directly target suppressive interactions within the visual cortex and, on the basis of initial data, appear to improve both binocular and monocular visual function, even in adults with amblyopia. The aim of this review is to provide an overview of recent studies that have investigated the structure, measurement and treatment of binocular vision in observers with strabismic, anisometropic and mixed amblyopia.
    Ophthalmic and Physiological Optics 03/2014; 34(2):146-62. · 1.74 Impact Factor
  • Jinrong Li, Minbin Yu, Robert F Hess, Lily Y Chan, Benjamin S Thompson
    Ophthalmology 01/2014; · 5.56 Impact Factor
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    ABSTRACT: Purpose: To develop and validate a technique for measuring global motion perception in 2-year-old children and assess the relationship between global motion perception and other measures of visual function. Methods: Random-dot-kinematogram stimuli were used to measure motion coherence thresholds in 366 children at risk of neurodevelopmental problems at 24±1 months of age. RDKs of variable coherence were presented and eye movements were analysed offline to grade the direction of the optokinetic reflex (OKR) for each trial. Motion coherence thresholds were calculated by fitting psychometric functions to the resulting datasets. Test-retest reliability was assessed in 15 children and motion coherence thresholds were measured in a group of 10 adults using both OKR and behavioural responses. Standard age appropriate optometry tests were also performed. Results: Motion coherence thresholds were successfully measured in 336 (91.8%) children using the OKR technique but only 31 (8.5%) using behavioural responses. The mean threshold was 41.7±13.5% for 2-year-old children and 3.3±1.2% for adults. Within-assessor reliability and test-retest reliability were high in children. Children's motion coherence thresholds were significantly correlated with stereoacuity (LANG stereotest I and II; rho=0.29, p<0.001, Frisby; rho=0.17, p=0.022) but not with binocular visual acuity (rho=0.11, p=0.07). In adults OKR and behavioural motion coherence thresholds were highly correlated (intraclass correlation = 0.81, p=0.001). Conclusions: Global motion perception can be measured in 2-year-old children using the OKR. This technique is reliable and data from adults suggest that motion coherence thresholds based on the OKR are related to motion perception. Global motion perception was related to stereoacuity in children.
    Investigative ophthalmology & visual science 11/2013; · 3.43 Impact Factor
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    Jiawei Zhou, Benjamin Thompson, Robert F Hess
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    ABSTRACT: Amblyopia is a neurological disorder of binocular vision affecting up to 3% of the population resulting from a disrupted period of early visual development. Recently, it has been shown that vision can be partially restored by intensive monocular or dichoptic training (4-6 weeks). This can occur even in adults owing to a residual degree of brain plasticity initiated by repetitive and successive sensory stimulation. Here we show that the binocular imbalance that characterizes amblyopia can be reduced by occluding the amblyopic eye with a translucent patch for as little as 2.5 hours, suggesting a degree of rapid binocular plasticity in adults resulting from a lack of sensory stimulation. The integrated binocular benefit is larger in our amblyopic group than in our normal control group. We propose that this rapid improvement in function, as a result of reduced sensory stimulation, represents a new form of plasticity operating at a binocular site.
    Scientific Reports 09/2013; 3:2638. · 5.08 Impact Factor
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    ABSTRACT: Purpose. Evidence is accumulating that suppression may be the cause of amblyopia rather than a secondary consequence of mismatched retinal images. For example, treatment interventions that target suppression may lead to better binocular and monocular outcomes. Furthermore, it has recently been demonstrated that the measurement of suppression may have prognostic value for patching therapy. For these reasons, the measurement of suppression in the clinic needs to be improved beyond the methods that are currently available, which provide a binary outcome. Method. We describe a novel quantitative method for measuring the regional extent of suppression that is suitable for clinical use. The method involves a dichoptic perceptual matching procedure at multiple visual field locations. We compare a group of normal controls (mean age 28±5yrs), a group with strabismic amblyopia (4 with micro-esotropia, 5 with esotropia and 1 with exotropia, mean age 35±10yrs), and a group with non-strabismic anisometropic amblyopia (mean age 33yrs±12yrs). Results. The extent and magnitude of suppression was similar for observers with strabismic and non-strabimsmic amblyopia. Suppression was strongest within the central field and extended throughout the 20° field that we measured. Conclusion. Suppression extends throughout the central visual field in both strabismic and anisometropic forms of amblyopia. The strongest suppression occurs within the region of the visual field corresponding to the fovea of the fixing eye.
