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Biomedical subjects

L Hyvärinen

Publications and source records attributed to L Hyvärinen.

At least 19 recordsLinked to original sources
PubMed2006

Training-induced cortical representation of a hemianopic hemifield.

BACKGROUND: Patients with homonymous hemianopia often have some residual sensitivity for visual stimuli in their blind hemifield. Previous imaging studies suggest an important role for extrastriate cortical areas in such residual vision, but results of training to improve vision in patients with hemianopia are conflicting. OBJECTIVE: To show that intensive training with flicker stimulation in the chronic stage of stroke can reorganise visual cortices of an adult patient. METHODS: A 61-year-old patient with homonymous hemianopia was trained with flicker stimulation, starting 22 months after stroke. Changes in functioning during training were documented with magnetoencephalography, and the cortical organisation after training was examined with functional magnetic resonance imaging (fMRI). RESULTS: Both imaging methods showed that, after training, visual information from both hemifields was processed mainly in the intact hemisphere. The fMRI mapping results showed the representations of both the blind and the normal hemifield in the same set of cortical areas in the intact hemisphere, more specifically in the visual motion-sensitive area V5, in a region around the superior temporal sulcus and in retinotopic visual areas V1 (primary visual cortex), V2, V3 and V3a. CONCLUSIONS: Intensive training of a blind hemifield can induce cortical reorganisation in an adult patient, and this case shows an ipsilateral representation of the trained visual hemifield in several cortical areas, including the primary visual cortex.

Flicker Fusion↗
PubMed2006

Temporal sensitivity in a hemianopic visual field can be improved by long-term training using flicker stimulation.

BACKGROUND: Blindness of a visual half-field (hemianopia) is a common symptom after postchiasmatic cerebral lesions. Although hemianopia severely limits activities of daily life, current clinical practice comprises no training of visual functions in the blind hemifield. OBJECTIVE: To find out whether flicker sensitivity in the blind hemifield can be improved with intensive training, and whether training with flicker stimulation can evoke changes in cortical responsiveness. METHODS: Two men with homonymous hemianopia participated in the experiments. They trained with flicker stimuli at 30 degrees or with flickering letters at 10 degrees eccentricity twice a week for a year, and continued training with more peripheral stimuli thereafter. Neuromagnetic responses were registered at 1-2-month intervals, and the Goldmann perimetry was recorded before, during and after training. RESULTS: Flicker sensitivity in the blind hemifield improved to the level of the intact hemifield within 30 degrees eccentricity in one participant and 20 degrees eccentricity in the other. Flickering letters were recognised equally at 10 degrees eccentricity in the blind and intact hemifields. Improvement spread from the stimulated horizontal meridian to the whole hemianopic field within 30 degrees. Before training, neuromagnetic recordings showed no signal above the noise level in the hemianopic side. During training, evoked fields emerged in both participants. No changes were found in the Goldmann perimetry. DISCUSSION: Results show that sensitivity to flicker could be fully restored in the stimulated region, that improvement in sensitivity spreads to the surrounding neuronal networks, and that, during training, accompanying changes occurred in the neuromagnetic fields.

Cerebral Cortex↗
PubMed2006

New standardised texts for assessing reading performance in four European languages.

AIMS: To develop standardised texts for assessing reading speed during repeated measurements and across languages for normal subjects and low vision patients. METHODS: 10 texts were designed by linguistic experts in English, Finnish, French, and German. The texts were at the level of a sixth grade reading material (reading ages 10-12 years) and were matched for length (830 (plus or minus 2) characters) and syntactic complexity, according to the syntactic prediction locality theory of Gibson. 100 normally sighted native speaking volunteers aged 18-35 years (25 per language) read each text aloud in randomised order. The newly designed text battery was then applied to test the reading performance of 100 normally sighted native speaking volunteers aged 60-85 years (25 per language). RESULTS: Reading speed was not significantly different with at least seven texts in all four languages. The maximum reading speed difference between texts, in the same language was 6.8% (Finnish). Average reading speeds (SD) in characters per minute are, for the young observer group: English 1234 (147), Finnish 1263 (142), French 1214 (152), German 1126 (105). The group of older readers showed statistically significant lower average reading speeds: English 951 (97), Finnish 1014 (179), French 1131 (160), German 934 (117). CONCLUSION: The authors have developed a set of standardised, homogeneous, and comparable texts in four European languages (English, Finnish, French, German). These texts will be a valuable tool for measuring reading speed in international studies in the field of reading and low vision research.

Adolescent↗
PubMed2001

Dynamics of cortical activation in a hemianopic patient.

Although residual vision in patients with cortical blindness is common, its brain mechanisms are poorly known. To study these mechanisms we measured neuromagnetic responses to visual stimuli in a patient with right posterior cerebral lesion and left visual field hemianopia. His vision had partially recovered with intensive training before our measurements. Compared with the processing in the healthy side, early occipital responses were attenuated for both passive viewing of checkerboard reversal patterns and a letter identification task. In both conditions there were prominent longer-latency responses at the right superior temporal cortex. We suggest that the activation in the superior temporal cortex can partially compensate for the failure to produce synchronized population responses at the early stages of visual cortical processing.

