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PubMed2005

Simulated prosthetic visual fixation, saccade, and smooth pursuit.

A visual tracking task was administered to 20 subjects afforded simulated prosthetic vision (a phosphene array); a total of 3h data was taken from each subject over the course of 10 visits. The experiment assessed prosthetic visual fixation, saccade and smooth pursuit and the effect of practice. Further, we demonstrated an image analysis technique that assisted fixation and pursuit (but not saccade) accuracy, and required less vigorous movement of the phosphene array in pursuing the target. As measured by mean deviation from the target, fixation and pursuit accuracies were improved by 8.3 and 3.3 min of visual arc, respectively (35.8% and 6.8%), for inter-phosphene spacing of 1.9 degrees . The analysis technique, involving overlapping Gaussian kernels, was an heuristic design; this is the first step of an iterative, experimental approach to devising effective image analysis to be contained in an electronic vision prosthesis. The approach should ultimately afford implanted patients improved prosthetic visual function.

Analysis of Variance↗
PubMed2006

Positive visual phenomena in space: A scientific case and a safety issue in space travel.

Most astronauts on Apollo, Skylab, and MIR reported 'flashes of light' occurring in different shapes and apparently moving across the visual field, in the absence of auditory, somatosensory, or olfactory abnormal percepts. A temporal correlation with heavy nuclei or protons has been documented in space and comparable phosphenes were observed by volunteers whose eyes were exposed to accelerated heavy ions at intensities below the threshold for Cerenkov visible radiation. An interaction between heavy ions and the retina was suggested. However, the biophysics of heavy ions or protons action remains undefined, the effects on photoreceptors and neuroretina have not been differentiated, and some direct action on the visual cortex never ruled out. Phosphenes are common in migraine and are known to occur also in response to the electrical stimulation of ganglion cells (in retinas without photoreceptors), optic pathways or visual cortex, with mechanisms that bypass the chemically gated channels. Intrinsic photosensitive ganglion cells exist in the retina of teleost fish and mammals. In the hypothesis of a peculiar sensitivity to subatomic particles of the visual system, phosphenes due to the activation of processes by-passing the photoreceptors would raise questions about human safety in space. The issue is particularly relevant with experiments of increasing duration being now operative in the International Space Station (ISS) and with plans of space travel outside the geomagnetic shield. Research is in progress both in the ISS and on animal models, in the framework of the NASA/ESA actions to improve the astronauts' health in space.

Cosmic Radiation↗
PubMed1999

A neural interface for a cortical vision prosthesis.

The development of a cortically based vision prosthesis has been hampered by a lack of basic experiments on phosphene psychophysics. This basic research has been hampered by the lack of a means to safely stimulate large numbers of cortical neurons. Recently, a number of laboratories have developed arrays of silicon microelectrodes that could enable such basic studies on phosphene psychophysics. This paper describes one such array, the Utah electrode array, and summarizes neurosurgical, physiological and histological experiments that suggest that such an array could be implanted safely in visual cortex. We also summarize a series of chronic behavioral experiments that show that modest levels of electrical currents passed into cortex via this array can evoke sensory percepts. Pending the successful outcome of biocompatibility studies using such arrays, high count arrays of penetrating microelectrodes similar to this design could provide a useful tool for studies of the psychophysics of phosphene perception in human volunteers. Such studies could provide a proof-of-concept for cortically based artificial vision.

Animals↗
PubMed2002

Mapping of the human visual cortex using image-guided transcranial magnetic stimulation.

We describe a protocol using transcranial magnetic stimulation (TMS) to systematically map the visual sensations induced by focal and non-invasive stimulation of the human occipital cortex. TMS is applied with a figure of eight coil to 28 positions arranged in a 2x2-cm grid over the occipital area. A digitizing tablet connected to a PC computer running customized software, and audio and video recording are used for detailed and accurate data collection and analysis of evoked phosphenes. A frameless image-guided neuronavigational device is used to describe the position of the actual sites of the stimulation coils relative to the cortical surface. Our results show that TMS is able to elicit phosphenes in almost all sighted subjects and in a proportion of blind subjects. Evoked phosphenes are topographically organized. Despite minor inter-individual variations, the mapping results are reproducible and show good congruence among different subjects. This procedure has potential to improve our understanding of physiologic organization and plastic changes in the human visual system and to establish the degree of remaining functional visual cortex in blind subjects. Such a non-invasive method is critical for selection of suitable subjects for a cortical visual prosthesis.

