Astigmatism and maternal myopia as important factors affecting success rate of DIMS lens treatment.

OBJECTIVE: To assess the efficacy of myopia control spectacle lenses (defocus incorporated multiple segments/DIMS) in slowing myopia progression among a diverse Central European paediatric population and investigate the contribution of baseline parameters on treatment outcomes. METHODS AND ANALYSIS: This retrospective observational study included 62 individuals aged 4-17 years (mean±SD: 10.21±2.70) with progressing myopia but without ocular pathology with a range of -0.88 to -8.25 D spherical equivalent refraction (SER) (-3.73±1.56), coupled with astigmatism up to -3.25 D cylindrical. All participants were prescribed DIMS (Hoya MiyoSmart) spectacles. Key outcome variables were cycloplegic SER, measured for all participants and axial length (AL), assessed in a subset of patients, recorded at baseline, 6 months and 12 months. Quality of life assessments were conducted at baseline, at 2 weeks, and 3, 6, 9 and 12 months. Additionally, parental myopic dioptre was recorded when applicable. RESULTS: At the 12-month mark, myopia progression in patients (mean±SE: -0.40±0.05) mirrored findings from prior European DIMS studies, but with 50% of patients showing no progression. A multivariate analysis of covariance model revealed that baseline astigmatism and younger age adversely affected therapy outcomes in both SER and AL, while severe maternal myopia led to greater SER progression. In contrast, only young age but not astigmatism was associated with AL increase in a comparable group of children with myopia, part of the LIFE Child Study, wearing single-vision spectacles. Patients reported consistent satisfaction with treatment, with minimal side effects, which diminished over the year. CONCLUSION: In the European population, astigmatism, young age and severe maternal myopia are risk factors for suboptimal outcomes following DIMS therapy. Further research is necessary to elucidate the impact of astigmatism on myopic defocus therapy.

Study protocol of the Hungarian Longitudinal Study of Healthy Brain Aging (HuBA).

Background and purpose:

Neuro­cog­nitive aging and the associated brain diseases impose a major social and economic burden. Therefore, substantial efforts have been put into revealing the lifestyle, the neurobiological and the genetic underpinnings of healthy neurocognitive aging. However, these studies take place almost exclusively in a limited number of highly-developed countries. Thus, it is an important open question to what extent their findings may generalize to neurocognitive aging in other, not yet investigated regions. The purpose of the Hungarian Longitudinal Study of Healthy Brain Aging (HuBA) is to collect multi-modal longitudinal data on healthy neurocognitive aging to address the data gap in this field in Central and Eastern Europe.

We adapted the Australian Ima­ging, Biomarkers and Lifestyle (AIBL) study of aging study protocol to local circumstances and collected demographic, lifestyle, men­tal and physical health, medication and medical history related information as well as re­cor­ded a series of magnetic resonance imaging (MRI) data. In addition, participants were al­so offered to participate in the collection of blood samples to assess circulating in­flam­matory biomarkers as well as a sleep study aimed at evaluating the general sleep quality based on multi-day collection of subjective sleep questionnaires and whole-night elec­troencephalographic (EEG) data.

Baseline data collection has al­ready been accomplished for more than a hundred participants and data collection in the se­cond
session is on the way. The collected data might reveal specific local trends or could also indicate the generalizability of previous findings. Moreover, as the HuBA protocol al­so offers a sleep study designed for tho­rough characterization of participants’ sleep quality and related factors, our extended multi-modal dataset might provide a base for incorporating these measures into healthy and clinical aging research. 

Besides its straightforward na­tional benefits in terms of health ex­pen­di­ture, we hope that this Hungarian initiative could provide results valid for the whole Cent­ral and Eastern European region and could also promote aging and Alzheimer’s disease research in these countries.

Fixation instability, astigmatism, and lack of stereopsis as factors impeding recovery of binocular balance in amblyopia following binocular therapy.

