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Homonymous hemianopia in multiple sclerosis. With report of bilateral case.

A patient with multiple sclerosis and bilateral retrochiasmal visual field defects is reported. Homonymous field defects are rare in multiple sclerosis despite the frequency of pathological involvement of the retrochiasmal visual pathways. A higher incidence might be found with a higher index of suspicion and careful visual field testing with qualitative confrontation technique. Other reasons for the infrequent clinical detection of retrochiasmal lesions are considered. Such lesions may exist without demonstrable defect. This may be explained by anatomical factors, for example, fibre arrangement, or physiological factors, such as, geniculate or retrogeniculate integration. Lesions producing demonstrable defects may be asymptomatic because they: affect only the peripheral field, are small scotomas that do not impair visual acuity, affect only one eye, or occur late in the course of disease when masked by optic nerve involvement.

Adrenocorticotropic Hormone↗

Adrenoleukodystrophy: correlating MR imaging with CT.

The effect on the brain of the sex-linked recessive form of adrenoleukodystrophy was studied in 40 boys, 4-18 years old. All underwent computed tomography (CT) scanning; six underwent magnetic resonance (MR) imaging. MR showed a high sensitivity in demonstrating white matter disease. Auditory pathway disease was characterized as involvement of the lateral lemniscus and medial geniculate body, and visual pathway disease was characterized by lateral geniculate body, Meyer loop, and optic radiation involvement. Contrast-enhanced CT still proved to have a greater capacity (at this time) to show the active, advancing form of the disease and concomitant calcifications. This large CT series also demonstrated the broad and variable expressions of adrenoleukodystrophy, which allowed the unification of previously described atypical forms of the disease.

Adolescent↗

Spatial processing and hemispheric asymmetry. Contributions of the transient/magnocellular visual system.

Right-handed observers were presented with stimuli consisting of a line and two horizontally separated dots. A categorical spatial task required observers to indicate whether the dots were above or below the line, and a coordinate spatial task required observers to indicate whether the line could fit into the space between the two dots. For the coordinate task, reaction time was faster when the stimuli were presented to the left visual field (right hemisphere) than when the stimuli were presented to the right visual field (left hemisphere). The opposite hemispheric asymmetry was obtained for the categorical task. In addition, coordinate spatial processing took longer with stimuli presented on a red background than with stimuli presented on a green background. The opposite hemispheric asymmetry was obtained for the categorical task. In addition, coordinate spatial processing took longer with stimuli presented on a red background than with stimuli presented on a green background. The opposite trend characterized categorical spatial processing. Because the color red attenuates processing in the transient/magnocellular visual pathway, these results suggest that coordinate spatial processing is more dependent on the transient/magnocellular pathway than is categorical spatial processing. However, manipulations of color condition had no effect on visual field (hemispheric) asymmetries, suggesting that the two hemispheres rely on the same visual information and on the same computational mechanisms as each other-although they do not always use that information with equal efficiency.

Adult↗

[Diagnosis of demyelination processes based on the visual evoked potential test using a checkerboard reversal pattern].

Visual evoked potentials in response to checkerboard reversal pattern were evaluated in 160 patients: 24 with isolated retrobulbar optic neuritis, 100 with unquestionable and probable multiple sclerosis, 36 with paraparesis or with disseminated changes of unestablished aetiology (degenerative or inflammatory) and in 80 healthy controls. Normal visual evoked potentials were obtained in all controls. In all cases of present or past optic neuritis abnormal potentials were observed, usually unilateral. In multiple sclerosis patients with unquestionable diagnosis abnormal potentials were present in 92% of cases, and in patients with probable multiple sclerosis they were found in 58%, and in cases without retrobulbar neuritis they were present in 71% and 48% of cases respectively. The abnormalities were found most frequently in both optic nerves. It was tried to find out other correlations making possible partial differentiation of the axonal and demyelinating type of damage to the anterior part of the visual pathways.

Adolescent↗

Recognition of motion-defined shapes in patients with multiple sclerosis and optic neuritis.