Blindness, Cortical↗
PubMed1999

Visual perception in 'low vision'.

'Low vision' has an international classification as an impairment of vision that is defined by loss of visual acuity and the size of the visual field. Functional classification that would depict capability to use vision in different activities has not yet been agreed upon. Abnormal visual information leads to changes in visual perception, and brain-damage-related visual impairment may alter or prevent one or several cognitive visual functions. Abnormal visual perception opens a window into brain mechanisms that the psychophysicists otherwise do not have. Together with clinicians, psychophysicists can help visually impaired persons to understand the nature of their disability by thoroughly studying the nature of the altered image and the profile of cognitive visual functions.

Humans↗
PubMed1997

Contrast sensitivity measurement in evaluations of visual symptoms caused by exposure to triethylamine.

OBJECTIVES: To determine whether blurred vision caused by exposure to triethylamine (TEA) can be detected by the measurement of contrast sensitivity. METHODS: 41 cold box core makers of three foundries and 82 control workers were examined. A detailed ocular and medical history was obtained from the subjects. The contrast sensitivity of the core makers was measured on Monday and Friday of the same week both before and immediately after work and also on a third day, when air samples of TEA were collected. Contrast sensitivity and visual acuity were measured by optotype figures at full contrast, 2.5% contrast, and 0.6% contrast. The changes in contrast sensitivity were used for the analysis. The results of binocular vision and the results of the dominant eye were analysed. Urine specimens for the analysis of TEA were collected on every occasion when contrast sensitivity was measured. RESULTS: 78% of the core makers had had symptoms of blurred vision, and 31% had had trouble driving or working. The breathing zone eight hour time weighted average TEA concentrations were 0.3-60 mg/m3. The mean urinary TEA concentration after the shift was 35 mmol/mol creatinine. Continuous monitoring showed high peaks of TEA leakage at a core making machine. Changes in binocular visual acuity did not differ between the exposed and unexposed workers. The contrast sensitivity decreased in 49% of the core makers and 21% of the controls (P = 0.002). CONCLUSIONS: The blurred vision caused by exposure to TEA can be documented by measuring contrast sensitivity. The mechanism by which TEA produces symptoms remains an issue of further study.

Adolescent↗
PubMed1995

Considerations in evaluation and treatment of the child with low vision.

Habilitation of infants and children with visual impairments should be based on a thorough understanding of their visual capabilities and limitations. Comprehensive evaluation of visual function includes measurement of visual acuity, contrast sensitivity, visual field, color vision, adaptation, visual sphere, accommodation, and oculomotor functions. It is best completed through a team approach that uses therapists, special educators, and physicians. A complete evaluation also includes examination of the effect of other motor functions on the use of vision. Nearly all aspects of a child's vision can be measured in play situations with tests that are easy to use. However, further education of nonphysician team members in refractive errors, optics, and function of optical devices may be necessary to ensure an accurate and thorough evaluation.

Adaptation, Ocular↗
PubMed1994

Pulmonary deposition and clinical response of 99mTc-labelled salbutamol delivered from a novel multiple dose powder inhaler.

Pulmonary deposition of 99mTc-labelled sulbutamol was determined after delivery from a novel multiple dose powder inhaler (Easyhaler). The clinical efficacy of the inhalation powder, evaluated simultaneously with gamma camera detection, was compared with that obtained after drug delivery from a metered dose inhaler-spacer combination. The study was performed as an open, non-randomized cross-over trial. A single dose of radiolabelled inhalation powder was inhaled on the first and the inhalation aerosol, as control, on the second study day. Sulbutamol sulphate was labelled with 99mtechnetium, and the inhalation powder was formulated by mixing radioactive drug particles with carrier material. Aerodynamic properties of the radiolabelled inhalation powder were similar to those of the unlabelled salbutamol powder. Delivered dose from the breath-actuated powder inhaler was adjusted to be equal to two puffs from a conventional aerosol actuator with a short plastic mouthpiece. Twelve non-smoking asthmatic patients participated in the trial. The mean pulmonary deposition of 24% was obtained after drug delivery from Easyhaler powder inhaler. Clinical efficacy of the medications was similar in terms of area under the FEV1 curve, maximum FEV1 and the improvement ratio. Thus it can be suggested that powder delivery from Easyhaler powder inhaler and the aerosol delivery through the spacer are equally effective.

Adult↗
PubMed1986

Contrast sensitivity in amblyopia. III. Effect of occlusion.

Contrast sensitivity of 26 children (mean age 9 years) was measured using vertical gratings during the course of pleoptic treatment. A statistically highly significant improvement in the vision of amblyopic eyes occurred during intensive treatment in the hospital. Occlusion of the amblyopic eye (inverse occlusion) before the pleoptic treatment did not effect the function of the amblyopic eyes. During 8-week occlusion of the dominant eye (direct occlusion) after pleoptic treatment changes in the vision of the amblyopic eyes were statistically insignificant. In some patients there was change in contrast sensitivity without a corresponding change in visual acuity. The contrast sensitivity of the dominant eye decreased markedly during occlusion in 12 patients. After a continuous occlusion of only 2 weeks there was a statistically significant decrease at spatial frequency 6 c/deg. There was no simultaneous decrease of visual acuity; thus the change can be called 'hidden occlusion amblyopia'. An additional 8-week occlusion did not cause any statistically significant decrease in contrast sensitivity, but visual acuity of 2 patients decreased slightly, a sign of beginning occlusion amblyopia. The changes disappeared during 'Einschleich'-occlusion or penalization except in one child whose previously dominant eye became non-dominant and slightly amblyopic.

