Investigating the human binocular visual system using multi-modal magnetic resonance imaging.

Having two forward-facing eyes with slightly different viewpoints enables animals, including humans, to discriminate fine differences in depth (disparities), which can facilitate interaction with the world. The binocular visual system starts in the primary visual cortex because that is where information from the eyes is integrated for the first time. Magnetic resonance imaging (MRI) is an ideal tool to non-invasively investigate this system since it can provide a range of detailed measures about structure, function, neurochemistry and connectivity of the human brain. Since binocular disparity is used for both action and object recognition, the binocular visual system is a valuable model system in neuroscience for understanding how basic sensory cues are transformed into behaviourally relevant signals. In this review, we consider how MRI has contributed to the understanding of binocular vision and depth perception in the human brain. Firstly, MRI provides the ability to image the entire brain simultaneously to compare the contribution of specific visual areas to depth perception. A large body of work using functional MRI has led to an understanding of the extensive networks of brain areas involved in depth perception, but also the fine-scale macro-organisation for binocular processing within individual visual areas. Secondly, MRI can uncover mechanistic information underlying binocular combination with the use of MR spectroscopy. This method can quantify neurotransmitters including GABA and glutamate within restricted regions of the brain, and evaluate the role of these inhibitory and excitatory neurochemicals in binocular vision. Thirdly, it is possible to measure the nature and microstructure of pathways underlying depth perception using diffusion MRI. Understanding these pathways provides insight into the importance of the connections between areas implicated in depth perception. Finally, MRI can help to understand changes in the visual system resulting from amblyopia, a neural condition where binocular vision does not develop correctly in childhood.

Correlated structure of neuronal firing in macaque visual cortex limits information for binocular depth discrimination.

Variability in cortical neural activity potentially limits sensory discriminations. Theoretical work shows that information required to discriminate two similar stimuli is limited by the correlation structure of cortical variability. We investigated these information-limiting correlations by recording simultaneously from visual cortical areas primary visual cortex (V1) and extrastriate area V4 in macaque monkeys performing a binocular, stereo depth discrimination task. Within both areas, noise correlations on a rapid temporal scale (20-30 ms) were stronger for neuron pairs with similar selectivity for binocular depth, meaning that these correlations potentially limit information for making the discrimination. Between-area correlations (V1 to V4) were different, being weaker for neuron pairs with similar tuning and having a slower temporal scale (100+ ms). Fluctuations in these information-limiting correlations just prior to the detection event were associated with changes in behavioral accuracy. Although these correlations limit the recovery of information about sensory targets, their impact may be curtailed by integrative processing of signals across multiple brain areas.NEW & NOTEWORTHY Correlated noise reduces the stimulus information in visual cortical neurons during experimental performance of binocular depth discriminations. The temporal scale of these correlations is important. Rapid (20-30 ms) correlations reduce information within and between areas V1 and V4, whereas slow (>100 ms) correlations between areas do not. Separate cortical areas appear to act together to maintain signal fidelity. Rapid correlations reduce the neuronal signal difference between stimuli and adversely affect perceptual discrimination.

A survey of neurosurgical management and prognostication of traumatic brain injury following the RESCUEicp trial.

PURPOSE: Decompressive craniectomy remains controversial because of uncertainty regarding its benefit to patients; this study aimed to explore current practice following the RESCUEicp Trial, an important study in the evolving literature on decompressive craniectomies. MATERIALS AND METHODS: Neurosurgeons in New Zealand, Australia, USA and Nepal were sent a survey consisting of two case scenarios and several multi-choice questions exploring their utilisation of decompressive craniectomy following the RESCUEicp Trial. RESULTS: One in ten neurosurgeons (n = 6, 10.3%) were no longer performing decompressive craniectomies for TBI following the RESCUEicp Trial and two fifths (n = 23, 39.7%) were less enthusiastic. Most neurosurgeons would not operate in the face of severe disability (n = 46, 79.3%) or vegetative state/death (n = 57, 98.3%). Neurosurgeons tended give more optimistic prognoses than the CRASH prognostic model. Those who suggested more pessimistic prognoses and those who use decision support tools were less likely to advise decompressive surgery. CONCLUSIONS: RESCUEicp has had a notable impact on neurosurgeons and their management of TBI. Although there remains no clear clinical consensus on the contraindications for decompressive craniectomy, most neurosurgeons would not operate if severe disability or vegetative state (the rates of which are increased by such surgery) seemed likely. Whilst unreliable, prognostic estimates still have an impact on clinical decision making and neurosurgical management. Wider use of decision support tools should be considered.

