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Visual evoked potentials in konzo, a spastic paraparesis of acute onset in Africa.

AIM: To assess whether or not visual evoked potentials (VEPs) are abnormal in konzo, a para/tetraparesis of sudden onset, and to correlate the findings to the clinical picture of the disorder. METHODS: VEPs were recorded in 23 patients (9 men and 14 women, mean age: 23 +/- 10 years) suffering from konzo, and 38 healthy subjects (20 men and 18 women, mean age: 27 +/- 15 years). The mean P100 latencies and peak-to-peak N75-P100 amplitudes of each eye were measured and compared in the two groups. The mean interocular P100 latency and amplitude differences were calculated and also compared. RESULTS: VEPs were abnormal in 11/23 patients (48%) consisting of P100 prolongation (7 subjects), absence of P100 wave (2 subjects) or an atypical waveform (2 subjects). The mean P100 latency value of the konzo group was significantly increased as compared with the mean (+ 2.5 SD) of the reference values from healthy subjects (p < 0.05). There was a statistically significant decrease of amplitude in konzo patients compared to normal subjects (p < 0.05) with, however, only 2 patients outside the 95% confidence limits. Six patients (27%) had abnormal VEPs despite normal visual acuity. These abnormalities were symmetric and a relation could be found between neither the duration nor the severity of the disease and the VEP perturbation. CONCLUSION: The main features of these abnormalities are delayed P100 latency and decreased amplitude. These findings indicate involvement of visual pathways and seem to suggest the presence of axonal loss in the prechiasmal visual pathways in konzo. This study provides evidence that the neurodamage in konzo extends to the visual pathways.

Acute Disease↗

The EEG response to repetitive photic stimulation in various regions of the chicken brain.

The EEG response in the chicken to repetitive photic stimulation was studied by frequency analysis and by the averaged response. Evoked responses were observable not only in stations along the visual pathway but also in broad areas apart from the visual pathway. The electrical activity in the archistriatum showed a marked response to flickering stimuli, indicating that this area is involved in the visual function in the chicken. In other telencephalic areas, photically evoked potentials could not be clearly demonstrated in the EEG records. In the hypothalamus and the nucleus rotundus of the diencephalon and in the nucleus reticularis superior of the mesencephalon, sinusoidal waves appeared during stimulation at 8-13/sec. No rhythmic after-discharge was observed following termination of photic stimulation. These finding are indicative of the difference of the visual response in the chicken from previously reported responses in other species.

Animals↗

Visual retinocortical function in dementia of the Alzheimer type.

BACKGROUND: Some histological investigations have reported anomalies in the primary visual pathways of individuals with dementia of the Alzheimer type (DAT), while others have suggested that these visual structures are spared by the disease process. OBJECTIVES: This study was conducted to address this issue of substantial controversy. We determined in vivo whether DAT alters the functioning of the primary visual pathways by evaluating pattern-reversal electroretinograms (ERGs) and cortical visual evoked potentials (VEPs). METHODS: Twenty-seven individuals with mild to moderate DAT and 27 age- and sex-matched control subjects were included in the investigation. ERG and VEP recordings were obtained from all participants with the use of a clinical electrodiagnostic system. Stimulus conditions were biased towards a preferential response from the magnocellular and parvocellular subdivisions of the visual system. RESULTS: Amplitude and latency of the ERG were not affected by DAT. The VEP amplitude was not attenuated in DAT individuals, but there was a delay in the latency of the VEPs arising from both magnocellular and parvocellular streams of visual processing. CONCLUSION: Our results indicate that while the inner retina appears to be spared by the disease process, the visual function is altered upstream in the retinocortical visual pathways of individuals with DAT.

Aged↗

Metabolic activity in the hyperstriatum of 2-day-old chicks during optomotor and contrasting visual stimulation.