Dichoptic therapy is a promising method for improving vision in pediatric and adult patients with amblyopia. However, a systematic understanding about changes in specific visual functions and substantial variation of effect among patients is lacking. Utilizing a novel stereoscopic augmented-reality based training program, 24 pediatric and 18 adult patients were trained for 20 h along a three-month time course with a one-month post-training follow-up for pediatric patients. Changes in stereopsis, distance and near visual acuity, and contrast sensitivity for amblyopic and fellow eyes were measured, and interocular differences were analyzed. To reveal what contributes to successful dichoptic therapy, ANCOVA models were used to analyze progress, considering clinical baseline parameters as covariates that are potential requirements for amblyopic recovery. Significant and lasting improvements have been achieved in stereoacuity, interocular near visual acuity, and interocular contrast sensitivity. Importantly, astigmatism, fixation instability, and lack of stereopsis were major limiting factors for visual acuity, stereoacuity, and contrast sensitivity recovery, respectively. The results demonstrate the feasibility of treatment-efficacy prediction in certain aspects of dichoptic amblyopia therapy. Furthermore, our findings may aid in developing personalized therapeutic protocols, capable of considering individual clinical status, to help clinicians in tailoring therapy to patient profiles for better outcome.

Dichoptic Spatial Contrast Sensitivity Reflects Binocular Balance in Normal and Stereoanomalous Subjects.

Purpose: To study binocular balance by comparing dichoptic and standard monocular contrast sensitivity function (CSF) in stereonormal and stereoanomalous/stereoblind amblyopic subjects. Methods: Sixteen amblyopes and 17 controls participated. Using the capability of the passive three-dimensional display, we measured their CSF both monocularly and dichoptically at spatial frequencies 0.5, 1, 2, 4, and 8 cpds using achromatic Gabor patches on a luminance noise background. During monocular stimulation, the untested eye was covered, while for the dichoptic stimulation the untested eye viewed background noise. Dichoptic CSF of both eyes was acquired within one block. Results: In patients with central fixation, dichoptic viewing had a large negative impact on the CSF of the amblyopic eye, although it hardly affected that of the dominant eye. In contrast, dichoptic viewing had a small but significant effect on both eyes for controls. In addition, all participants lay along a continuum in terms of how much their two eyes were affected by dichoptic stimulation: by using two predefined contrast sensitivity ratios, namely, amblyopic sensitivity decrement and dichoptic sensitivity decrement, not only did we find a significant correlation between these variables among all participants, but also the two groups were identified with minimum error using a cluster analysis. Conclusions: Dichoptic CSF may be considered to measure visual performance in patients with altered binocular vision, because it better reflects the visual capacity of the amblyopic eye than the standard monocular examinations. It may also be a more reliable parameter to assess the efficacy of modern approaches to treat amblyopia.

ALTERED BOLD RESPONSE WITHIN THE CORE FACE-PROCESSING NETWORK IN CONGENITAL PROSOPAGNOSIA.

BACKGROUND AND PURPOSE: Congenital prosopagnosia is a life-long disorder of face perception. To study the neural backgrounds of congenital prosopagnosia we measured the blood oxygen level-dependent response of congenital prosopagnosic participants, using functional magnetic resonance imaging. METHODS: We tested three persons of the family (father, daughter and son), having symptoms of congenital prosopagnosia, as well as healthy controls, using combined neuropsychological and functional magnetic resonance imaging methods. To reveal the neural correlates of the impairments, blood oxygen level-dependent responses within the occipito-temporal cortex were measured to faces and nonsense object images in a block-design experiment. RESULTS: Neuropsychological tests demonstrated significant impairments of face perception/recognition in each subject. We found that the activity of the fusiform and occipital face areas as well as of the lateral occipital cortex was significantly reduced in congenital prosopagnosic participants when compared to controls. Analysis of the hemodynamic response function revealed a lower peak response, but also a significantly faster and stronger decay of the blood oxygen level-dependent response in the occipito-temporal areas in congenital prosopagnosic participants when compared to controls. CONCLUSION: Our results emphasize the dysfunction of the core face processing system, as well as the lateral occipital complex, in congenital prosopagnosia. Further, the functional impairment of these areas is signalled best by the altered hemodynamic response function, showing abnormally low initial peak and stronger and faster decay in the later parts of the blood oxygen level-dependent response.