We have developed a simple procedure for assessing the ability of the visual pathway to extract a two-dimensional shape from motion. The test requires a patient to read motion-defined (MD) letters. These letters differ physically from the familiar contrast-defined (CD) letters that are dimmer or brighter than their surroundings in that the boundaries of MD letters are rendered visible exclusively by a step in velocity while the boundaries of CD letters are rendered visible by a step in luminance. Subjects viewed a random pattern of bright dots containing a perfectly camouflaged letter. Then the letter was revealed by moving dots within and outside the letter at equal speeds in opposite directions. Letter reading scores for 50 eyes of 25 patients with multiple sclerosis (MS) or optic neuritis were compared with norms based on 50 control subjects. When tested with large (50 arc min, i.e., 6/60) MD letters, 34/50 eyes of patients required abnormally high dot speeds to read letters, visual loss being sufficiently selective in 10 eyes that contrast sensitivity, Snellen acuity, 11%-contrast and 4%-contrast acuity were all spared. Four eyes were effectively motion blind in the sense that they could not read large letters even at our highest relative speed of 0.9 deg/s and the failure could not be attributed to reduced Snellen acuity. Our normal limit was 2.5 SD from the control mean and there were 1/50 false positives. Of the 34/50 eyes with elevated speed thresholds, 23 had normal Snellen acuities. The number of eyes abnormal for intermediate (11%) contrast CD letters, was 19/50 of which 8 had normal Snellen acuity, confirming our previous finding that MS can degrade the ability to see low-contrast objects while sparing Snellen acuity. We conclude that MD test letters can detect lesions that are not picked up by testing with CD test letters of high or low contrast. We suggest that the MD letter test can detect dysfunction in the human equivalent of a pathway in monkey brain that originates in large retinal ganglion cells, passes through the magnocellular layers of the lateral geniculate body, includes cortical area MT, and is involved in processing motion.

Adult↗

High quality visualization of biochemical pathways in BioPath.

Biochemical reactions form large and complex networks. Comprehensible visual representations of these networks help biochemists understand the relationships between the chemical components. Typically pathway diagrams are manually produced drawings. Because of the steady progress of knowledge and the complex relationships in these networks, automatic visualizations are necessary. Bio-Path is a system for the exploration and automatic visualization of biochemical pathways. It has been developed to obtain an electronic version of the well-known Boehringer Biochemical Pathways poster and offers new possibilities to find information and to navigate through pathways. BioPath has a specific database containing reactions and a hierarchical clustering of reactions and reaction networks. One feature is the automatic generation of pathways from the database and their high quality visualization. This paper states the requirements for the visualization of biochemical pathways, presents a layout algorithm and shows how BioPath can be used to explore biochemical reaction networks.

Algorithms↗

Cortico-cortical and cortico-amygdaloid projections of the rat occipital cortex: a Phaseolus vulgaris leucoagglutinin study.

The efferent projections of the occipital cortex of the rat were investigated using the Phaseolus vulgaris leucoagglutinin anterograde tract tracing technique. Particular attention was focused on projections to the amygdala and amygdalopetal cortical areas. The primary visual cortex had projections to the medial and lateral portions of occipital area 2 and other cortical regions, but no projections to the amygdala or amygdalopetal cortical areas. The only occipital area that had direct projections to the amygdala was the most ventral portion of lateral occipital area 2, located just dorsal to temporal area 2. This occipitotemporal junction region, which received projections from secondary visual cortical areas but not from the primary visual cortex, had projections to the lateral nucleus, magnocellular basal nucleus, and lateral capsular subdivision of the central nucleus of the amygdala. Occipital area 2 had projections to seven amygdalopetal cortical regions: temporal area 2, temporal area 3, frontal area 2, ventrolateral orbitofrontal area, occipitotemporal junction region, lateral entorhinal area, and the perirhinal cortex. Projections to the perirhinal cortex targeted regions located adjacent to the parietal cortex and caudal temporal cortex, but not regions adjacent to the rostral temporal cortex. Other cortical regions receiving projections from medial and lateral portions of occipital area 2 included the presubiculum, retrosplenial areas, and caudal portions of the parietal cortical areas 1 and 2. The results of the present investigation, in conjunction with previous anatomical and neurobehavioral studies, support the concept that rodent cortical visual pathways, like those of primates, consist of a dorsal system involved with visuospatial functions and a ventral system involved with object recognition. As in primates, the ventral pathway projects to the temporal-perirhinal region in a cascading manner; only highly processed information from tertiary visual cortical areas reaches the amygdala. Unlike primates, however, cortical areas in the rat brain that receive highly processed visual information appear to be regions of multisensory convergence.

Amygdala↗

Comparison of pattern visual-evoked potentials to perimetry in the detection of visual loss in children with optic pathway gliomas.

