Effects of categorical and numerical feedback on category learning.

Real-world learning signals often come in the form of a continuous range of rewards or punishments, such as receiving more or less money or other reward. However, in laboratory studies, feedback used to examine how humans learn new categories has almost invariably been categorical in nature (i.e. Correct/Incorrect, or A/Not-A). Whether numerical or categorical feedback leads to better learning is an open question. One possibility is that numerical feedback could give more fine-grained information about a category. Alternatively, categorical feedback is more dichotomous, potentially leading to larger error signals. Here we test how feedback impacts category learning by having participants learn to categorize novel line stimuli from either numerical, categorical, or a combination of both types of feedback. Performance was better for categorical relative to the more variable numerical feedback. However, participants were able to learn to effectively categorize from numerical feedback, and providing larger numerical rewards for easier, more representative stimuli was more successful in promoting learning than providing larger rewards for harder to classify stimuli. Simulations and fits of a connectionist model to participants' performance data suggest that categorical feedback promotes better learning by eliciting larger prediction errors than numerical feedback.

Neural regions associated with gain-loss frequency and average reward in older and younger adults.

Research on the biological basis of reinforcement-learning has focused on how brain regions track expected value based on average reward. However, recent work suggests that humans are more attuned to reward frequency. Furthermore, older adults are less likely to use expected values to guide choice than younger adults. This raises the question of whether brain regions assumed to be sensitive to average reward, like the medial and lateral PFC, also track reward frequency, and whether there are age-based differences. Older (60-81 years) and younger (18-30 years) adults performed the Soochow Gambling task, which separates reward frequency from average reward, while undergoing fMRI. Overall, participants preferred options that provided negative net payoffs, but frequent gains. Older adults improved less over time, were more reactive to recent negative outcomes, and showed greater frequency-related activation in several regions, including DLPFC. We also found broader recruitment of prefrontal and parietal regions associated with frequency value and reward prediction errors in older adults, which may indicate compensation. The results suggest greater reliance on average reward for younger adults than older adults.

Preliminary effects of prefrontal tDCS on dopamine-mediated behavior and psychophysiology.

The ability to manipulate dopamine in vivo through non-invasive, reversible mechanisms has the potential to impact clinical, translational, and basic research. Recent PET studies have demonstrated increased dopamine release in the striatum after bifrontal transcranial direct current stimulation (tDCS). We sought to extend this work by examining whether bifrontal tDCS could demonstrate an effect on behavioral and physiological correlates of subcortical dopamine activity. We conducted a preliminary between-subjects study (n = 30) with active and sham tDCS and used spontaneous eye blink rate (EBR), facial attractiveness ratings, and greyscales orienting bias as indirect proxies for dopamine functioning. The initial design and analyses were pre-registered (https://osf.io/gmnpc). Stimulation did not significantly affect any of the three measures, though effect sizes were often moderately large and were all in the predicted directions. Additional exploratory analyses suggested that stimulation's effect on EBR might depend on pre-stimulation dopamine levels. Our results suggest that larger samples than those that are standard in tDCS literature should be used to assess the effect of tDCS on dopamine using indirect measures. Further, exploratory results add to a growing body of work demonstrating the importance of accounting for individual differences in tDCS response.

Learning reward frequency over reward probability: A tale of two learning rules.

Learning about the expected value of choice alternatives associated with reward is critical for adaptive behavior. Although human choice preferences are affected by the presentation frequency of reward-related alternatives, this may not be captured by some dominant models of value learning, such as the delta rule. In this study, we examined whether reward learning is driven more by learning the probability of reward provided by each option, or how frequently each option has been rewarded, and assess how well models based on average reward (e.g. the delta model) and models based on cumulative reward (e.g. the decay model) can account for choice preferences. In a binary-outcome choice task, participants selected between pairs of options that had reward probabilities of 0.65 (A) versus 0.35 (B) or 0.75 (C) versus 0.25 (D). Crucially, during training there were twice the number of AB trials as CD trials, such that option A was associated with higher cumulative reward, while option C gave higher average reward. Participants then decided between novel combinations of options (e.g., AC). Most participants preferred option A over C, a result predicted by the Decay model, but not the Delta model. We also compared the Delta and Decay models to both more simplified as well as more complex models that assumed additional mechanisms, such as representation of uncertainty. Overall, models that assume learning about cumulative reward provided the best account of the data.

