Effectively reducing sensory eye dominance with a push-pull perceptual learning protocol.

Much knowledge of sensory cortical plasticity is gleaned from perceptual learning studies that improve visual performance [1-7]. Although the improvements are likely caused by modifications of excitatory and inhibitory neural networks, most studies were not primarily designed to differentiate their relative contributions. Here we designed a novel push-pull training protocol to reduce sensory eye dominance (SED), a condition that is mainly caused by unbalanced interocular inhibition [8-10]. During the training, an attention cue presented to the weak eye precedes the binocular competitive stimulation. The cue stimulates the weak eye (push) while causing interocular inhibition of the strong eye (pull). We found that this push-pull protocol reduces SED (shifts the balance toward the weak eye) and improves stereopsis more so than the push-only protocol, which solely stimulates the weak eye without inhibiting the strong eye. The stronger learning effect with the push-pull training than the push-only training underscores the crucial involvement of a putative inhibitory mechanism in sensory plasticity. The design principle of the push-pull protocol can potentially lend itself as an effective, noninvasive treatment of amblyopia.