Blindness↗
PubMed2003

Excitability of visual V1-V2 and motor cortices to single transcranial magnetic stimuli in migraine: a reappraisal using a figure-of-eight coil.

We used transcranial magnetic stimulation (TMS) with a figure-of-eight coil to excite motor and visual V1-V2 cortices in patients suffering from migraine without (MO) (n = 24) or with aura (MA) (n = 13) and in healthy volunteers (HV) (n = 33). Patients who had a migraine attack within 3 days before or after the recordings were excluded. All females were recorded at mid-cycle. Single TMS pulses over the occipital cortex elicited phosphenes in 64% of HV, 63% of MO and 69% of MA patients. Compared with HV, the phosphene threshold was significantly increased in MO (P = 0.001) and in MA (P = 0.007), but there was no difference between the two groups of migraineurs. The motor threshold tended to be higher in both migraine groups than in HV, but the differences were not significant. In conclusion, this study shows that two-thirds (64.86%) of patients affected by either migraine type present an increased phosphene threshold in the interictal period, which suggests that their visual cortex is hypoexcitable.

Adult↗
PubMed2003

Increased visual cortical excitability in ecstasy users: a transcranial magnetic stimulation study.

OBJECTIVES: To test the presence of abnormalities of visual cortical excitability in people using ecstasy as a recreational drug. METHODS: Ecstasy users and control subjects underwent single pulse transcranial magnetic stimulation (TMS) of the occipital cortex. The phosphene threshold was analysed and compared in the two groups. RESULTS: Phosphene thresholds were significantly lower in ecstasy users compared with control subjects, and were correlated negatively with frequency of ecstasy use. Frequency of use was positively correlated with the presence of visual hallucinations. The phosphene threshold of subjects with hallucinations was significantly lower than that of subjects without hallucinations. CONCLUSIONS: The use of ecstasy as a recreational drug is associated with an increased excitability of the visual cortex, possibly linked with massive serotonin release, followed by serotonin depletion, in this cortical area.

Adult↗
PubMedDate not supplied

[Psychophysiological components of electrostimulation of the visual analyzer and their use to choose adequate parameters of therapeutic current].

The paper deals with search for signs or controllers of the adequacy of chosen visual analyzer electrostimulation (ES) parameters accessible for an outpatient physician. The subjective characteristics of phosphene-elementary visual sensation under the influence of electric current on the visual tract are identified; changes in the properties of phosphene in response to those of ES parameters were traced. The subjective characteristics of phosphene indirectly evaluates the degree of visual tract lesion and may serve as a controller of adequacy of ES parameters. The resultant algorithm of management of the properties of each identified characteristics of phoshene significantly enhances the efficiency of therapeutical ES.

Adult↗
PubMed1992

[Psychological aspects of perception of magnetophosphenes and electrophosphenes].

Scientific research at the Helmholtz Institute for Biomedical Engineering at Aachen University indicates that ELF (extremely-low frequency) electric and magnetic fields may generate visual perceptions in the human retina which are similar to the pressure phosphenes. During our own experiments we found that 90% of subjects undergoing a blind experiment reported various visual sensations which were mostly colored and moving. Our findings indicate that the psychological component of the perception of electric and magnetic phosphenes must not be underestimated. It is possible that there is a connection between retinal noise in the dark (due to metabolic processes [5, 8]) and magnetic or electric phosphenes.

Adolescent↗
PubMed1990

[A method and a device for the differential diagnosis of retinal pathological states].

A new method and a device--a stimulator ophthalmological KNSO 1-88 "Phosphene" is suggested for differential diagnosis of pathologic conditions of the retina. It is shown that by means of the proposed method, after 20-25 minutes of dark adaptation the threshold of electric sensitivity by phosphene increases differently with respect to the initial level (on the first minute of dark adaptation): in norm--by 15.2%, in optic nerve atrophy--by 14%, in pigmentary and nonpigmentary forms of retinal dystrophy--by 33.2%. Thus, investigation of the threshold of electric sensitivity by phosphene presents valuable supplementary data for differential diagnosis between optic nerve atrophy and nonpigmentary form of retinal degeneration: in optic nerve atrophy the degree of the threshold increase of absolute electric sensitivity differs, as a rule, but a little from normal values, while in pigmentary and nonpigmentary forms of retinal degeneration it is 2-3 time above norm.

