Peripheral Visual Cues Research Articles

Landmark cueing and exogenous (onset) cueing: How are they related?

Attentional consequences of (i) mere onset of a peripheral visual cue, and (ii)encoding spatially predictive, landmark features of that cue were studied in two experiments. Target location was associated with landmark features of peripheral cues. Cue onset elicited both attention capture (Experiment Two) and inhibition of return (Experiment One) effects. In both experiments, attentional effects of landmark features of the cues were observed early in practice, and diminished with time on task. Contrary to hypotheses based on models that liken attention to a moving spotlight or zoom lens, in both experiments attentional effects of landmark features were confined to the location where the cue was presented. To explain this, we enlist the concept of attentional priority maps, and propose that visual encoding causes attentional priorities to be updated via alternative input routes and mechanisms. We suggest that onset cueing effects are associated with retinotectal ‘spatial indexing’, which registers the location, but not the attributes of new stimuli, while landmark cueing effects are associated with interaction between spatial indexing and dorsal stream visual processing of attentionally relevant landmark features.

Dissociable Cortical and Subcortical Mechanisms for Mediating the Influences of Visual Cues on Microsaccadic Eye Movements.

Visual selection in primates is intricately linked to eye movements, which are generated by a network of cortical and subcortical neural circuits. When visual selection is performed covertly, without foveating eye movements toward the selected targets, a class of fixational eye movements, called microsaccades, is still involved. Microsaccades are small saccades that occur when maintaining precise gaze fixation on a stationary point, and they exhibit robust modulations in peripheral cueing paradigms used to investigate covert visual selection mechanisms. These modulations consist of changes in both microsaccade directions and frequencies after cue onsets. Over the past two decades, the properties and functional implications of these modulations have been heavily studied, revealing a potentially important role for microsaccades in mediating covert visual selection effects. However, the neural mechanisms underlying cueing effects on microsaccades are only beginning to be investigated. Here we review the available causal manipulation evidence for these effects’ cortical and subcortical substrates. In the superior colliculus (SC), activity representing peripheral visual cues strongly influences microsaccade direction, but not frequency, modulations. In the cortical frontal eye fields (FEF), activity only compensates for early reflexive effects of cues on microsaccades. Using evidence from behavior, theoretical modeling, and preliminary lesion data from the primary visual cortex and microstimulation data from the lower brainstem, we argue that the early reflexive microsaccade effects arise subcortically, downstream of the SC. Overall, studying cueing effects on microsaccades in primates represents an important opportunity to link perception, cognition, and action through unaddressed cortical-subcortical neural interactions. These interactions are also likely relevant in other sensory and motor modalities during other active behaviors.

Does cue processing modulate inhibition of return in a detection task?

While the abrupt onset of a peripheral visual cue usually leads to speeded responses to following targets at the cued relative to other positions, responses are slowed if targets lag behind the cue by more than ~200 ms. This response delay is termed inhibition of return (IOR) and has been considered as a mechanism to orient behavior toward novel areas. IOR has been found in both detection and discrimination tasks with later onset in discrimination tasks, probably due to a higher processing demand. Here we examined whether the processing demand of cues can modulate IOR in the detection task. The task to the peripheral cues, either color or gap cues, was passive viewing in one session (single task) and discrimination in another session (dual task). The results showed that the time course of IOR was resistant to the cue processing, while the magnitude of IOR was increased when the processing load became larger in the dual task relative to the single task. These results indicate that IOR in target detection is both reflexive in that its temporal dynamics remain invariant, and flexible in that its magnitude is modulated by task requirement.

Inhibition failures and late errors in the antisaccade task: influence of cue delay.