    Investigative ophthalmology & visual science 09/2013; · 3.43 Impact Factor
  • Nicola S Anstice, Benjamin Thompson
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    ABSTRACT: Over the past decade, a number of large clinical trials have provided important information relating to the reliability and repeatability of commonly used paediatric tests of vision and their role in the diagnosis and management of paediatric ocular diseases. The aim of this review is to summarise recent findings on the use of paediatric visual acuity tests in clinical practice and to discuss the validity and accuracy of visual acuity measurements in infants and young children. We provide a broad overview of the benefits and challenges of measuring visual acuity in children and then discuss age-appropriate tests for measuring visual acuity in infants through to school-age children. We also discuss normative values for visual acuity in each age group and, where possible, provide comparisons of results between tests with a particular focus on the importance of optotype design.
    Clinical and Experimental Optometry 07/2013; · 0.92 Impact Factor
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    ABSTRACT: Amblyopia is a neurodevelopmental disorder of vision caused by abnormal visual experience during early childhood that is often considered to be untreatable in adulthood. Recently, it has been shown that a novel dichoptic videogame-based treatment for amblyopia can improve visual function in adult patients, at least in part, by reducing inhibition of inputs from the amblyopic eye to the visual cortex. Non-invasive anodal transcranial direct current stimulation has been shown to reduce the activity of inhibitory cortical interneurons when applied to the primary motor or visual cortex. In this double-blind, sham-controlled cross-over study we tested the hypothesis that anodal transcranial direct current stimulation of the visual cortex would enhance the therapeutic effects of dichoptic videogame-based treatment. A homogeneous group of 16 young adults (mean age 22.1 ± 1.1 years) with amblyopia were studied to compare the effect of dichoptic treatment alone and dichoptic treatment combined with visual cortex direct current stimulation on measures of binocular (stereopsis) and monocular (visual acuity) visual function. The combined treatment led to greater improvements in stereoacuity than dichoptic treatment alone, indicating that direct current stimulation of the visual cortex boosts the efficacy of dichoptic videogame-based treatment. This intervention warrants further evaluation as a novel therapeutic approach for adults with amblyopia.
    Journal of the American Society for Experimental NeuroTherapeutics 07/2013; · 5.38 Impact Factor
  • Child Vision Research Society, Waterloo, Canada; 06/2013
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    ABSTRACT: BACKGROUND: . Amblyopia is a neurodevelopmental disorder of vision that is associated with abnormal patterns of neural inhibition within the visual cortex. This disorder is often considered to be untreatable in adulthood because of insufficient visual cortex plasticity. There is increasing evidence that interventions that target inhibitory interactions within the visual cortex, including certain types of noninvasive brain stimulation, can improve visual function in adults with amblyopia. OBJECTIVE: . We tested the hypothesis that anodal transcranial direct current stimulation (a-tDCS) would improve visual function in adults with amblyopia by enhancing the neural response to inputs from the amblyopic eye. METHODS: . Thirteen adults with amblyopia participated and contrast sensitivity in the amblyopic and fellow fixing eye was assessed before, during and after a-tDCS or cathodal tDCS (c-tDCS). Five participants also completed a functional magnetic resonance imaging (fMRI) study designed to investigate the effect of a-tDCS on the blood oxygen level-dependent response within the visual cortex to inputs from the amblyopic versus the fellow fixing eye. RESULTS: . A subgroup of 8/13 participants showed a transient improvement in amblyopic eye contrast sensitivity for at least 30 minutes after a-tDCS. fMRI measurements indicated that the characteristic cortical response asymmetry in amblyopes, which favors the fellow eye, was reduced by a-tDCS. CONCLUSIONS: . These preliminary results suggest that a-tDCS deserves further investigation as a potential tool to enhance amblyopia treatment outcomes in adults.