PURPOSE: We sought to compare visual evoked potentials (VEPs) with standard visual field testing in children with visual pathway gliomas. METHODS: Fifteen of 40 children with visual pathway gliomas verified on magnetic resonance imaging scan who cooperated with Goldmann visual field (GVF) and 3-channel VEPs were studied. GVFs were obtained in 25 eyes with adequate vision. VEP amplitudes, latencies, and signal-to-noise ratios (SNRs) were compared with control subjects. Four of the patients (5 eyes) also had Humphrey visual field testing. RESULTS: Twenty-two of 25 eyes had a field defect, 15 eyes showed a relative or absolute hemianopia, 7 eyes showed a central or generalized depression, and 3 eyes were normal. In hemianopic eyes, 87% showed a depression (GVF) or reduced sensitivity (Humphrey field) in the opposite hemifield. VEP amplitudes and SNRs, normally largest at the midline electrode, were significantly reduced in all eyes with visual field loss. By comparison, lateral electrodes showed significantly lower amplitudes and SNRs in patients and controls. Interhemispheric VEP asymmetry (>2:1 ratio) was seen in 67% of patients with hemianopia and 53% of controls. CONCLUSIONS: Reduction of amplitude and SNR at the midline VEP electrode was a sensitive indicator of visual field loss. Interhemispheric VEP asymmetry was not reliable in detection of a hemianopic field defect. VEPs can be a reliable and objective alternative for the detection of visual loss due to optic pathway glioma in children who are intolerant to visual field testing. We recommend the test protocol include pattern-onset and check reversal stimuli of at least one high and one low spatial frequency.

Adolescent↗

Effects of early periods of monocular deprivation and reverse lid suture on the development of Cat-301 immunoreactivity in the dorsal lateral geniculate nucleus (dLGN) of the cat.

During certain sensitive periods early in postnatal life, the anatomical and physiological development of the central visual pathways of cats and monkeys can be affected by the nature of an animal's early visual experience. In the last few years, studies have been started on some of the molecular and biochemical events that underlie the many functional changes induced by early selected visual deprivation in the visual cortex of kittens. In this respect, the monoclonal antibody Cat-301 provides a potentially powerful tool, because it recognizes in the cat dorsal lateral geniculate nucleus (dLGN) a proteoglycan associated with the surface of a particular class of cells, namely Y cells. In the dLGN, the Cat-301 proteoglycan appears late in postnatal development, and it expression has been shown to be experience dependent in both the dLGN and visual cortex (M. Sur, D. Frost, and S. Hockfield, 1988, J. Neurosci. 8:874-882; A. Guimaraes, S. Zaremba, and S. Hockfield, 1990, J. Neurosci. 10:3014-3024). We have explored further the experience-dependent nature of Cat-301 expression in the dLGN with a view to establishing a biochemical correlate of the many functional changes induced by early monocular deprivation and its reversal in the kitten visual system. In addition to demonstrating differences in Cat-301 expression between deprived and nondeprived laminae of the dLGNs of kittens monocularly deprived to only 4 or 5 weeks of age, the magnitude of the laminar difference was found to increase as the period of deprivation was extended. Moreover, monocularly deprived kittens that subsequently received long periods of reverse lid suture exhibited a reversal of the pattern of immunoreactivity, so that the greatest immunoreactivity occurred in laminae innervated by the initially deprived eye. However, possibly the most surprising and important finding was the extremely low levels of immunoreactivity observed in both A laminae of monocularly deprived animals that had received relatively short periods of reverse lid suture. These data suggest that Y cell development can be drastically altered depending on the time of initiation of the period of reverse lid suture and its duration.

Animals↗

Electrodiagnostics of chiasmal compressive lesions.

Recording of visual evoked potentials (VEPs) is not yet a routine test in patients with suspected chiasmal compressive lesions, but has proved useful to a clinician in assessing and following-up visual pathway dysfunctions. Abnormalities of VEPs can be found even in patients without clinical evidence of the visual impairment: VEP delays and alterations of the waveform, asymmetric distribution in one eye or in both eyes (crossed asymmetry) can indicate chiasmal compressive lesion. Simultaneous recording of pattern electroretinograms (PERGs) can additionally provide useful information about the patient's cooperation as well as about eventual retrograde degeneration of the ganglion cells. Electrophysiologic tests can be regarded as an integral part of diagnostic procedures--ocular diagnostic tests and neuroimaging--in suspected compressive lesions of the optic chiasm.

Electrodiagnosis↗

Real-world evaluation of visual function.