In the antisaccade task participants are required to saccade in the opposite direction of a peripheral visual cue (PVC). This paradigm is often used to investigate inhibition of reflexive responses as well as voluntary response generation. However, it is not clear to what extent different versions of this task probe the same underlying processes. Here, we explored with the Stochastic Early Reaction, Inhibition, and late Action (SERIA) model how the delay between task cue and PVC affects reaction time (RT) and error rate (ER) when pro- and antisaccade trials are randomly interleaved. Specifically, we contrasted a condition in which the task cue was presented before the PVC with a condition in which the PVC served also as task cue. Summary statistics indicate that ERs and RTs are reduced and contextual effects largely removed when the task is signaled before the PVC appears. The SERIA model accounts for RT and ER in both conditions and better so than other candidate models. Modeling demonstrates that voluntary pro- and antisaccades are frequent in both conditions. Moreover, early task cue presentation results in better control of reflexive saccades, leading to fewer fast antisaccade errors and more rapid correct prosaccades. Finally, high-latency errors are shown to be prevalent in both conditions. In summary, SERIA provides an explanation for the differences in the delayed and nondelayed antisaccade task. NEW & NOTEWORTHY In this article, we use a computational model to study the mixed antisaccade task. We contrast two conditions in which the task cue is presented either before or concurrently with the saccadic target. Modeling provides a highly accurate account of participants' behavior and demonstrates that a significant number of prosaccades are voluntary actions. Moreover, we provide a detailed quantitative analysis of the types of error that occur in pro- and antisaccade trials.

Dynamic Changes in Upper-Limb Corticospinal Excitability during a 'Pro-/Anti-saccade' Double-Choice Task.

Under natural behavioral conditions, visually guided eye movements are linked to direction-specific modulations of cortico-spinal system (CSS) excitability in upper-limb muscles, even in absence of a manual response. These excitability changes have been shown to be compatible with a covert motor program encoding a manual movement toward the same target of the eyes. The aim of this study is to investigate whether this implicit oculo-manual coupling is enforced following every saccade execution or it depends on the behavioral context. Twenty-two healthy young adults participated in the study. Single-pulse transcranial magnetic stimulation was applied to the motor cortex at nine different time epochs during a double-choice eye task, in which the decision to execute a prosaccade or an antisaccade was made on the color of a peripheral visual cue. By analyzing the amplitude of the motor evoked potentials (MEP) in three distal muscles of the resting upper-limb, a facilitation peak of CSS excitability was found in two of them at 120 ms before the eyes begin to move. Furthermore, a long-lasting, generalized reduced corticomotor excitability develops following the eye response. Finally, a quite large modulation of MEP amplitude, depending on the direction of the saccade, is observed only in the first dorsal interosseous muscle, in a narrow time window at about 150 ms before the eye movement, irrespective of the type of the ocular response (pro-/anti-saccade). This change in CSS excitability is not tied up to the timing of the occurrence of the visual cue but, instead, appears to be tightly time-related to the saccade onset. Observed excitability changes differ in many respects from those previously reported with different behavioral paradigms. A main finding of our study is that the implicit coupling between eye and hand motor systems is contingent upon the particular motor set determined by the cognitive aspects of the performed oculomotor task. In particular, the direction-specific modulation in CSS excitability described in this study appears to be related to perceptual and decision-making processes rather than representing an implicit upper-limb motor program, coupled to the saccade execution.

Peripheral Visual Cues Contribute to the Perception of Object Movement During Self-Movement.

Safe movement through the environment requires us to monitor our surroundings for moving objects or people. However, identification of moving objects in the scene is complicated by self-movement, which adds motion across the retina. To identify world-relative object movement, the brain thus has to ‘compensate for’ or ‘parse out’ the components of retinal motion that are due to self-movement. We have previously demonstrated that retinal cues arising from central vision contribute to solving this problem. Here, we investigate the contribution of peripheral vision, commonly thought to provide strong cues to self-movement. Stationary participants viewed a large field of view display, with radial flow patterns presented in the periphery, and judged the trajectory of a centrally presented probe. Across two experiments, we demonstrate and quantify the contribution of peripheral optic flow to flow parsing during forward and backward movement.

Attention to body-parts varies with visual preference and verb-effector associations.