    Neurorehabilitation and neural repair 06/2013; · 4.28 Impact Factor
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    ABSTRACT: Purpose:Global motion perception is thought to be particularly susceptible to atypical development and therefore may provide a sensitive measure of neurological function in young children. The aim of this study was to assess global motion perception in a cohort of two-year old children born at risk of neonatal hypoglycaemia by utilizing the optokinetic reflex. Methods:Random-dot-kinetogram stimuli (250 dots, dot speed 8°/sec) were used to measure motion coherence thresholds in 275 children born with risk factors for neonatal hypoglycaemia including; small or large for gestational age, child of a diabetic mother and pre-term delivery (35 weeks gestation). Data were also collected from 11 adult volunteers. Motion coherence was varied using the method of constant stimuli and detection of global motion was determined by observing the optokinetic reflex (OKR), and also behavioural responses in adults. Standard age-appropriate optometry tests were also performed. Results:Motion coherence thresholds were successfully measured in 261 (95%) children, which compared favourably with success rates for standard age-appropriate clinical tests (such as Cardiff cards, LANG I&II stereo test, Frisby stereo test). As expected, motion coherence thresholds were higher for 2-year old children (mean 42.0±13%) than for adults (mean (3.2± 1%), and were in good agreement with previous studies on global motion perception infants and older children. Motion coherence thresholds were significantly correlated with stereoacuity (R=0.22, p=0.002) in children. In addition, motion coherence thresholds assessed using OKR were significantly correlated with behavioural thresholds in adults (R = 0.67, p = 0.047), suggesting that OKR is indicative of perceived global motion. Conclusions:Motion coherence thresholds measured using OKR eye movements reflect behavioural responses in adults. This method can be applied to two-year old children born at risk of abnormal neurodevelopment.
    ARVO 2013, Seattle, USA; 06/2013
  • Simon Clavagnier, Benjamin Thompson, Robert F Hess
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    ABSTRACT: BACKGROUND: It has been reported that a single session of 1 Hz or 10 Hz repetitive transcranial magnetic stimulation (rTMS) of the visual cortex can temporarily improve contrast sensitivity in adults with amblyopia. More recently, continuous theta burst stimulation (cTBS) of the visual cortex has been found to improve contrast sensitivity in observers with normal vision. OBJECTIVE/HYPOTHESIS: The aims of this study were to assess whether cTBS of the visual cortex could improve contrast sensitivity in adults with amblyopia and whether repeated sessions of cTBS would lead to more pronounced and/or longer lasting effects. METHODS: cTBS was delivered to the visual cortex while patients viewed a high contrast stimulus with their non-amblyopic eye. This manipulation was designed to bias the effects of cTBS toward inputs from the amblyopic eye. Contrast sensitivity was measured before and after stimulation. The effects of one cTBS session were measured in five patients and the effects of five consecutive daily sessions were measured in four patients. Three patients were available for follow-up at varying intervals after the final session. RESULTS: cTBS improved amblyopic eye contrast sensitivity to high spatial frequencies (P < 0.05) and there was a cumulative improvement across sessions with asymptotic improvement occurring after 2 daily sessions of stimulation. The contrast sensitivity improvements were stable over a period of up to 78 days. CONCLUSIONS: These initial results in a small number of patients indicate the cTBS may allow for enduring visual function improvements in adults with amblyopia.
    Brain Stimulation 04/2013; · 4.54 Impact Factor
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    ABSTRACT: OBJECTIVE: The aims of this study were to assess (1) the relationship between interocular suppression and visual function in patients with anisometropic amblyopia, (2) whether suppression can be simulated in matched controls using monocular defocus or neutral density filters, (3) the effects of spectacle or rigid gas-permeable contact lens correction on suppression in patients with anisometropic amblyopia, and (4) the relationship between interocular suppression and outcomes of occlusion therapy. DESIGN: Case-control study (aims 1-3) and cohort study (aim 4). PARTICIPANTS: Forty-five participants with anisometropic amblyopia and 45 matched controls (mean age, 8.8 years for both groups). METHODS: Interocular suppression was assessed using Bagolini striated lenses, neutral density filters, and an objective psychophysical technique that measures the amount of contrast imbalance between the 2 eyes that is required to overcome suppression (dichoptic motion coherence thresholds). Visual acuity was assessed using a logarithm minimum angle of resolution tumbling E chart and stereopsis using the Randot preschool test. MAIN OUTCOME MEASURES: Interocular suppression assessed using dichoptic motion coherence thresholds. RESULTS: Patients exhibited significantly stronger suppression than controls, and stronger suppression was correlated significantly with poorer visual acuity in amblyopic eyes. Reducing monocular acuity in controls to match that of cases using neutral density filters (luminance reduction) resulted in levels of interocular suppression comparable with that in patients. This was not the case for monocular defocus (optical blur). Rigid gas-permeable contact lens correction resulted in less suppression than spectacle correction, and stronger suppression was associated with poorer outcomes after occlusion therapy. CONCLUSIONS: Interocular suppression plays a key role in the visual deficits associated with anisometropic amblyopia and can be simulated in controls by inducing a luminance difference between the eyes. Accurate quantification of suppression using the dichoptic motion coherence threshold technique may provide useful information for the management and treatment of anisometropic amblyopia. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.