Acute stress improves long-term reward maximization in decision-making under uncertainty.

Acute stress influences reward-seeking tendencies and risky decision-making. However, it is unclear how acute stress influences decision-making in situations in which individuals must learn to either maximize long-term or immediate rewards from experience. Consequently, this study sought to investigate whether acute stress enhances salience of small, immediate or large, delayed rewards on decision-making under uncertainty. The Socially Evaluated Cold Pressor Task (SECPT) was used to induce acute stress. Participants in Experiment 1 (N = 50) were exposed to either the SECPT or a warm-water control condition and then completed a decision-making task in which participants needed to learn to forego immediate rewards in favor of larger delayed rewards. The results demonstrated that acute stress enhanced decisions that maximized long-term, large rewards over immediate, small rewards. Experiment 2 (N = 50) included an assessment of salivary cortisol. Results replicated the behavioral findings in Experiment 1 and demonstrated that the acute stress manipulation increased salivary cortisol, thus providing a potential physiological mechanism for these results. This work suggests that moderate acute stress can improve decision-making under uncertainty that depends on learning to maximize long-term rewards from experience.

A Case of Divergent Predictions Made by Delta and Decay Rule Learning Models.

The Delta and Decay rules are two learning rules used to update expected values in reinforcement learning (RL) models. The delta rule learns average rewards, whereas the decay rule learns cumulative rewards for each option. Participants learned to select between pairs of options that had reward probabilities of .65 (option A) versus .35 (option B) or .75 (option C) versus .25 (option D) on separate trials in a binary-outcome choice task. Crucially, during training there were twice as AB trials as CD trials, therefore participants experienced more cumulative reward from option A even though option C had a higher average reward rate (.75 versus .65). Participants then decided between novel combinations of options (e.g, A versus C). The Decay model predicted more A choices, but the Delta model predicted more C choices, because those respective options had higher cumulative versus average reward values. Results were more in line with the Decay model's predictions. This suggests that people may retrieve memories of cumulative reward to compute expected value instead of learning average rewards for each option.

Gender differences in preference for reward frequency versus reward magnitude in decision-making under uncertainty.

Extensive research has focused on gender differences in intertemporal choices made from description in which participants must choose from multiple options that are specified without ambiguity. However, there has been limited work examining gender differences in intertemporal choices made from experience in which the possible payoffs among choice alternatives are not initially known and can only be gained from experience. Other work suggests that females attend more to reward frequency, whereas males attend more to reward magnitude. However, the tasks used in this research have been complex and did not examine intertemporal decision-making. To specifically test whether females are more sensitive to reward frequency and males are more sensitive to reward magnitude on intertemporal decisions made from experience, we designed a simple choice task in which participants pressed a response button at a time of their own choosing on each of many trials. Faster responses led to smaller, but more frequent rewards, whereas slower responses led to larger, but less frequently given rewards. As predicted, females tended to respond quicker for more certain, smaller rewards than males, supporting our prediction that women attend more to reward frequency whereas men attend more to reward magnitude.

Amiodarone keratopathy and rigid contact lens wear.

Two cases are presented of patients wearing rigid gas permeable contact lenses who exhibited the typical fan-shaped patterns of corneal pigment deposition related to long-term medication containing amiodarone. The vortex corneal epitheliopathy and contact lens tolerance were monitored over several years. In both cases, the lens material was replaced with one incorporating an ultra-violet light inhibitor in view of the possibility of medically induced photosensitivity.

Contact lens fitting in high degree myopia.

Advantages and disadvantages of both spectacle and contact lens correction of high degree myopia are reviewed. Pertinent aftercare problems in this group of patients are discussed. Aspects of contact lens wear with regard to the eyelids are described. Soft contact lens problems are discussed in relation to the greater thickness of lenses of high power. Guidelines are provided for the fitting of rigid gas permeable and of soft contact lenses for this patient group. Other factors are explored in lens fitting such as over-refraction, near vision and practitioner costs. Recommendations are given for advising on lens care and aftercare.