Theories of embodied conceptual meaning suggest fundamental relations between others' actions, language, and our own actions and visual attention processes. Prior studies have found that when people view an image of a neutral body in a scene they first look toward, in order, the head, torso, hands, and legs. Other studies show associations between action verbs and the body-effectors used in performing the action (e.g., "jump" with feet/legs; "talk" with face/head). In the present experiment, the visual attention of participants was recorded with a remote eye-tracking system while they viewed an image of an actor pantomiming an action and heard a concrete action verb. Participants manually responded whether or not the action image was a good example of the verb they heard. The eye-tracking results confirmed that participants looked at the head most, followed by the hands, and the feet least of all; however, visual attention to each of the body-parts also varied as a function of the effector associated with the spoken verb on image/verb congruent trials, particularly for verbs associated with the legs. Overall, these results suggest that language influences some perceptual processes; however, hearing auditory verbs did not alter the previously reported fundamental hierarchical sequence of directed attention, and fixations on specific body-effectors may not be essential for verb comprehension as peripheral visual cues may be sufficient to perform the task.

Peripheral Visual Cues: Their Fate in Processing and Effects on Attention and Temporal-Order Perception.

Peripheral visual cues lead to large shifts in psychometric distributions of temporal-order judgments. In one view, such shifts are attributed to attention speeding up processing of the cued stimulus, so-called prior entry. However, sometimes these shifts are so large that it is unlikely that they are caused by attention alone. Here we tested the prevalent alternative explanation that the cue is sometimes confused with the target on a perceptual level, bolstering the shift of the psychometric function. We applied a novel model of cued temporal-order judgments, derived from Bundesen's Theory of Visual Attention. We found that cue–target confusions indeed contribute to shifting psychometric functions. However, cue-induced changes in the processing rates of the target stimuli play an important role, too. At smaller cueing intervals, the cue increased the processing speed of the target. At larger intervals, inhibition of return was predominant. Earlier studies of cued TOJs were insensitive to these effects because in psychometric distributions they are concealed by the conjoint effects of cue–target confusions and processing rate changes.

Effect of temporal predictability on exogenous attentional modulation of feedforward processing in the striate cortex

Non-informative peripheral visual cues facilitate extrastriate processing of targets [as indexed by enhanced amplitude of contralateral P1 event-related potential (ERP) component] presented at the cued location as opposed to those presented at uncued locations, at short cue-target stimulus onset asynchrony (SOA). Recently, two lines of research are emerging to suggest that the locus of attentional modulation is flexible and depends on 1) perceptual load and 2) temporal predictability of visual stimuli. We aimed to examine the effect of temporal predictability on attentional modulation of feed-forward activation of the striate cortex (as indexed by the C1 ERP component) by high-perceptual-load (HPL) stimuli. We conducted two ERP experiments where exogenously-cued HPL targets were presented under two temporal predictability conditions. In Experiment 1 [high-temporal-predictability (HTP) condition], 17 healthy subjects (age 18–26years) performed a line-orientation discrimination task on HPL targets presented in the periphery of the left upper or diagonally opposite right lower visual field, validly or invalidly cued by peripheral cues. SOA was fixed at 160ms. In Experiment 2 [low-temporal-predictability (LTP) condition], (n=10, age 19–36years) we retained HPL stimuli but randomly intermixed short-SOA trials with long-SOA (1000ms) trials in the task-blocks. In Experiment 1 and the short-SOA condition of the Experiment 2, validly-cued targets elicited significantly faster reaction times and larger contralateral P1, consistent with previous literature. A significant attentional enhancement of C1 amplitude was also observed in the HTP, but not LTP condition. The findings suggest that exogenous visual attention can facilitate the earliest stage of cortical processing under HTP conditions.

Modulation of auditory spatial attention by visual emotional cues: differential effects of attentional engagement and disengagement for pleasant and unpleasant cues.