    Ophthalmology 04/2013; · 5.56 Impact Factor
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    ABSTRACT: Adults with amblyopia, a common visual cortex disorder caused primarily by binocular disruption during an early critical period, do not respond to conventional therapy involving occlusion of one eye [1]. But it is now clear that the adult human visual cortex has a significant degree of plasticity [2], suggesting that something must be actively preventing the adult brain from learning to see through the amblyopic eye. One possibility is an inhibitory signal from the contralateral eye that suppresses cortical inputs from the amblyopic eye [3,4]. Such a gating mechanism could explain the apparent lack of plasticity within the adult amblyopic visual cortex [5,6]. Here we provide direct evidence that alleviating suppression of the amblyopic eye through dichoptic stimulus presentation induces greater levels of plasticity than forced use of the amblyopic eye alone. This indicates that suppression is a key gating mechanism that prevents the amblyopic brain from learning to see.
    Current biology: CB 04/2013; 23(8):R308-9. · 10.99 Impact Factor
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    ABSTRACT: This study examined the effects of visual cortex transcranial direct current stimulation (tDCS) on visual processing and learning. Participants performed a contrast detection task on two consecutive days. Each session consisted of a baseline measurement followed by measurements made during active or sham stimulation. On the first day, one group received anodal stimulation to primary visual cortex (V1), while another received cathodal stimulation. Stimulation polarity was reversed for these groups on the second day. The third (control) group of subjects received sham stimulation on both days. No improvements or decrements in contrast sensitivity relative to the same-day baseline were observed during real tDCS, nor was any within-session learning trend observed. However, task performance improved significantly from Day 1 to Day 2 for the participants who received cathodal tDCS on Day 1 and for the sham group. No such improvement was found for the participants who received anodal stimulation on Day 1, indicating that anodal tDCS blocked overnight consolidation of visual learning, perhaps through engagement of inhibitory homeostatic plasticity mechanisms or alteration of the signal-to-noise ratio within stimulated cortex. These results show that applying tDCS to the visual cortex can modify consolidation of visual learning.
    Neuropsychologia 04/2013; · 3.48 Impact Factor
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    Robert F Hess, Benjamin Thompson
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    ABSTRACT: The current approach to the treatment of amblyopia is problematic for a number of reasons. First, it promotes recovery of monocular vision but because it is not designed to promote binocularity, its binocular outcomes often are disappointing. Second, compliance is poor and variable. Third, the effectiveness of the treatment is thought to decrease with increasing age. We discuss 2 new approaches aimed at recovering visual function in adults with amblyopia. The first is a binocular approach to amblyopia treatment that is showing promise in initial clinical studies. The second is still in development and involves the use of well-established noninvasive brain stimulation techniques to temporarily alter the balance of excitation and inhibition in the visual cortex.
    Journal of AAPOS: the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus 01/2013; · 1.07 Impact Factor
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    ABSTRACT: PURPOSE: We have recently described a rapid technique for measuring suppression using a dichoptic signal/noise task. Here, we report a modification of this technique that allows for accurate measurements to be made in amblyopic patients with high levels of anisometropia. This was necessary because aniseikonic image size differences between the two eyes can provide a cue for signal/noise segregation and, therefore, influence suppression measurement in these patients. METHODS: Suppression was measured using our original technique and with a modified technique whereby the size of the signal and noise elements was randomized across the stimulus to eliminate size differences as a cue for task performance. Eleven patients with anisometropic amblyopia, five with more than 5 diopters (D) spherical equivalent difference (SED), six with less than 5 D SED between the eyes, and 10 control observers completed suppression measurements using both techniques. RESULTS: Suppression measurements in controls and patients with less than 5 D SED were constant across the two techniques; however, patients with more than 5 D SED showed significantly stronger suppression on the modified technique with randomized element size. Measurements made with the modified technique correlated with the loss of visual acuity in the amblyopic eye and were in good agreement with previous reports using detailed psychophysical measurements. CONCLUSIONS: The signal/noise technique for measuring suppression can be applied to patients with high levels of anisometropia and aniseikonia if element size is randomized. In addition, deeper suppression is associated with a greater loss of visual acuity in patients with anisometropic amblyopia.