Neural basis of identity information extraction from noisy face images.

Previous research has made significant progress in identifying the neural basis of the remarkably efficient and seemingly effortless face perception in humans. However, the neural processes that enable the extraction of facial information under challenging conditions when face images are noisy and deteriorated remains poorly understood. Here we investigated the neural processes underlying the extraction of identity information from noisy face images using fMRI. For each participant, we measured (1) face-identity discrimination performance outside the scanner, (2) visual cortical fMRI responses for intact and phase-randomized face stimuli, and (3) intrinsic functional connectivity using resting-state fMRI. Our whole-brain analysis showed that the presence of noise led to reduced and increased fMRI responses in the mid-fusiform gyrus and the lateral occipital cortex, respectively. Furthermore, the noise-induced modulation of the fMRI responses in the right face-selective fusiform face area (FFA) was closely associated with individual differences in the identity discrimination performance of noisy faces: smaller decrease of the fMRI responses was accompanied by better identity discrimination. The results also revealed that the strength of the intrinsic functional connectivity within the visual cortical network composed of bilateral FFA and bilateral object-selective lateral occipital cortex (LOC) predicted the participants' ability to discriminate the identity of noisy face images. These results imply that perception of facial identity in the case of noisy face images is subserved by neural computations within the right FFA as well as a re-entrant processing loop involving bilateral FFA and LOC.

Amblyopic deficit beyond the fovea: delayed and variable single-trial ERP response latencies, but unaltered amplitudes.

PURPOSE: Amblyopia was first described as a deficit of central vision. However, it has long been debated whether this dysfunction is limited to the fovea or whether extrafoveal vision is also affected, as studies concerning the latter are equivocal. The purpose of the study was to resolve this issue. METHODS: We investigated the amblyopic effect on event-related potentials (ERPs) with foveal and perifoveal stimuli, either matched in size based on cortical magnification or presented as large annular stimuli. In two separate experiments we measured ERPs on amblyopic patients and control subjects using face images. Latency and amplitude of averaged ERPs and their single-trial distributions were analyzed. RESULTS: When the fovea was stimulated, latency and amplitude of the early averaged ERP components increased and were reduced, respectively, in the amblyopic compared with the fellow eye. Importantly, perifoveal stimulation also elicited similar amblyopic deficits, which were clearly significant in the case of using cortical magnification scaled stimuli. However, single-trial peak analysis revealed that foveal and perifoveal effects differed in nature: Peak amplitudes were reduced only in foveal stimulation, while latencies were delayed and jittered at both the fovea and perifovea. Event-related potentials obtained from fellow eyes were not significantly different from those of normal observers. CONCLUSIONS: Our findings revealed the existence of amblyopic deficits at the perifovea when the stimulated cortical area was matched in size to that of foveal stimulation. These deficits manifested themselves only in the temporal structure of the responses, unlike foveal deficits, which affected both component amplitude and latency.

How the visual cortex handles stimulus noise: insights from amblyopia.

Adding noise to a visual image makes object recognition more effortful and has a widespread effect on human electrophysiological responses. However, visual cortical processes directly involved in handling the stimulus noise have yet to be identified and dissociated from the modulation of the neural responses due to the deteriorated structural information and increased stimulus uncertainty in the case of noisy images. Here we show that the impairment of face gender categorization performance in the case of noisy images in amblyopic patients correlates with amblyopic deficits measured in the noise-induced modulation of the P1/P2 components of single-trial event-related potentials (ERP). On the other hand, the N170 ERP component is similarly affected by the presence of noise in the two eyes and its modulation does not predict the behavioral deficit. These results have revealed that the efficient processing of noisy images depends on the engagement of additional processing resources both at the early, feature-specific as well as later, object-level stages of visual cortical processing reflected in the P1 and P2 ERP components, respectively. Our findings also suggest that noise-induced modulation of the N170 component might reflect diminished face-selective neuronal responses to face images with deteriorated structural information.