Our earlier report of differences in metabolic activity within the visual regions of the hyperstriatum and ectostriatum, in 2-day-old chicks compared with 23-day-old chicks, suggested that two visual pathways within the visual system develop at different rates. Here we have investigated whether the demands of varying visual environments will increase the activity of the hyperstriatum accessorium (HA) in 2-day-olds. Metabolic activity in the HA was monitored in 2-day-old chicks by the radioactive 2-deoxyglucose technique during monocular stimulation with three different visual environments: moving stripes in a rotating drum, which induced eye and head movements, a featureless white environment, and the complex visual environment of the home cage with other chicks. Although a small but significant level of activity was found in HA in the hemisphere opposite the open eye, the activity did not vary with the visual treatment. On the other hand, a raised level of activity in the hyperstriatum dorsale (HD) appeared in chicks viewing the rotating stripes, indicating that at this age the thalamo-hyperstriatal pathway may be involved in processing whole-field visual movement. The optomoter environment also produced high activity in the medial hyperstriatum ventrale (MHV), a region that has been implicated in memory formation of imprinting. We suggest that during the sensitive period for imprinting, HA may either have not developed its fully functional capacity, or that following or during imprinting it is actively shut down to protect itself and associated regions from interfering visual input. In contrast to the 2-day-olds, 17-day-old chicks in a visually rich cage environment, had high levels of activity in HA, demonstrating that the functional maturation of the HA, related to performance in the cage environment, is complete at least 6 days earlier than previously observed.

Aging↗

Midline brain lesions in children with hormone insufficiency indicate early prenatal damage.

The relationships between midline brain morphology, anterior visual pathway morphology and hormonal status in children with impaired growth were studied. Intracranial morphology was studied by magnetic resonance imaging in 47 children (14F, 33M), median age 9.7y (range 2.6-18.7y) undergoing growth hormone treatment (GH; 0.1 U/kg/d). They were chosen to represent various birth sizes and a spectrum of hormone insufficiencies. There was a relationship between GH secretion and the morphology of the neurohypophysis, the pituitary stalk and the anterior visual pathways, i.e. the greater the GH insufficiency, the more abnormal were these structures. The children with anterior visual pathway abnormalities had the lowest GH levels and the smallest adenohypophysis. The association between abnormalities of the anterior visual pathways and the hypothalamo-pituitary structures may reflect a common prenatal neural damage in embryologically and anatomically closely related structures.

Adolescent↗

Behavioral, structural and neurochemical asymmetries in the avian brain: a model system for studying visual development and processing.

The emphasis of this review is on the visual systems and lateralized visually guided behavior in several avian species. Lateral asymmetry is known to be present in the tectofugal visual projections to the forebrain of the pigeon and in the thalamofugal visual projections to the forebrain of the chicken. These structural asymmetries are discussed in the context of the behavioral and neurochemical asymmetries. While recognizing the need to investigate the organization of both of the visual pathways within one avian species; this review reasons inductively that the lateralized organization of the two visual pathways leads to binocular input to the right hemisphere via the thalamofugal visual system and to the left hemisphere via the tectofugal visual system. For each system, input to the other hemisphere is primarily monocular. This specialization of the hemispheres for visual processing has predictable effects on behavior. The role of asymmetrical light stimulation of the eyes of the embryo in determining the lateralizations in the visual pathways and some behaviors is discussed, as are other lateralizations generated or altered by imprinting and passive avoidance learning.

Animals↗

Chromatic light adaptation measured using functional magnetic resonance imaging.

Sensitivity changes, beginning at the first stages of visual transduction, permit neurons with modest dynamic range to respond to contrast variations across an enormous range of mean illumination. We have used functional magnetic resonance imaging (fMRI) to investigate how these sensitivity changes are controlled within the visual pathways. We measured responses in human visual area V1 to a constant-amplitude, contrast-reversing probe presented on a range of mean backgrounds. We found that signals from probes initiated in the L and M cones were affected by backgrounds that changed the mean absorption rates in the L and M cones, but not by background changes seen only by the S cones. Similarly, signals from S cone-initiated probes were altered by background changes in the S cones, but not by background changes in the L and M cones. Performance in psychophysical tests under similar conditions closely mirrored the changes in V1 fMRI signals. We compare our data with simulations of the visual pathway from photon catch rates to cortical blood-oxygen level-dependent signals and show that the quantitative fMRI signals are consistent with a simple model of mean-field adaptation based on Naka-Rushton (Naka and Rushton, 1966) adaptation mechanisms within cone photoreceptor classes.