    Optometry and vision science: official publication of the American Academy of Optometry 01/2013; · 1.53 Impact Factor
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    ABSTRACT: Visual acuity is a common measurement in general practice, and the advent of new technology such as tablet computers offers a change in the way in which these tests are delivered. The aim of this study was to assess whether measurements of distance visual acuity using LogMAR letter charts displayed on an iPad tablet computer were in agreement with standard clinical tests of visual acuity in adults with normal vision. Blinded, diagnostic test study. Single centre (University) in Auckland, New Zealand. University staff and students (n=85). Participants were required to have visual acuity better than 6/60 and wear habitual refractive correction during testing. Participants were excluded if there was any history of ocular pathology. Visual acuity measured under a number of conditions. The iPad tablet with its glossy screen was highly susceptible to glare resulting in acuity measurements that were significantly poorer (approximately 2 LogMAR lines) than those made using an ETDRS chart and a standard computerised testing system (n=56). However, fitting the iPad with an antiglare screen and positioning the device away from sources creating reflected (veiling) glare resulted in acuity measurements that were equivalent those made using gold standard charts (n=29). Tablet computers are an attractive option for visual acuity measurement due to portability, the ability to randomise letters, automated scoring of acuity and the ability to select from a range of charts. However, these devices are only suitable for use in situations where sources of glare can be eliminated.
    BMJ Open 01/2013; 3(6). · 1.58 Impact Factor
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    Benjamin Thompson, Bosco S Tjan, Zili Liu
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    ABSTRACT: The middle temporal area of the extrastriate visual cortex (area MT) is integral to motion perception and is thought to play a key role in the perceptual learning of motion tasks. We have previously found, however, that perceptual learning of a motion discrimination task is possible even when the training stimulus contains locally balanced, motion opponent signals that putatively suppress the response of MT. Assuming at least partial suppression of MT, possible explanations for this learning are that 1) training made MT more responsive by reducing motion opponency, 2) MT remained suppressed and alternative visual areas such as V1 enabled learning and/or 3) suppression of MT increased with training, possibly to reduce noise. Here we used fMRI to test these possibilities. We first confirmed that the motion opponent stimulus did indeed suppress the BOLD response within hMT+ compared to an almost identical stimulus without locally balanced motion signals. We then trained participants on motion opponent or non-opponent stimuli. Training with the motion opponent stimulus reduced the BOLD response within hMT+ and greater reductions in BOLD response were correlated with greater amounts of learning. The opposite relationship between BOLD and behaviour was found at V1 for the group trained on the motion-opponent stimulus and at both V1 and hMT+ for the group trained on the non-opponent motion stimulus. As the average response of many cells within MT to motion opponent stimuli is the same as their response to non-directional flickering noise, the reduced activation of hMT+ after training may reflect noise reduction.
    PLoS ONE 01/2013; 8(1):e53458. · 3.73 Impact Factor

Publication Stats

509 Citations
189.17 Total Impact Points


  • 2010–2013
    • Sun Yat-Sen University
      • State Key Laboratory of Oncology
      Guangzhou, Guangdong Sheng, China
  • 2009–2013
    • University of Auckland
      • Department of Optometry and Vision Sciences
      Auckland, Auckland, New Zealand
  • 2007–2012
    • McGill University
      • Division of Ophthalmology
      Montréal, Quebec, Canada
  • 2011
    • University of Waterloo
      Waterloo, Ontario, Canada
    • Massachusetts General Hospital
      • Athinoula A. Martinos Center for Biomedical Imaging
      Boston, MA, United States
    • The University of Tokyo
      • College of Art and Science & Graduate School of Arts and Sciences
      Tokyo, Tokyo-to, Japan
  • 2008
    • Colgate University
      • Department of Psychology
      Hamilton, NY, United States
  • 2006
    • University of California, Los Angeles
      • Department of Psychology
      Los Angeles, CA, United States