Amblyopic deficits in the timing and strength of visual cortical responses to faces.

Behavioral research revealed that object vision is impaired in amblyopia. Nevertheless, neurophysiological research in humans has focused on the amblyopic effects at the earliest stage of visual cortical processing, leaving the question of later, object-specific neural processing deficits unexplored. By measuring event-related potentials (ERPs) to foveal face stimuli we characterized the amblyopic effects on the N170 component, reflecting higher-level structural face processing. Single trial analysis revealed that latencies of the ERP components increased and were more variable in the amblyopic eye compared to the fellow eye both in strabismic and anisometropic patent groups. Moreover, there was an additional delay of N170 relative to the early P1 component over the right hemisphere, which was absent in the fellow eye, suggesting a slower evolution of face specific cortical responses in amblyopia. On the other hand, distribution of single trial N170 peak amplitudes differed between the amblyopic and fellow eye only in the strabismic but not in the anisometropic patients. Furthermore, the amblyopic N170 latency increment but not the amplitude reduction correlated with the interocular differences in visual acuity and fixation stability. We found no difference in the anticipatory neural oscillations between stimulation of the amblyopic and the fellow eye implying that impairment of the neural processes underlying generation of stimulus-driven visual cortical responses might be the primary reason behind the observed amblyopic effects. These findings provide evidence that amblyopic disruption of early visual experience leads to deficits in the strength and timing of higher-level, face specific visual cortical responses, reflected in the N170 component.

Visual cortical responses to the input from the amblyopic eye are suppressed during binocular viewing.

Amblyopia is a visual disorder caused by an anomalous early visual experience. It has been suggested that suppression of the visual input from the weaker eye might be a primary underlying mechanism of the amblyopic syndrome. However, it is still an unresolved question to what extent neural responses to the visual information coming from the amblyopic eye are suppressed during binocular viewing. To address this question we measured event-related potentials (ERP) to foveal face stimuli in amblyopic patients, both in monocular and binocular viewing conditions. The results revealed no difference in the amplitude and latency of early components of the ERP responses between the binocular and fellow eye stimulation. On the other hand, early ERP components were reduced and delayed in the case of monocular stimulation of the amblyopic eye as compared to the fellow eye stimulation or to binocular viewing. The magnitude of the amblyopic effect measured on the ERP amplitudes was comparable to that found on the fMRI responses in the fusiform face area using the same face stimuli and task conditions. Our findings showing that the amblyopic effects present on the early ERP components in the case of monocular stimulation are not manifested in the ERP responses during binocular viewing suggest that input from the amblyopic eye is completely suppressed already at the earliest stages of visual cortical processing when stimuli are viewed by both eyes.

Dissociating the effect of noise on sensory processing and overall decision difficulty.

It has been proposed that perceptual decision making involves a task-difficulty component, which detects perceptual uncertainty and guides allocation of attentional resources. It is thought to take place immediately after the early extraction of sensory information and is specifically reflected in a positive component of the event related potentials, peaking at ∼ 220 ms after stimulus onset. However, in the previous research, neural processes associated with the monitoring of overall task difficulty were confounded by those associated with the increased sensory processing demands as a result of adding noise to the stimuli. Here we dissociated the effect of phase noise on sensory processing and overall decision difficulty using a face gender categorization task. Task difficulty was manipulated either by adding noise to the stimuli or by adjusting the female/male characteristics of the face images. We found that it is the presence of noise and not the increased overall task difficulty that affects the electrophysiological responses in the first 300 ms following stimulus onset in humans. Furthermore, we also showed that processing of phase-randomized as compared to intact faces is associated with increased fMRI responses in the lateral occipital cortex. These results revealed that noise-induced modulation of the early electrophysiological responses reflects increased visual cortical processing demands and thus failed to provide support for a task-difficulty component taking place between the early sensory processing and the later sensory accumulation stages of perceptual decision making.

Electrophysiological correlates of learning-induced modulation of visual motion processing in humans.