Previous research has demonstrated that threatening, compared to neutral pictures, can bias attention towards non-emotional auditory targets. Here we investigated which subcomponents of attention contributed to the influence of emotional visual stimuli on auditory spatial attention. Participants indicated the location of an auditory target, after brief (250 ms) presentation of a spatially non-predictive peripheral visual cue. Responses to targets were faster at the location of the preceding visual cue, compared to at the opposite location (cue validity effect). The cue validity effect was larger for targets following pleasant and unpleasant cues compared to neutral cues, for right-sided targets. For unpleasant cues, the crossmodal cue validity effect was driven by delayed attentional disengagement, and for pleasant cues, it was driven by enhanced engagement. We conclude that both pleasant and unpleasant visual cues influence the distribution of attention across modalities and that the associated attentional mechanisms depend on the valence of the visual cue.

Novelty enhances visual salience independently of reward in the parietal lobe.

Novelty modulates sensory and reward processes, but it remains unknown how these effects interact, i.e., how the visual effects of novelty are related to its motivational effects. A widespread hypothesis, based on findings that novelty activates reward-related structures, is that all the effects of novelty are explained in terms of reward. According to this idea, a novel stimulus is by default assigned high reward value and hence high salience, but this salience rapidly decreases if the stimulus signals a negative outcome. Here we show that, contrary to this idea, novelty affects visual salience in the monkey lateral intraparietal area (LIP) in ways that are independent of expected reward. Monkeys viewed peripheral visual cues that were novel or familiar (received few or many exposures) and predicted whether the trial will have a positive or a negative outcome--i.e., end in a reward or a lack of reward. We used a saccade-based assay to detect whether the cues automatically attracted or repelled attention from their visual field location. We show that salience--measured in saccades and LIP responses--was enhanced by both novelty and positive reward associations, but these factors were dissociable and habituated on different timescales. The monkeys rapidly recognized that a novel stimulus signaled a negative outcome (and withheld anticipatory licking within the first few presentations), but the salience of that stimulus remained high for multiple subsequent presentations. Therefore, novelty can provide an intrinsic bonus for attention that extends beyond the first presentation and is independent of physical rewards.

Dyslexic children suffer from less informative visual cues to control posture.

The goal of this study was to investigate the effects of manipulation of the characteristics of visual stimulus on postural control in dyslexic children. A total of 18 dyslexic and 18 non-dyslexic children stood upright inside a moving room, as still as possible, and looked at a target at different conditions of distance between the participant and a moving room frontal wall (25-150 cm) and vision (full and central). The first trial was performed without vision (baseline). Then four trials were performed in which the room remained stationary and eight trials with the room moving, lasting 60s each. Mean sway amplitude, coherence, relative phase, and angular deviation were calculated. The results revealed that dyslexic children swayed with larger magnitude in both stationary and moving conditions. When the room remained stationary, all children showed larger body sway magnitude at 150 cm distance. Dyslexic children showed larger body sway magnitude in central compared to full vision condition. In the moving condition, body sway magnitude was similar between dyslexic and non-dyslexic children but the coupling between visual information and body sway was weaker in dyslexic children. Moreover, in the absence of peripheral visual cues, induced body sway in dyslexic children was temporally delayed regarding visual stimulus. Taken together, these results indicate that poor postural control performance in dyslexic children is related to how sensory information is acquired from the environment and used to produce postural responses. In conditions in which sensory cues are less informative, dyslexic children take longer to process sensory stimuli in order to obtain precise information, which leads to performance deterioration.

Dyslexia and the Integration of Sensory Cues into Motor Action

Besides difficulties in mastering literacy, dyslexic children also show poor postural control that might be related to how sensory cues coming from different sensory channels are integrated and trigger proper motor activity. The purpose of this study was to review the body of literature about the functioning of the postural control system in dyslexic children and understand how they use sensory information to produce motor actions. It has been demonstrated that dyslexic children sway more than non-dyslexic ones. Studies have shown that although manipulation of vision and somatosensory information provided by a moving room and a moving touch bar, respectively, induced correspondent body sway in dyslexic children, their postural responses to such manipulations were less coherent as compared to non-dyslexic children. When dyslexic children applied higher force on the moving bar, however, coherence between body sway and sensory manipulations was similar for dyslexic and non-dyslexic children. Finally, in the absence of peripheral visual cues, induced body sway in dyslexic children was temporally delayed regarding visual stimulus. Taken together, these results indicate that poor postural control in dyslexic children is related to impairments in the manner sensory information is acquired and used to produce postural responses. The need of dyslexic children to apply more force on the touch bar to improve coherence between sensory stimulus and body sway, together with the fact that in conditions in which visual cues were less informative, dyslexic children took longer to process sensory stimuli and produce motor responses, suggests that dyslexic children are more dependent on the quality of sensory cues.