Adult↗
PubMed2003

Effects of repetitive transcranial magnetic stimulation on visual evoked potentials: new insights in healthy subjects.

In a previous comparative study with migraineurs, we found in 24 normal subjects that the amplitude of the pattern-reversal visual evoked potential (PR-VEP) in the first block of 100 responses and its habituation over 6 sequential blocks were significantly decreased after 1 Hz repetitive transcranial magnetic stimulation (rTMS), while 10 Hz rTMS had no significant effect. We report here our results on the reproducibility of the rTMS effect studied in ten of these subjects by repeating the recordings for each frequency three times on different days. We have also reanalysed the data obtained in 24 normal subjects, looking separately at the results in those stimulated at an intensity equal to phosphene threshold (group 1; n=14) and those stimulated at 110% of motor threshold because of unelicitable phosphenes (group 2; n=10). We finally determined the precise duration of the rTMS effect. Despite some interindividual variability, the effects of both rTMS frequencies on first block amplitude, habituation between first and sixth block and habituation slope over the six blocks were highly reproducible. The only difference between the two groups of subjects was the effect of 1 Hz rTMS on the second measured PR-VEP component. Whereas first block amplitude of the first P1-N1 component and habituation were decreased in both groups, such a decrease was found for the second P1-N2 component only in group 1 stimulated at phosphene threshold. The dishabituation of the N1-P1 component after 1 Hz rTMS was maximal at 15 min, but lasted up to 33 min, while that of P1-N2 disappeared after 3 min. There was a non-significant trend ( p=0.06) for a reduction of first block amplitude after 10 Hz rTMS in the total group of subjects, but no effect on habituation. The inhibitory effect of 1 Hz rTMS, which reduces in healthy controls both first block PR-VEP amplitude and habituation, probably by decreasing the preactivation excitability level of the underlying visual cortex, is thus reproducible and long lasting. Long trains of 10 Hz rTMS tend to attenuate reproducibly the cortical preactivation level in normal subjects, but they do not affect habituation at all, which contrasts with their effect in migraineurs, in whom, as previously reported, they significantly correct the habituation deficit. The absence of an effect of 1 Hz rTMS on PR-VEP P1-N2 in subjects stimulated at 110% of motor threshold may be explained by the deeper anatomical location of the cortical generators of this component and the lower stimulation intensity used. Taken together our results confirm that the effect of rTMS on the underlying cortex depends on several variables such as frequency, intensity and level of cortical preactivation.

Adult↗
PubMed2002

Visual cortex excitability in migraine before and after valproate prophylaxis: a pilot study using TMS.

We examined the effect of standard migraine prophylaxis with sodium valproate on repeated measures of occipital excitability using transcranial magnetic stimulation (TMS). We predicted that, comparing pre- and post-treatment assessments, a reduction in clinical migraine parameters would be paralleled by a decrease in excitability measurements.A total of 31 migraine patients enrolled in the study, for assessment prior to and 1 month after commencement of sodium valproate prophylaxis. At each assessment, we used a standardized protocol to stimulate the occipital cortex with a 90-mm circular (coil A) and 70 mm figure-of-eight (coil B) coil. We recorded the threshold stimulation intensity at which subjects just perceived phosphenes. Subjects kept detailed records of headache parameters 1 month before and also during the study period. Valproate therapy significantly improved headache indexes, as expected. In MA subjects assessed with coil B, phosphene thresholds were significantly higher post-treatment than pre-treatment, but those for MO did not change. Modest correlations were observed in MA patients between increase in phosphene threshold and decrease in headache index. Although preliminary, the findings with coil B lend some support to the notion that effective migraine prophylaxis may be achieved through lowering cortical excitability by gamma-aminobutyric acid (GABA)-ergic intervention. Further investigation of the effect of sodium valproate or other similarly acting substances on cortical excitability in migraine is warranted.

Anticonvulsants↗
PubMed1998

Interictal cortical excitability in migraine: a study using transcranial magnetic stimulation of motor and visual cortices.