Adaptation, Ocular↗

A practical approach to albino diagnosis. VEP misrouting across the age span.

In addition to the genetic heterogeneity in albinism, widespread clinical heterogeneity frequently impedes albino detection and differential diagnosis. Further, several auxiliary ocular and/or cutaneous manifestations of this inherited error of pigmentary metabolism are neither pre-requisite nor specific to the albino condition. However, one feature that is specific to albinism regardless of genotype or phenotype is a unique pattern of abnormal visual pathway organization. With an appropriate test paradigm, the albino visual pathway can be revealed by the non-invasive recording of the visual evoked potential (VEP) distribution across the occiput which shows contralateral hemispheric asymmetry following full field monocular stimulation. As described in this report, the VEP albino misrouting detection test has been refined to yield extraordinarily high sensitivity and selectivity across the age span from the neonate to the elderly. As the VEP profile undergoes maturational changes, these changes have been taken into account in the development of an albino age-range VEP test recipe which includes the pattern onset paradigm for older albinos and a luminance flash paradigm for the albino infant. The age appropriate optic pathway misrouting test provides reliable albino detection and definitive differential diagnosis. Further, as the albino VEP signature of contralateral asymmetry is also age specific, the VEP misrouting test can be extended to the objective assessment of visual pathway maturation.

Adolescent↗

Patterns of visual loss associated with pituitary macroadenomas.

PURPOSE: To describe the patterns of visual loss associated with pituitary macroadenomas compressing the anterior visual pathway. METHOD: A prospective survey of 29 patients with pituitary macroadenomas who presented to the neurosurgical unit at St Vincent's Hospital, Melbourne. Selected patients had histologically verified pituitary macroadenomas, and visual defects (acuity, colour and/or field loss) consistent with anterior visual pathway compression. RESULTS: All patients had visual field defects detected on perimetry, and the majority were asymmetrical. Bitemporal defects were most common but field defects ranged from monocular defects to generalised constriction. Four patients (13.8%) did not report visual symptoms, and of those who had symptoms, blurred vision was the most common complaint. Ninety-six per cent of eyes had field loss, 56% had decreased colour vision, 46% had decreased acuity, 31% had optic disc pallor, and 2% had an ophthalmoplegia. CONCLUSIONS: Patients with visual pathway compression by pituitary macroadenomas may be asymptomatic despite having field defects. Perimetry is the most sensitive method of identifying compression, followed by colour vision, visual acuity, then the presence of optic atrophy. Automated static threshold perimetry appears to show early field defects better than manual kinetic perimetry. All patients with pituitary macroadenomas should have thorough ophthalmological examinations, including perimetry to document visual deficits secondary to compression.

Adenoma↗

Lens-injury-stimulated axonal regeneration throughout the optic pathway of adult rats.