Changes in trunk orientation do not induce asymmetries in covert orienting

We explored the effect of trunk orientation on responses to visual targets in five experiments, following work suggesting a disengage deficit in covert orienting related to changes in the trunk orientation of healthy participants. In two experiments, participants responded to the color of a target appearing in the left or right visual field following a peripheral visual cue that was informative about target location. In three additional experiments, participants responded to the location (left/right) of a target using a spatially compatible motor response. In none of the experiments did trunk orientation interact with spatial-cuing effects, suggesting that orienting behavior is not affected by the rotation of the body relative to the head. Theoretical implications are discussed.

The Modulation of Auditory-visual Deviant Distraction by Working Memory Load: Evidence from Periphery Visual Cue with Different Validity

The present study addressed the controversy around the effect of a working memory load and cognitive distraction, and more specifically the finding in past work that this load sometimes increases distraction, sometimes reduces it. SanMiguel et al. (2010) found that the effect of unexpected novel sounds on performance in a visual working memory task reduced when the task placed significant demands on executive processing by imposing a memory load approaching capacity limits. This load reduced the involuntary orienting of attention toward the sounds and, in turn, their impact (facilitation or distraction) on behavioral performance. In contrast, Lavie (2005) argues that a working memory load increases distraction because load competes for resources with executive control mechanism that attempt to inhibit prepotent responses towards distractors and help limit distraction. We argue that there are two important factors that might influence the deviance distraction: whether distractors are inhibited because they provide no relevant information for the task (e.g., when cueing targets with 50% validity), and whether a load depletes resources otherwise needed for this inhibition. We predicted deviance distraction when attentional resources are directed toward the distractors because they are informative and when a load monopolizes resources otherwise used to inhibit uninformative distractors. In our experiments, participants performed a two-alternative categorization task in which they indicated whether a target stimulus appeared above or below the vertical centre of a computer screen. These targets were preceded by a location cue and, shortly after, a bilateral auditory distractor (standard sound on most trials, deviant sound on the others). Across experiments we manipulated the degree of validity of the location cue (50% or 80%) and whether participants performed the task with a load (1-back task) or without. The location cue was uninformative (50% valid) in Experiments 1 and 2, and informative (80% valid) in Experiments 3 and 4. A load was introduced in Experiments 2 and 4 by use of a 1-back task in which participants responded to the previous trial instead of the current one. The results from Experiment 1 revealed no deviance distraction but longer response times for valid trials, suggesting the inhibition of the distractors. Remarkably, the introduction of a load in Experiment 2 led to observation of deviance distraction, suggesting that the load used resources no longer available for the executive control mechanisms inhibiting responses towards the distractors. In Experiment 3, where location cues were 80% valid, deviance distraction was observed in the absence of a load. Interestingly, it remained so in the presence of a load (Experiment 4). Our results demonstrate that with peripheral visual cues can mediate the extent to which auditory distractors are processed. Distraction seems to appear when attentional resources are available to be directed toward deviant sounds.