Comparison of Neurochemical and BOLD Signal Contrast Response Functions in the Human Visual Cortex.

We investigated the relationship between neurochemical and hemodynamic responses as a function of image contrast in the human primary visual cortex (V1). Simultaneously acquired BOLD-fMRI and single voxel proton MR spectroscopy signals were measured in V1 of 24 healthy human participants of either sex at 7 tesla field strength, in response to presentations (64 s blocks) of different levels of image contrast (3%, 12.5%, 50%, 100%). Our results suggest that complementary measures of neurotransmission and energy metabolism are in partial agreement: BOLD and glutamate signals were linear with image contrast; however, a significant increase in glutamate concentration was evident only at the highest intensity level. In contrast, GABA signals were steady across all intensity levels. These results suggest that neurochemical concentrations are maintained at lower ranges of contrast levels, which match the statistics of natural vision, and that high stimulus intensity may be critical to increase sensitivity to visually modulated glutamate signals in the early visual cortex using MR spectroscopy.SIGNIFICANCE STATEMENT Glutamate and GABA are the major excitatory and inhibitory neurotransmitters of the brain. To better understand the relationship between MRS-visible neurochemicals, the BOLD signal change, and stimulus intensity, we measured combined neurochemical and BOLD signals (combined fMRI-MRS) to different image contrasts in human V1 at 7 tesla. While a linear change to contrast was present for both signals, the increase in glutamate was significant only at the highest stimulus intensity. These results suggest that hemodynamic and neurochemical signals reflect common metabolic markers of neural activity, whereas the mismatch at lower contrast levels may indicate a sensitivity threshold for detecting neurochemical changes during visual processing. Our results highlight the challenge and importance of reconciling cellular and metabolic measures of neural activity in the human brain.

Normative cerebral cortical thickness for human visual areas.

Studies of changes in cerebral neocortical thickness often rely on small control samples for comparison with specific populations with abnormal visual systems. We present a normative dataset for FreeSurfer-derived cortical thickness across 25 human visual areas derived from 960 participants in the Human Connectome Project. Cortical thickness varies systematically across visual areas, in broad agreement with canonical visual system hierarchies in the dorsal and ventral pathways. In addition, cortical thickness estimates show consistent within-subject variability and reliability. Importantly, cortical thickness estimates in visual areas are well described by a normal distribution, making them amenable to direct statistical comparison.

Combined fMRI-MRS acquires simultaneous glutamate and BOLD-fMRI signals in the human brain.

Combined fMRI-MRS is a novel method to non-invasively investigate functional activation in the human brain using simultaneous acquisition of hemodynamic and neurochemical measures. The aim of the current study was to quantify neural activity using combined fMRI-MRS at 7T. BOLD-fMRI and semi-LASER localization MRS data were acquired from the visual cortex of 13 participants during short blocks (64s) of flickering checkerboards. We demonstrate a correlation between glutamate and BOLD-fMRI time courses (R=0.381, p=0.031). In addition, we show increases in BOLD-fMRI (1.43±0.17%) and glutamate concentrations (0.15±0.05 I.U., ~2%) during visual stimulation. In contrast, we observed no change in glutamate concentrations in resting state MRS data during sham stimulation periods. Spectral line width changes generated by the BOLD-response were corrected using line broadening. In summary, our results establish the feasibility of concurrent measurements of BOLD-fMRI and neurochemicals using a novel combined fMRI-MRS sequence. Our findings strengthen the link between glutamate and functional activity in the human brain by demonstrating a significant correlation of BOLD-fMRI and glutamate over time, and by showing ~2% glutamate increases during 64s of visual stimulation. Our tool may become useful for studies characterizing functional dynamics between neurochemicals and hemodynamics in health and disease.

Structural and functional changes across the visual cortex of a patient with visual form agnosia.