Visual function declines with age in a variety of ways. It must also be kept in mind, however, that the results reported here are primarily group findings. When evaluating the performance of older persons, there is extremely wide variability, and even though average performance may decline as a function of age, many older adults maintain excellent visual function throughout their lifetimes. It is important to keep the variability of individual performance in mind to avoid ageist stereotypes. Although declines in age-related vision are well documented, it is less clear why these declines have occurred. Most recent studies have controlled for criterion differences by using forced-choice methods. These studies confirm that even after correcting for differences in threshold criteria, age-related declines persist. Many other studies have controlled for optical changes using a variety of techniques. Again, some age-related declines still exist Although it is widely believed that the neuroanatomy and physiology of the visual pathways are affected by aging, there is still relatively little understanding of how these changes impact visual function. Thus, there is a need for further studies to link potential neural mechanisms to observed changes in functional visual performance. Furthermore, there is also a possibility that there may be multiple sites of decline within a given person and that these sites of decline may vary across persons. Thus, the use of an individual-differences approach is needed to evaluate the many potential explanations for sensory decline. Finally, there is frequently a discrepancy between performance in the laboratory and real-world performance. In trying to predict the performance of real-world tasks and in designing the best environments for the elderly, sensory function should not be considered in isolation. Rather contributing factors such as cognitive ability, expectations, distractions, and other health-related and motor problems must also be considered. Traditional clinical measures of visual function, though appropriate for evaluating the presence of disease, are often inadequate in explaining everyday performance impairments. Thus, further research is needed to fully understand the complex interactions between sensory, cognitive, motor, economic, and physical factors that together determine one's level of ability or disability in everyday tasks.

Activities of Daily Living↗

Lateral interactions in visual cortex.

The findings presented in these studies have brought out different ideas concerning the mechanisms of processing in primary visual cortex than were held at the outset. Rather than thinking of receptive fields as being restricted in their extent, with the process of integration of the components of an image occurring at a much later stage along the visual pathway, we have shown that the integrative process is a progressive one, beginning in the primary visual cortex (or perhaps even earlier) and building up in a cascading series of converging and diverging connections. Rather than thinking of the filter characteristics of a cell as being fixed, it is apparent that they are dynamic and can be modified by the context in which features are presented. Finally, rather than a cortex with a functional architecture that is fixed after a critical period ending in infancy, we find that perturbing the system can lead to long-term topographical reorganization. Other examples of contextual interactions have been demonstrated in the submodalities of motion, where a cell's directional selectivity is modulated by the presence of movement in the surround (Allman et al. 1985; Tanaka et al. 1986; Gulyas et al. 1987; Orban et al. 1987). In the domain of color, the phenomenon of color constancy, reported for cells in visual area V4 (Zeki 1983), also requires lateral interactions in visual space, comparing the wavelength distribution of light coming from surfaces in different parts of the visual field. The influences presented in these studies, as in our own work in the domain of orientation, are modulatory. The long-term changes in cortical topography following removal of somatosensory input (Merzenich et al. 1984, 1988) or by retinal lesions suggest that with the appropriate manipulations the lateral interactions can be enhanced to the point of activating the postsynaptic cells. Although retinal lesions clearly represent an abnormal disruption of sensory input, they may nevertheless be representative of long-term reorganizations of neural networks occurring under normal circumstances, such as those required for memory.

Animals↗

Clinical evidence for the onset of the sensitive period in infancy.

Seven neonates had a IIIrd or VIth nerve palsy or afferent visual pathway pathology at birth. These abnormalities resolved within 6 weeks and the children have developed normal visual acuity, motor fusion, and stereopsis. We conclude that there is a latent period of 6 weeks before the onset of the sensitive period.

Abducens Nerve↗

Electrophysiology and perimetry in acute retrobulbar neuritis.

Eighteen patients with acute retrobulbar neuritis were examined by visual field analysis and electroophthalmological recordings. The visual fields were measured to 30 degrees with the automatic perimeter Octopus 201. The pattern-evoked cortical potential showed an increased P-100 latency followed by a decrease in 12 patients during the first two weeks of the disease. This latency change cannot be explained by remyelinization. Teh positive component of the pattern ERG (P-50) was reduced in all acutely affected eyes in comparison with the fellow eye. During recovery, the amplitude of the positive PERG component increased to normal, but remained slightly reduced in comparison with the response from the fellow eyes. Thirteen patients out of 18 were clinically and electrophysiologically diagnosed as having unilateral retrobulbar neuritis. However, static perimetry showed paracentral scotomas in the fellow eye in 5 cases. Recovery of the severely affected eye was accompanied by complete normalization of the visual field in the fellow eye. Thus static perimetry seems to be a more sensitive test than even the visual evoked potentials for detecting lesions in the visual pathway.