The effect of contextual cues on the encoding of motor memories

Several studies have shown that sensory contextual cues can reduce the interference observed during learning of opposing force fields. However, because each study examined a small set of cues, often in a unique paradigm, the relative efficacy of different sensory contextual cues is unclear. In the present study we quantify how seven contextual cues, some investigated previously and some novel, affect the formation and recall of motor memories. Subjects made movements in a velocity-dependent curl field, with direction varying randomly from trial to trial but always associated with a unique contextual cue. Linking field direction to the cursor or background color, or to peripheral visual motion cues, did not reduce interference. In contrast, the orientation of a visual object attached to the hand cursor significantly reduced interference, albeit by a small amount. When the fields were associated with movement in different locations in the workspace, a substantial reduction in interference was observed. We tested whether this reduction in interference was due to the different locations of the visual feedback (targets and cursor) or the movements (proprioceptive). When the fields were associated only with changes in visual display location (movements always made centrally) or only with changes in the movement location (visual feedback always displayed centrally), a substantial reduction in interference was observed. These results show that although some visual cues can lead to the formation and recall of distinct representations in motor memory, changes in spatial visual and proprioceptive states of the movement are far more effective than changes in simple visual contextual cues.

Depth Modulation of the Attentional Repulsion Effect

Shifts of attention can cause mislocalisation of visual objects. Abriefcue that attracts attention can cause a shift in the perceived location of a subsequently presented visual object--specifically, moving it away from the focus of attention (attentional repulsion). In the present study we investigated whether depth would influence the magnitude of attentional repulsion by presenting peripheral visual cues in different depth planes from the target or fixation. In experiment 1 the results showed that the magnitude of the attentional repulsion was larger when the cue was presented at the depth plane farther away from the target and fixation. In experiment 2 we presented the fixation point in the same depth plane as the nearest cues and found larger repulsion effects when the cues were presented in depth planes farther away from the fixation. In experiment 3 no depth modulation was observed when the fixation was presented in the same depth plane with the farthest cues. Taken together, when the cues were presented in the depth plane farther away from the fixation, the magnitude of the attentional repulsion effect increased. It is speculated that the residual coarser spatial representation in the space farther from the fixation plane or the enhanced attentional process for the space closer than the fixation may be responsible for the larger attentional repulsion effect.

The role of lower peripheral visual cues in the visuomotor coordination of locomotion and prehension

It has been previously suggested that coupled upper and limb movements need visuomotor coordination to be achieved. Previous studies have not investigated the role that visual cues may play in the coordination of locomotion and prehension. The aim of this study was to investigate if lower peripheral visual cues provide online control of the coordination of locomotion and prehension as they have been showed to do during adaptive gait and level walking. Twelve subjects reached a semi-empty or a full glass with their dominant or non-dominant hand at gait termination. Two binocular visual conditions were investigated: normal vision and lower visual occlusion. Outcome measures were determined using 3D motion capture techniques. Results showed that although the subjects were able to successfully complete the task without spilling the water from the glass under lower visual occlusion, they increased the margin of safety between final foot placements and glass. These findings suggest that lower visual cues are mainly used online to fine tune the trajectory of the upper and lower limbs moving toward the target.

Visual Context Processing Deficits in Schizophrenia: Effects of Deafness and Disorganization

Visual illusions allow for strong tests of perceptual functioning. Perceptual impairments can produce superior task performance on certain tasks (i.e., more veridical perception), thereby avoiding generalized deficit confounds while tapping mechanisms that are largely outside of conscious control. Using a task based on the Ebbinghaus illusion, a perceptual phenomenon where the perceived size of a central target object is affected by the size of surrounding inducers, we tested hypotheses related to visual integration in deaf (n = 31) and hearing (n = 34) patients with schizophrenia. In past studies, psychiatrically healthy samples displayed increased visual integration relative to schizophrenia samples and thus were less able to correctly judge target sizes. Deafness, and especially the use of sign language, leads to heightened sensitivity to peripheral visual cues and increased sensitivity to visual context. Therefore, relative to hearing subjects, deaf subjects were expected to display increased context sensitivity (ie, a more normal illusion effect as evidenced by a decreased ability to correctly judge central target sizes). Confirming the hypothesis, deaf signers were significantly more sensitive to the illusion than nonsigning hearing patients. Moreover, an earlier age of sign language acquisition, higher levels of linguistic ability, and shorter illness duration were significantly related to increased context sensitivity. As predicted, disorganization was associated with reduced context sensitivity for all subjects. The primary implications of these data are that perceptual organization impairment in schizophrenia is plastic and that it is related to a broader failure in coordinating cognitive activity.