Loss of shape recognition in visual-form agnosia occurs without equivalent losses in the use of vision to guide actions, providing support for the hypothesis of two visual systems (for "perception" and "action"). The human individual DF received a toxic exposure to carbon monoxide some years ago, which resulted in a persisting visual-form agnosia that has been extensively characterized at the behavioral level. We conducted a detailed high-resolution MRI study of DF's cortex, combining structural and functional measurements. We present the first accurate quantification of the changes in thickness across DF's occipital cortex, finding the most substantial loss in the lateral occipital cortex (LOC). There are reduced white matter connections between LOC and other areas. Functional measures show pockets of activity that survive within structurally damaged areas. The topographic mapping of visual areas showed that ordered retinotopic maps were evident for DF in the ventral portions of visual cortical areas V1, V2, V3, and hV4. Although V1 shows evidence of topographic order in its dorsal portion, such maps could not be found in the dorsal parts of V2 and V3. We conclude that it is not possible to understand fully the deficits in object perception in visual-form agnosia without the exploitation of both structural and functional measurements. Our results also highlight for DF the cortical routes through which visual information is able to pass to support her well-documented abilities to use visual information to guide actions.

Responses to interocular disparity correlation in the human cerebral cortex.

PURPOSE: Perceiving binocular depth relies on the ability of our visual system to precisely match corresponding features in the left and right eyes. Yet how the human brain extracts interocular disparity correlation is poorly understood. METHODS: We used functional magnetic resonance imaging (fMRI) to characterize brain regions involved in processing interocular disparity correlation. By varying the amount of interocular correlation of a disparity-defined random-dot-stereogram, we concomitantly controlled the perception of binocular depth and measured the percent Blood-Oxygenation-Level-Dependent (%BOLD)-signal in multiple regions-of-interest in the human occipital cortex and along the intra-parietal sulcus. RESULTS: A linear support vector machine classification analysis applied to cortical responses showed patterns of activation that represented different disparity correlation levels within regions-of-interest in the visual cortex. These also revealed a positive trend between the difference in disparity correlation and classification accuracy in V1, V3 and lateral occipital cortex. Classifier performance was significantly related to behavioural performance in dorsal visual area V3. Cortical responses to random-dot-stereogram stimuli were greater in the right compared to the left hemisphere. CONCLUSIONS: Our results show that multiple regions in the cerebral cortex are sensitive to changes in interocular disparity correlation, and that dorsal area V3 may play an important role in the early transformation of binocular disparity to depth perception.

Factors determining whether diffuse large B-cell lymphoma samples are detected by flow cytometry.

INTRODUCTION: Flow cytometry (FCM) is widely used in the diagnosis of mature B-cell neoplasms (MBN), and FCM data are usually consistent with morphological findings. However, diffuse large B-cell lymphoma (DLBCL), a common MBN, is sometimes not detected by FCM. This study aimed to explore factors that increase the likelihood of failure to detect DLBCL by FCM. METHODS: Cases with a final diagnosis of DLBCL that were analysed by eight-colour FCM were retrospectively collated. Clinical, FCM, histopathological and genetic data were compared between cases detected and cases not detected by FCM. RESULTS: DLBCL cases from 135 different patients were analysed, of which 22 (16%) were not detected by FCM. In samples not detected by flow cytometry, lymphocytes were a lower percentage of total events (p = 0.02), and T cells were a higher percentage of total lymphocytes (p = 0.01). Cases with high MYC protein expression on immunohistochemistry were less likely to be missed by FCM (p = 0.011). Detection of DLBCL was not different between germinal centre B-cell (GCB) and non-GCB subtypes, not significantly affected by the presence of necrosis or fibrosis, and not significantly different between biopsy specimens compared to fine-needle aspirates, or between samples from nodal compared to extranodal tissue. CONCLUSION: The study identifies several factors which affect the likelihood of DLBCL being missed by FCM. Even with eight-colour analysis, FCM fails to detect numerous cases of DLBCL.

Neurons in dorsal visual area V5/MT signal relative disparity.

Judgments of visual depth rely crucially on the relative binocular disparity between two visual features. While areas of ventral visual cortex contain neurons that signal the relative disparity between spatially adjacent visual features, the same tests in dorsal visual areas yield little evidence for relative disparity selectivity. We investigated the sensitivity of neurons in dorsal visual area V5/MT of macaque monkeys to relative disparity, using two superimposed, transparent planes composed of dots moving in opposite directions. The separation of the planes in depth specifies their relative disparity, while absolute disparity can be altered independently by changing the binocular depth of the two planes with respect to the monkey's fixation point. Many V5/MT neurons were tuned to relative disparity, independent of the absolute disparities of the individual planes. For the two plane stimulus, neuronal responses were often linearly related to responses to the absolute disparity of each component plane presented individually, but some aspects of relative disparity tuning were not explained by linear combination. Selectivity for relative disparity could not predict whether neuronal firing was related to the monkeys' perceptual reports of the rotation direction of structure-from-motion figures centered on the plane of fixation. In sum, V5/MT neurons are not just selective for absolute disparity, but also code for relative disparity between visual features. This selectivity may be important for segmentation and depth order of moving visual features, particularly the processing of three-dimensional information in scenes viewed by an actively moving observer.