Adult↗

Short latency visual evoked potentials in man.

Contrary to auditory and somatosensory evoked potentials, surface recorded visual evoked potentials which arise in subcortical neural elements have rarely been described. Considerable disagreement exists between the reports in the literature on such visual potentials. In this study, flash stimuli were used to evoke the potentials which were recorded from the skin overlying the infra-orbital ridge, outer canthus, middle of the forehead, vertex, mastoid ipsilateral to the stimulated eye and inion, using a non-cephalic reference. The potentials were amplified in a band which was chosen to omit slow retinal and cortical potentials, and to enhance activity which might include compound neural activity. Potentials were recorded from 9 subjects (13 eyes), and for each one the effects of eye position and stimulus intensity were studied. The results indicate that the series of components recorded within the first 100 msec following photic stimulation were volume-conducted activity generated by a subset of the visual system which is activated by luminosity changes. The generators of the first 4 or 5 components seem to be situated within the retina, the subsequent components seem to be generated in the optic nerve or tracts, and the later components may be thalamo-cortical in origin. These potentials may complement pattern evoked potentials in a more accurate definition of sites of lesions along the visual pathway.

Adult↗

[Visual evoked potentials from different unpatterned stimuli in normal subjects and subjects with multiple sclerosis].

A study of VEP was carried out by stimulation with white and red flashes in 20 normal subjects and 58 patients with definite or possible Multiple Sclerosis (MS). In normal subjects, the VEP obtained with the red flash exhibited a simplified waveform and a significantly higher latency of the III and IV peaks than with the white flash. This is due to the different spectral component of the stimulation, which specifically excites foveal receptors whose fibers have a smaller diameter and therefore a lower conduction velocity. The subjects with definite or probable MS showed average VEP latencies which were significantly higher than those of normal subjects. A comparison of the results obtained with the two types of stimulation demonstrates that the red flash reveals a higher number of modified VEPs, thus pointing out even subclinical impairments of the visual pathways.

Adult↗

Visualizing networks.

An interrelated set of genes or proteins can be represented effectively as a network that describes physical interactions, regulatory relationships, or metabolic pathways. Visualizing a network can be a helpful method to extract biological meaning and to generate testable hypotheses about large-scale biological data. This chapter describes some potential rationales for visualizing networks of microarray and other data types, which can be integrated and filtered to show potentially significant relationships. It also presents a practical introduction to Osprey and Cytoscape, two software platforms that are powerful tools for visualizing, integrating, and manipulating networks.

Animals↗

Expression of low affinity NGF (p75) receptors in rat superior colliculus: studies in vivo, in vitro, and in fetal tectal grafts.

The distribution and level of expression of the low affinity nerve growth factor receptor (LNGFR) in the rat visual system has been investigated under a number of experimental conditions. The aim was to determine the cellular location of the receptor and to study the factors which influence its expression. The monoclonal antibody 192-Ig and immunohistochemical techniques were used to examine LNGFR expression in (i) developing and adult rat superior colliculus (SC), (ii) fetal collicular tissue transplanted to the midbrain of newborn host rats, (iii) the SC of rats which had been unilaterally enucleated at birth, and (iv) mixed glial cell cultures from the neonatal SC. The effect of eye removal on LNGFR immunoreactivity in other normally retino-recipient areas was also assessed. Postnatal maturation of the rat SC was associated with an increase in LNGFR immunoreactivity. At birth, weak staining was seen ventral to the superficial gray layer. Staining gradually became located more dorsally until in the adult there was a dense band of immunoreactivity that extended 50-100 microns from the surface. Immunoreactive processes and cellular-like profiles were seen. Compared to adult host SC there was considerably more LNGFR immunoreactivity in transplanted tectal tissue, irrespective of whether the grafts were connected to the host. LNGFR expression in transplants was patchy and usually contiguous with the graft surface. Staining was not obviously related to the distribution of astrocytes or microglia and very few cells were LNGFR positive in tectal glial cell cultures. In SC and in tectal grafts it is probable that LNGFR immunoreactivity was primarily associated with intrinsic neurons. In support of this, LNGFR expression in the superficial SC was unaffected by neonatal eye removal; however, LNGFR staining in the pretectum and diencephalon was reduced or absent on the side contralateral to visual deafferentation. These conflicting sets of data suggest that (i) LNGFRs in central visual pathways are sometimes, but by no means always, associated with retinal innervation and (ii) LNGFR expression in visual target areas originates from diverse sources and is influenced and regulated by a variety of factors.

Animals↗