1493 PERIPHERAL VISUAL CUE SUPPLEMENTED TARGET TASK FOCUS – ADVANCED EXERCISE REGIME FOR GAZE CONTROL IN LAPAROSCOPIC UROLOGICAL SURGERY

You have accessJournal of UrologyTechnology & Instruments: Surgical Education & Skills Assessment1 Apr 20111493 PERIPHERAL VISUAL CUE SUPPLEMENTED TARGET TASK FOCUS – ADVANCED EXERCISE REGIME FOR GAZE CONTROL IN LAPAROSCOPIC UROLOGICAL SURGERY Sashi S. Kommu, Bhaskar Somani, Philip James, Thomas Finnigan, David Cartlidge, Hashim Zafar, Aniruddha Chakravarti, and STILUS Academic Research Group (SARG) Sashi S. KommuSashi S. Kommu London, United Kingdom More articles by this author , Bhaskar SomaniBhaskar Somani London, United Kingdom More articles by this author , Philip JamesPhilip James London, United Kingdom More articles by this author , Thomas FinniganThomas Finnigan London, United Kingdom More articles by this author , David CartlidgeDavid Cartlidge London, United Kingdom More articles by this author , Hashim ZafarHashim Zafar London, United Kingdom More articles by this author , Aniruddha ChakravartiAniruddha Chakravarti London, United Kingdom More articles by this author , and STILUS Academic Research Group (SARG) More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1451AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Human gaze patterns are purported to be sensitive to the probabilistic structure of the environment thus suggesting that subjects tend to cope by actively allocating gaze on the basis of a learned structural environment. The laparoscopic urological platform is no exception where visual cues are important for the surgeon to perform optimally in a real-time manner. In the process of conducting a previous study we incidentally noted that expert laparoscopic surgeons had better or more targeted gaze control relative to the target task even while physically handling the instruments as compared to trainees. Trainees seemed to require greater visual feedback of instrument locale to perform given tasks compared to experts. We developed and tested the concept of Peripheral Visual Cue Supplemented Target Task Focus (PVC-TF) as an advanced exercise regime for improved Gaze Control during laparoscopic urological surgery. METHODS We developed a box kit with zonal mapping such that there were two circles. The inner circle was 4 cms in diameter and housed target tasks including loop stacking, suturing elements and cutting complex shapes. The outer circle was designed such that distracting lights of varying colours randomly switched automatically. Six trainees were initially asked to complete the preset target tasks. Three trainees were then primed to control gaze actively by extending the peripheral visual field of focus such that they were able to perform tasks while actively ignoring the distracting lights. The other 3 were not primed. All candidates then each asked to perform the index tasks of two ex-vivo vesicourethral anastomosis (VUA). A non-contact method for measuring eye motion using video camera analysis was used for mapping gaze in each of the tasks. RESULTS Prior to priming, there was haphazard gaze in all trainees. Following priming with Peripheral Visual Cue Supplemented Target Task Focus, gaze control was noted to markedly improve in the primed group. Gaze control was also markedly improved during the VUA in the primed group as opposed to the non-primed group. The mean time for task completion was 1.8 times quicker for the primed group. CONCLUSIONS Peripheral Visual Cue Supplemented Target Task Focus (PVC-TF) appears to significantly improve Gaze Control and performance during laparoscopic urological surgery in the ex-vivo setting. Optimal gaze control could act as a useful supplementary tool during skill acquisition among trainees interested in laparoscopic surgery. Further analysis through large scale studies is warranted. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e598 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sashi S. Kommu London, United Kingdom More articles by this author Bhaskar Somani London, United Kingdom More articles by this author Philip James London, United Kingdom More articles by this author Thomas Finnigan London, United Kingdom More articles by this author David Cartlidge London, United Kingdom More articles by this author Hashim Zafar London, United Kingdom More articles by this author Aniruddha Chakravarti London, United Kingdom More articles by this author STILUS Academic Research Group (SARG) More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...