Adolescent↗
PubMed1986

Contrast sensitivity in amblyopia. IV. Assessment of vision using vertical and horizontal gratings and optotypes at different contrast levels.

The contrast sensitivity of 49 amblyopic children (mean age 9 years) was measured in the beginning and at the end of a treatment period using both vertical gratings and optotypes (LH-4 contrast test) at 2, 3, 5 and 75% contrast. The contrast sensitivity of 37 patients was also measure using horizontal gratings. The contrast sensitivity of the dominant eyes measured with vertical gratings was generally higher than when measured with horizontal gratings. The difference was statistically significant at spatial frequencies 1 and 6 c/deg. A similar difference was present in the amblyopic eyes only at the spatial frequency 1 c/deg both before and after the treatment. Individual variation was great; in a given patient the relationship between the two measurements varied from one spatial frequency to the next. It has been shown in earlier investigations that contrast sensitivity measurements using gratings reveal important new information in the study of amblyopia. Both tests, used in this investigation, measure visual function in the low contrast domain and improve follow-up of the changes in vision during treatment of amblyopia when used in addition to visual acuity measurements. Low contrast optotype test seems to measure contrast sensitivity in amblyopia closely similarly to the grating test. The slight difference in detecting a 'hidden occlusion amblyopia' at the intermediate spatial frequencies needs further study.

Adolescent↗
PubMed1986

Persistent behavioural blindness after early visual deprivation and active visual rehabilitation: a case report.

Early long lasting binocular deprivation results in behavioural blindness in both man and experimental animals. However, few reported cases show that visual rehabilitation may improve visual behaviour. A 34-year-old man who had experienced 30 years of binocular deprivation due to bilateral cataracts received visual rehabilitation for one year. The rehabilitation included training in eye-hand co-ordination, recognition of objects, evaluation of distance and size, and mobility training. Despite signs of recovery of visual functions the patient never started to use vision in his normal life. The negative outcome of the rehabilitation is partly attributed to the patient's motivational problems and to the relatively short rehabilitation time. Visual rehabilitation may be successful when started immediately after the corrective operation on the eyes when the level of motivation is also high.

Adult↗
PubMed1985

Visual illusion mimicking dyslexia. A case history.

A 14-year-old girl with reading difficulties was found to have an unusual illusory movement of objects in the central visual field. The movement could be blocked by using a 26 mm Visolette magnifier with an arrow pasted on its lower surface to function as a reference point. After having read with help of this arrangement for 19 months the girl suddenly could see normally and has now been able to read without difficulties for over 3 years. We report the first documented case of visual illusion as the cause of reading difficulty which disappeared at the age of 15 years, thus years after the maturation of visual functions is thought to be completed. Although visual illusion like the one presented here must be rare, it should be diagnosed, because the treatment is totally different from that of usual dyslexia.

Adolescent↗
PubMed1983

Contrast sensitivity in evaluation of visual impairment due to diabetes.

Spatial contrast sensitivity of 19 diabetics with different degrees of visual impairment was studied. It was found that contrast sensitivity at intermediate and low spatial frequencies may decrease without corresponding loss of visual acuity. In advanced cases of diabetes the opposite may be true: contrast sensitivity was better than expected on the basis of visual acuity. Thus both visual acuity and contrast sensitivity measurements are useful in the evaluation of the nature of visual impairment due to diabetic eye disease.

Color Perception Tests↗
PubMed1983

Contrast sensitivity in evaluation of visual impairment due to macular degeneration and optic nerve lesions.

Spatial contrast sensitivity was investigated in a group of 17 patients with macular degeneration or optic atrophy. It has been reported earlier that patients with optic atrophy may have reduced contrast sensitivity at low spatial frequencies without decrease of visual acuity, a phenomenon called 'hidden visual loss'. The present study shows that also the opposite may be true: patients with macular degeneration or optic atrophy may have greatly decreased visual acuity and yet normal or nearly normal contrast sensitivity at low spatial frequencies and reasonably good sensitivity at intermediate spatial frequencies. This phenomenon could be called 'hidden vision'. In normal individuals and many visually impaired patients the spatial contrast sensitivity at high and intermediate spatial frequencies is equal when measured using grating fields of different size. In patients with central scotoma due to macular degeneration or optic atrophy contrast sensitivity is dependent on the size of the grating field: the maximal contrast sensitivity is higher when larger grating fields are used. The size of the smallest grating field that is needed for normal contrast sensitivity values at low spatial frequencies is one measure of visual impairment in this group of patients. Another measure of the function of the eccentric viewing area is the grating acuity which may also vary as a function of the grating field size.

Humans↗