We performed transcranial magnetic stimulations of the motor and visual cortices in healthy controls (n = 27) and in patients suffering from migraine without (n = 33) or with (n = 25) aura between attacks. By using a 13-cm circular coil placed over the vertex and recordings of the first dorsal interosseus muscle, we measured thresholds (at rest and during contraction), amplitudes of motor evoked potentials and cortical silent periods. Paired stimulations with short (1-20 msec) interstimulus intervals were performed to assess intracortical inhibition. The visual cortex was stimulated with the same coil placed over the occipital scalp (7 cm above the inion) and the prevalence and threshold of phosphene production was determined. In patients with migraine with aura, motor thresholds during isometric contraction were significantly higher, whereas the prevalence of stimulation-induced phosphene production was lower compared with healthy controls. These changes were not correlated with attack frequency or disease duration. No differences were found between subject groups in thresholds at rest, motor evoked potential amplitudes, cortical silent periods, or response curves after paired stimuli. These results are in favor of cortical hypoexcitability rather than hyperexcitability in patients with migraine with aura between attacks.

Adult↗
PubMed2001

In vivo assessment of human visual system connectivity with transcranial electrical stimulation during functional magnetic resonance imaging.

Functional magnetic resonance imaging (fMRI) was used to investigate local and distant cerebral activation induced by transcranial electrical stimulation in order to noninvasively map functional connectivity in the human visual system. Stimulation with lateromedially directed currents and the anode 4.5 cm dorsally to the inion over the right visual cortex induced phosphenes extending into the contralateral lower quadrant of the visual field. fMRI showed a focal hemodynamic response underneath the anode in extrastriate cortex and distant coactivation in subcortical (lateral geniculate nucleus), cortical visual (striate and extrastriate), and visuomotor areas (frontal and supplementary eye fields). This pattern of activation resembles a network of presumably interconnected visual and visuomotor areas. Analysis of activation sites supplies new information about cerebral correlates of phosphenes and shows that the cortical region underneath the cranial stimulation site is not necessarily the origin of behavioral and/or perceptual effects of transcranial stimulation. We conclude that combining transcranial electrical stimulation of neural tissue with simultaneous fMRI offers the possibility to study noninvasively cerebral connectivity in the human brain.

Adult↗
PubMed2005

Microstimulation of V1 affects the detection of visual targets: manipulation of target contrast.

Electrical microstimulation of the striate cortex (area V1) in monkeys delays the execution of saccadic eye movements generated to a visual target located in the receptive field of the stimulated neurons. We have argued that this effect is because of disruption of the visual signal transmitted along the geniculostriate pathway. The delivery of electrical stimulation to V1 evokes a punctate light or dark phosphene in human subjects. If electrical stimulation of V1 in monkeys evokes a light or dark phosphene, then one might expect that the delay effect might vary according to whether monkeys are required to detect a light or a dark visual target. For instance, if the stimulation is activating V1 elements coding for a light visual stimulus but not a dark visual stimulus then stimulation may delay saccades generated to a light target but not to a dark target. We tested this idea by having monkeys generate saccadic eye movements to light or dark visual targets immediately after the stimulation was delivered to V1. We found that the delay effect induced by stimulation varied with target contrast, but remained invariant to whether a bright or dark visual target was presented in the receptive field of the stimulated neurons. The significance of these results is discussed with regard to using monkeys to develop a visual prosthesis for the blind.

Animals↗
PubMed1998

Transient visual field defects induced by transcranial magnetic stimulation over human occipital pole.

Transient visual field defects (VFDs) and phosphenes were induced in normal volunteers by means of transcranial magnetic stimulation (TMS) using a circular magnetic coil of 12.5 cm diameter placed with its lower rim 2-4 cm above the inion in the midline. Subjects had to detect small, bright dots presented randomly for 14 ms in one of 60 locations on a computer screen resulting in a plot of the central 9 degrees of the visual field. In 8 of 17 subjects, transient VFDs were inducible at peak magnetic field strenghts of 1.1-1.4 T. In the central 1-3 degrees, detection of targets was impaired in both the upper and lower visual field, whereas at 4-9 degrees large parts of only the lower visual field were affected with a sharp cut-off along the horizontal meridian. Targets at 1 degree in the lower field were affected with lower TMS intensities than corresponding locations in the upper or peripheral locations in the lower field. Detection of central targets was affected at more caudal stimulation sites than detection of peripheral targets. Phosphenes were elicitable in 14 of 17 subjects at clearly lower field strengths of 0.6-1.0 T. Many subjects perceived chromatophosphenes. From a discussion of the literature on patients with VFDs and the known topography of the human visual system, it is concluded that the transient VFDs at 1-3 degrees are probably due to stimulation of both striate cortex (V1) and extrastriate areas (V2/V3), while VFDs in the lower visual field at eccentricities 4-9 degrees are due to stimulation of V2/V3 but not V1.