Axonal regrowth and restoration of visual function were studied in adult rats. The optic nerve was completely cut behind the eye. The proximal and distal nerve stumps were realigned and the meninges sutured back together. During the same surgical procedure, the lens was lesioned in order to induce secondary cellular cascades, which are known to strongly support the survival of retinal ganglion cells (RGCs) and to promote axonal regeneration. The anatomical and topographic restoration of the visual pathway was assessed neuroanatomically with the aid of anterograde and retrograde tracing using fluorescent dyes. It appeared that the axons formed growth cones at the junction of the suture soon after injury, before glial cells and extracellular matrix proteins were able to cause local scar formation. Growth cones first entered the distal optic nerve stump 3 days after injury, grew through it to reach the optic chiasm approximately 3 weeks after the lesion was made, and terminated within the retinoreceptive layers of the superior colliculus 5 weeks after lesioning. Quantification of the retrogradely labeled cell bodies within the regenerating retina revealed that up to 30% of the RGCs, which includes all major cell types, were capable of regenerating their axons along the entire visual pathway. To assess whether topography was restored, double-labeling experiments were performed, revealing only crude topographic restoration during the initial stages of regeneration. However, visual-evoked potentials could be recorded, indicating that synaptic transmission in higher visual areas was relatively intact. The data show, in principle, that cut axons can regenerate over long distances within the white matter of a central nerve like the adult optic nerve, spanning over 11 mm to the chiasm and between 12 and 15 mm to the thalamus and midbrain. The findings suggest, for the first time, that lentogenic stimulation of RGCs is sufficient to induce the formation of growth cones that can override inhibitors at the site of injury, grow through the white matter of the optic nerve, pass through the optic chiasm, and make synaptic connections within the brain.

Animals↗

Adult cortical dynamics.

There are many influences on our perception of local features. What we see is not strictly a reflection of the physical characteristics of a scene but instead is highly dependent on the processes by which our brain attempts to interpret the scene. As a result, our percepts are shaped by the context within which local features are presented, by our previous visual experiences, operating over a wide range of time scales, and by our expectation of what is before us. The substrate for these influences is likely to be found in the lateral interactions operating within individual areas of the cerebral cortex and in the feedback from higher to lower order cortical areas. Even at early stages in the visual pathway, cells are far more flexible in their functional properties than previously thought. It had long been assumed that cells in primary visual cortex had fixed properties, passing along the product of a stereotyped operation to the next stage in the visual pathway. Any plasticity dependent on visual experience was thought to be restricted to a period early in the life of the animal, the critical period. Furthermore, the assembly of contours and surfaces into unified percepts was assumed to take place at high levels in the visual pathway, whereas the receptive fields of cells in primary visual cortex represented very small windows on the visual scene. These concepts of spatial integration and plasticity have been radically modified in the past few years. The emerging view is that even at the earliest stages in the cortical processing of visual information, cells are highly mutable in their functional properties and are capable of integrating information over a much larger part of visual space than originally believed.

Adult↗

Two functional channels from primary visual cortex to dorsal visual cortical areas.

Relationships between the M and P retino-geniculo-cortical visual pathways and "dorsal" visual areas were investigated by measuring the sources of local excitatory input to individual neurons in layer 4B of primary visual cortex. We found that contributions of the M and P pathways to layer 4B neurons are dependent on cell type. Spiny stellate neurons receive strong M input through layer 4Calpha and no significant P input through layer 4Cbeta. In contrast, pyramidal neurons in layer 4B receive strong input from both layers 4Calpha and 4Cbeta. These observations, along with evidence that direct input from layer 4B to area MT arises predominantly from spiny stellates, suggest that these different cell types constitute two functionally specialized subsystems.

Animals↗

Contributions of the visual ventral pathway to long-range apparent motion.

Objects displaced intermittently across the visual field will nonetheless give an illusion of continuous motion [called apparent motion (AM)] under many common conditions. It is believed that form perception is of minor importance in determining AM, and that AM is mediated by motion-sensitive areas in the "where" pathway of the cortex. However, form and motion typically interact in specific ways when natural objects move through the environment. We used functional magnetic resonance imaging to measure cortical activation to long-range AM, compared to short-range AM and flicker, while we varied stability of structural differences between forms. Long-range AM activated the anterior-temporal lobe in the visual ventral pathway, and the response varied according to the form stability. The results suggest that long-range AM is associated with neural systems for form perception.

Brain Mapping↗

Uncertainty and invariance in the human visual cortex.