The use of occluding tinted contact lenses.

PURPOSE: We explored the clinical issues surrounding the use of tinted contact lenses for vision occlusion in cases of debilitating vision disturbance, such as intractable diplopia. METHODS: We report the results with four patients fit with occluding tinted contact lenses. RESULTS: Vision occlusion by contact lenses provided a suitable comfortable occlusion method with improved cosmesis compared to occlusion by spectacles. Lens parameters and tint specifications were ordered for each patient. Correct lens care and handling were necessary to avoid contact lens related ocular inflammation. CONCLUSION: Provided that lens care is satisfactory and the patient does not have unreasonable expectations, a tinted contact lens can be a useful alternative to a covered spectacle lens or eye patch when occluding one eye, such as in cases of intractable diplopia, severe vision distortion, or intolerable photophobia.

Contact lens fitting after photorefractive keratectomy.

AIMS/BACKGROUND: This study evaluated contact lens fitting and the longer term response of the photorefractive keratectomy (PRK) cornea to lens wear. In PRK for myopia problems such as regression, anterior stromal haze, irregular astigmatism, halo aberration, and anisometropia have been reported. Certain patients therefore require contact lens correction to obtain best corrected visual acuity (BCVA). METHOD: From an original cohort of 80 patients, 15 were dissatisfied with their visual outcome 6 months after PRK. Ten of these were fitted with lenses and monitored regularly. RESULTS: The best fit rigid gas permeable lens of diameter 9.20-10.00 mm was generally 0.10 mm steeper than mean keratometry readings. Because of lid discomfort five patients were refitted with daily wear soft lenses. All 10 achieved satisfactory lens wear of 10 hours per day. Central corneal steepening of 0.75 D (0.15 mm) occurred in one patient. Two patients had slight central corneal flattening. Three patients discontinued lens wear as they found lens care a nuisance. Four finally opted for retreatment by PRK. CONCLUSIONS: In most cases, contact lenses gave good visual acuity and, in cases of mild irregular astigmatism, a significant improvement over spectacle BCVA. No significant adverse reaction to contact lens wear was found. Although ocular tolerance of lenses was satisfactory, several patients discontinued lens wear or sought improved unaided vision.

Contact lens fitting after photorefractive keratectomy: a comparison of two groups of patients.

From a research programme comparing two photorefractive keratectomy (PRK) methods, Group S using Summit ExciMed UV 200, and Group V using the VisX 20:20 excimer laser system, 10 patients from each group were recruited. They were referred 6-12 months post-PRK for lens fitting to correct resultant ametropia or irregular astigmatism. Ablation zone diameters were: Group S, 4.5 mm; Group V, 4-6 mm. For Group S, best fit rigid gas permeable (RGP) lenses generally had a back optic zone radius (BOZR) 0.10 mm steeper than the mean keratometry reading (K) and overall diameter of 9.20-10.0 mm. For Group V best fit RGP lenses generally had a BOZR of 0.20 mm steeper than the mean K. The lenses often required large diameters to improve lens centration and extra negative power to compensate for the positive power of the central tear pool. Several patients required soft lens fitting to improve comfort and some finally opted for repeat PRK.

The long-term use of the SoftPerm lens on pellucid marginal corneal degeneration.

Pellucid marginal corneal degeneration (PMCD) is a corneal degeneration often confused with keratoconus because of the presence of high regular and irregular astigmatism. Vision correction can be achieved with rigid contact lenses, but the asymmetric topographic profile often makes obtaining a stable lens fit difficult. This study describes the fitting and satisfactory daily wear during 4 years of a combination lens design (2 years Saturn II and 2 years SoftPerm) on a patient with PMCD. The lens consisted of a central rigid gas permeable portion surrounded by a soft hydrophilic "skirt." Although the degree of astigmatism was high, 1.6 mm (8.00 D) by keratometry and 12.00 D by refraction, the patient was able to wear the lens comfortably 12 hours per day and achieve visual acuity of 20/20. Routine keratometry, pachymetry, and slit lamp examination showed no significant corneal changes resulting from lens wear.