Adult↗
PubMed2002

Visual cortex excitability increases during visual mental imagery--a TMS study in healthy human subjects.

Previous neuroimaging studies provided evidence that visual mental imagery relies, in part, on the primary visual cortex. We hypothesized that, analogous to the finding that motor imagery increases the excitability of motor cortex, visual imagery should increase visual cortex excitability, as indexed by a decrease in the phosphene threshold (PT). In order to test visual cortex excitability, the primary visual cortex was stimulated with transcranial magnetic stimulation (TMS), so as to elicit phosphenes in the right lower visual quadrant. Subjects performed a visual imagery task and an auditory control task. We applied TMS with increasing intensity to determine the PT for each subject. Independent of the quadrant in which subjects placed their visual images, imagery decreased PT compared to baseline PT; in contrast, the auditory task did not change PT. These findings demonstrate for the first time a short-term, task-dependent modulation of PT. These results constitute evidence that early visual areas participate in visual imagery processing.

Adult↗
PubMed2002

Visual and motor cortex excitability: a transcranial magnetic stimulation study.

OBJECTIVES: Phosphene thresholds (PTs) to transcranial magnetic stimulation over the occipital cortex and motor thresholds (MTs) have been used increasingly as measures of the excitability of the visual and motor cortex. MT has been utilized as a guide to the excitability of other, non-motor cortical areas such as dorsolateral prefrontal cortex. The aims of this study were to compare the PTs to MTs; to assess their stability across sessions; and to investigate their relation to MTs. METHODS: PTs and MTs were determined using focal transcranial magnetic stimulation over the visual and motor cortex. RESULTS: PTs were shown to be significantly higher than MTs. Both PTs and MTs were stable across sessions. No correlation between PTs and MTs could be established. CONCLUSIONS: Phosphene threshold is a stable parameter of the visual cortex excitability. MTs were not related to the excitability of non-motor cortical areas.

Adult↗
PubMedDate not supplied

Visual resolution with epi-retinal electrical stimulation estimated from activation profiles in cat visual cortex.

Blinds with receptor degeneration can perceive localized phosphenes in response to focal electrical epi-retinal stimuli. To avoid extensive basic stimulation tests in human patients, we developed techniques for estimating visual spatial resolution in anesthetized cats. Electrical epi-retinal and visual stimulation was combined with multiple-site retinal and cortical microelectrode recordings of local field potentials (LFPs) from visual areas 17 and 18. Classical visual receptive fields were characterized for retinal and cortical recording sites using multifocal visual stimulation combined with stimulus-response cross-correlation. We estimated visual spatial resolution from the size of the cortical activation profiles in response to single focal stimuli. For comparison, we determined activation profiles in response to visual stimuli at the same retinal location. Activation profiles were single peaked or multipeaked. In multipeaked profiles, the peak locations coincided with discontinuities in cortical retinotopy. Location and width of cortical activation profiles were distinct for retinal stimulation sites. On average, the activation profiles had a size of 1.28 +/- 0.03 mm cortex. Projected to visual space this corresponds to a spatial resolution of 1.49 deg +/- 0.04 deg visual angle. Best resolutions were 0.5 deg at low and medium stimulation currents corresponding to a visus of 1/30. Higher stimulation currents caused lower spatial, but higher temporal resolution (up to 70 stimuli/s). In analogy to the receptive-field concept in visual space, we defined and characterized electrical receptive fields. As our estimates of visual resolutions are conservative, we assume that a visual prosthesis will induce phosphenes at least at this resolution. This would enable visuomotor coordinations and object recognition in many indoor and outdoor situations of daily life.

Animals↗