Training on a visual task leads to increased perceptual and neural responses to visual features that were attended during training as well as decreased responses to neglected distractor features. However, the time course of these attention-based modulations of neural sensitivity for visual features has not been investigated before. Here we measured event related potentials (ERP) in response to motion stimuli with different coherence levels before and after training on a speed discrimination task requiring object-based attentional selection of one of the two competing motion stimuli. We found that two peaks on the ERP waveform were modulated by the strength of the coherent motion signal; the response amplitude associated with motion directions that were neglected during training was smaller than the response amplitude associated with motion directions that were attended during training. The first peak of motion coherence-dependent modulation of the ERP responses was at 300 ms after stimulus onset and it was most pronounced over the occipitotemporal cortex. The second peak was around 500 ms and was focused over the parietal cortex. A control experiment suggests that the earlier motion coherence-related response modulation reflects the extraction of the coherent motion signal whereas the later peak might index accumulation and readout of motion signals by parietal decision mechanisms. These findings suggest that attention-based learning affects neural responses both at the sensory and decision processing stages.

Retention interval affects visual short-term memory encoding.

Humans can efficiently store fine-detailed facial emotional information in visual short-term memory for several seconds. However, an unresolved question is whether the same neural mechanisms underlie high-fidelity short-term memory for emotional expressions at different retention intervals. Here we show that retention interval affects the neural processes of short-term memory encoding using a delayed facial emotion discrimination task. The early sensory P100 component of the event-related potentials (ERP) was larger in the 1-s interstimulus interval (ISI) condition than in the 6-s ISI condition, whereas the face-specific N170 component was larger in the longer ISI condition. Furthermore, the memory-related late P3b component of the ERP responses was also modulated by retention interval: it was reduced in the 1-s ISI as compared with the 6-s condition. The present findings cannot be explained based on differences in sensory processing demands or overall task difficulty because there was no difference in the stimulus information and subjects' performance between the two different ISI conditions. These results reveal that encoding processes underlying high-precision short-term memory for facial emotional expressions are modulated depending on whether information has to be stored for one or for several seconds.

Learning to filter out visual distractors.

When learning to master a visual task in a cluttered natural environment, it is important to optimize the processing of task-relevant information and to efficiently filter out distractors. However, the mechanisms that suppress task-irrelevant information are not well understood. Here we show that training leads to a selective increase in motion coherence detection thresholds for task-irrelevant motion directions that interfered with the processing of task-relevant directions during training. Furthermore, using functional magnetic resonance imaging we found that training attenuated neural responses associated with the task-irrelevant direction compared with the task-relevant direction in the visual cortical areas involved in processing of visual motion. The strongest suppression of functional magnetic resonance imaging responses to task-irrelevant motion information was observed in human area MT+. These findings reveal that perceptual learning leads to the suppression and efficient filtering of task-irrelevant visual information.

Flawless visual short-term memory for facial emotional expressions.

Facial emotions are important cues of human social interactions. Emotional expressions are continuously changing and thus should be monitored, memorized, and compared from time to time during social intercourse. However, it is not known how efficiently emotional expressions can be stored in short-term memory. Here we show that emotion discrimination is not impaired when the faces to be compared are separated by several seconds, requiring storage of fine-grained emotion-related information in short-term memory. Likewise, we found no significant effect of increasing the delay between the sample and the test face in the case of facial identity discrimination. Furthermore, a second experiment conducted on a large subject sample (N = 160) revealed flawless short-term memory for both facial emotions and facial identity also when observers performed the discrimination tasks only twice with novel faces. We also performed an fMRI experiment, which confirmed that discrimination of fine-grained emotional expressions in our experimental paradigm involved processing of high-level facial emotional attributes. Significantly stronger fMRI responses were found in a cortical network--including the posterior superior temporal sulcus--that is known to be involved in processing of facial emotional expression during emotion discrimination than during identity discrimination. These findings reveal flawless, high-resolution visual short-term memory for emotional expressions, which might underlie efficient monitoring of continuously changing facial emotions.