Silicone rubber contact lenses for the compromised cornea.

Silicone rubber contact lenses (SRCLs) are infrequently used because of the risk of developing unpredictable lens tightening, their poor availability, and their expense. However, their high oxygen transmissibility and nonabsorption of water make them valuable as therapeutic lenses. SRCLs are routinely used in our management of severely dry eyes, decompensated or vascularised corneas, and conditions where the corneal shape is flat or irregular. The records of 48 consecutive patients fitted with SRCLs between January 1989 and June 1990 were studied. The clinical history, indications, complications, success, and duration of SRCL wear were analysed. Therapeutic goals, which included epithelial healing, sealing of corneal perforations, and improved comfort and vision, were achieved in 53 of 62 eyes. The best corrected acuity was attained using SRCLs in 58 of 62 eyes. Failure of lens wear was due to lens tightening (four eyes), spoilation (two), discomfort, fornix shortening, handling problems, and decentration (one each). Infective keratitis complicated one case, but SRCL wear was resumed after successful treatment. With adequate follow-up, SRCLs have a low complication rate and are well tolerated even in severely compromised eyes, for which conventional lenses may be contraindicated. Their continued use as therapeutic lenses is advocated in carefully selected cases.

Excimer laser photorefractive keratectomy for myopia: 12 month follow-up.

A prospective study of excimer laser photorefractive keratectomy was performed with the aim of correcting a range of myopic errors between -1.00 and -10.00 dioptres. Corneal healing was monitored through the first post-operative year by serial assessments of refraction, contrast sensitivity, corneal haze, pachymetry and keratometry. Eighty-one patients were recruited for the study. At 12 months 81% were within +/- 1.00 dioptre of desired emmetropia and with unaided vision of 6/12. Contrast sensitivity was found by Pelli-Robson assessment to be reduced throughout the 12 months and regression analysis predicted recovery by 2 years. At 12 months, however, only 15% of patients were found to have lost a single line of best corrected Snellen acuity. Predictability of results was found to be greatest for initial errors less than -4.00 dioptres. No serious complications were observed during the follow-up period, but refraction had not stabilised in all cases and patients remain under review.

Keratoreformation by contact lenses after radial keratotomy: a re-analysis.

A recent paper analysed change in refraction and corneal curvature associated with contact lens wear in patients who had had radial keratotomy at least a year beforehand. Conventional methods of analysis were used. This paper applies methods that have only recently become available. The results are clearer and less ambiguous. Formally, the analysis shows that there are significant mean changes in refraction (estimated to be +1.69/-0.50 x 105) and corneal power (-0.66/-0.25 x 155). In spite of the difference between these two mean changes, the analysis shows that the change in refraction may be associated with change in the corneal power alone. There is no reason to believe that any other change is occurring in the eye. Care needs to be executed in assigning a causative role to contact lenses in changing refraction and corneal curvature. Almost certainly the lenses do have such a role but the analysis does not formally allow an unequivocal conclusion concerning that role.

Keratoreformation by contact lenses after radial keratotomy.

Since the number of patients undergoing radial keratotomy has increased, more have required contact lens fitting to correct residual ametropia. A number of practitioners suggest that the postoperative changes stabilize after 12 months, so contact lens fitting on the unusual resultant corneal topography can begin. This paper discusses corneal and refractive changes that are revealed even when correctly fitting lenses are worn 1-5 years postoperatively. These changes indicate that lens wear may influence corneal topography and refraction even several years after radial keratotomy.

Alternatives to toric contact lens fitting--for regular and irregular astigmatism.

Although toric contact lenses have improved in design and development and their use is increasing, further consideration should be given to the alternative methods of astigmatism correction by contact lenses. Much can still be achieved by non-toric lens, both for a wide range of astigmatism and for ease of supply. A number of these alternatives are examined, their advantages and disadvantages reappraised, and the merits of lens correction compared with surgical methods considered.