The way in which input noise perturbs the behavior of a system depends on the internal processing structure of the system. In visual psychophysics, there is a long tradition of using external noise methods (i.e., adding noise to visual stimuli) as tools for system identification. Here, we demonstrate that external noise affects processing of visual scenes at different cortical areas along the human ventral visual pathway, from retinotopic regions to higher occipitotemporal areas implicated in visual shape processing. We found that when the contrast of the stimulus was held constant, the further away from the retinal input a cortical area was the more its activity, as measured with functional magnetic resonance imaging (fMRI), depended on the signal-to-noise ratio (SNR) of the visual stimulus. A similar pattern of results was observed when trials with correct and incorrect responses were analyzed separately. We interpret these findings by extending signal detection theory to fMRI data analysis. This approach reveals the sequential ordering of decision stages in the cortex by exploiting the relation between fMRI response and stimulus SNR. In particular, our findings provide novel evidence that occipitotemporal areas in the ventral visual pathway form a cascade of decision stages with increasing degree of signal uncertainty and feature invariance.

Adult↗

Contrasting the dorsal and ventral visual systems: guidance of movement versus decision making.

It is widely accepted that the ventral visual pathways are involved in the identification of objects and the dorsal visual pathways in the visual guidance of reaching and grasping movements. But there are also situations, such as in a choice reaction time task, in which the subjects must select between actions on the basis of visual cues. This paper uses brain imaging to explore the pathways that are involved. Studies using PET and fMRI show that when subjects learn which actions are appropriate given the visual context, there are learning-related increases in the inferotemporal cortex and the ventral prefrontal cortex to which it projects. An event-related fMRI study shows that the activity in the inferotemporal cortex is time-locked to the presentation of the visual cue and the activity in the ventral prefrontal cortex to the response. Finally two PET studies directly compare the dorsal and ventral systems. In the second of these the subjects either move their finger on a moving target or identify the direction of movement and press one of two buttons to report the direction. When the subjects report the direction there is activity in the middle temporal gyrus and ventral prefrontal cortex. It is suggested that, when subjects must consciously identify the context and decide on the appropriate action, ventral pathways are involved.

Association Learning↗

Initial processing of visual information within the retina and the LGN.

The initial stage of information processing by the visual system reduces the information contained in the continuous image on the retina into a discrete set of responses which are carried from the lateral geniculate nucleus (LGN) to the visual cortex. -- 1. The optimal sampling of the light intensity distribution in the visual environment is achieved only if each channel in the visual pathways carries undistorted information corresponding to an image element. The visual system approaches as closely as possible the scheme of optimal spatial sampling, retaining the full information on the low spatial frequency content of the object light intensity. The ideal receptive field of a sustained LGN cell is then of the form J1(Kr)/Kr. -- 2. The experimentally determined receptive fields of sustained LGN cells (and to some extent retinal ganglion cells as well) in cat closely resemble the functional form J1(Kr)/Kr. The centre-surround organization of the receptive fields is therefore understood as a scheme which leads to a maximal information flow through the visual pathways. -- 3. The optimal sampling scheme cannot be realized by the retina alone, because of restrictions on the size of neural networks. It is therefore constructed in two stages, ending at the LGN level. A recombination of ganglion cell signals into optimal receptive fields is a major role of the LGN.

Animals↗

Abnormal pattern electroretinograms in patients with senile dementia of the Alzheimer type.

Patients with senile dementia of the Alzheimer type frequently have difficulty performing visual tasks. These difficulties may be due, at least partially, to degenerative changes in both the primary visual pathway and the visual association areas. To determine whether retinal ganglion cell dysfunction contributes to visual loss in senile dementia of the Alzheimer type, we tested a group of patients with this disease (n = 13) using the pattern-reversal electroretinogram to both low (4.0 reversals per second) and high (16.0 reversals per second) temporal frequency checkerboard patterns (1.0 degree checks). Significant amplitude reductions were noted for the patients relative to age-matched control subjects (n = 30). In addition, the observed amplitude reductions were most pronounced for the high temporal frequency condition. Therefore, the results are consistent with retinal ganglion cell dysfunction and support the notion that optic nerve damage induced by senile dementia of the Alzheimer type preferentially affects the larger, faster-conducting retinal ganglion cells along with their retinocortical projections.

Aged↗