MRI Stereoscope: A Miniature Stereoscope for Human Neuroimaging.

Stereoscopic vision enables the perception of depth. To study the brain mechanisms behind stereoscopic vision using noninvasive brain imaging (magnetic resonance brain imaging; MRI), scientists need to reproduce the independent views of the left and right eyes in the brain scanner using "dichoptic" displays. However, high-quality dichoptic displays are technically challenging and costly to implement in the MRI scanner. The novel miniature stereoscope system ("MRI stereoscope") is an affordable and open-source tool that displays high-quality dichoptic images inside the MRI scanner. The MRI stereoscope takes advantage of commonly used display equipment, the MRI head coil, and a display screen. To validate the MRI stereoscope, binocular disparity stimuli were presented in a 3T MRI scanner while neural activation was recorded using functional MRI in six human participants. The comparison of large binocular disparities compared with disparities close to zero evoked strong responses across dorsal and ventral extra-striate visual cortex. In contrast, binocularly anti-correlated stimuli, which are not perceived in depth, did not evoke comparable activation. These results are the proof-of-concept that the MRI stereoscope can deliver dichoptic images that produce the perception of stereoscopic depth during acquisition of MR responses. Application of the MRI stereoscope to neuroscience can help to address important questions in perception and consciousness.

Comparison of flow cytometry with other modalities in the diagnosis of myelodysplastic syndrome.

INTRODUCTION: The myelodysplastic syndromes (MDSs) are heterogeneous myeloid malignancies, conventionally diagnosed by cytomorphology and cytogenetics, with an emerging role for flow cytometry. This study compared the performance of a 4-parameter flow cytometry scoring system, the Ogata Score, with other modalities in the diagnosis of MDS. METHODS: Bone marrow aspirate and trephine biopsies from 238 patients performed to assess for possible MDS were analysed, and the flow cytometry score was retrospectively applied. The sensitivity and specificity of the flow cytometry score, the aspirate microscopy, the trephine microscopy with immunohistochemistry, and cytogenetic and molecular results were determined relative to the final diagnosis. RESULTS: The medical records of the 238 patients were reviewed to determine the final clinical diagnosis made at the time of the bone marrow examination. This final diagnosis of MDS, possible MDS or not MDS, was based on clinical features and laboratory tests, including all parameters of the bone marrow investigation, except for the flow cytometry score, which was only determined for this study. The flow cytometry score was 67.4% sensitive and 93.8% specific. Aspirate microscopy had higher sensitivity (83.7%) and similar specificity (92.0%), whereas trephine microscopy had similar sensitivity (66.3%) and specificity (89.4%) to flow cytometry. Although the flow cytometry score had a lower sensitivity than aspirate microscopy, in 18 patients (7.6% of the total) the flow cytometry score was positive for MDS, whereas aspirate microscopy was negative or inconclusive. CONCLUSION: The flow cytometry score and trephine microscopy exhibited reasonable sensitivity and high specificity, and complement aspirate microscopy in the assessment of MDS.

Human primary visual cortex shows larger population receptive fields for binocular disparity-defined stimuli.

The visual perception of 3D depth is underpinned by the brain's ability to combine signals from the left and right eyes to produce a neural representation of binocular disparity for perception and behaviour. Electrophysiological studies of binocular disparity over the past 2 decades have investigated the computational role of neurons in area V1 for binocular combination, while more recent neuroimaging investigations have focused on identifying specific roles for different extrastriate visual areas in depth perception. Here we investigate the population receptive field properties of neural responses to binocular information in striate and extrastriate cortical visual areas using ultra-high field fMRI. We measured BOLD fMRI responses while participants viewed retinotopic mapping stimuli defined by different visual properties: contrast, luminance, motion, correlated and anti-correlated stereoscopic disparity. By fitting each condition with a population receptive field model, we compared quantitatively the size of the population receptive field for disparity-specific stimulation. We found larger population receptive fields for disparity compared with contrast and luminance in area V1, the first stage of binocular combination, which likely reflects the binocular integration zone, an interpretation supported by modelling of the binocular energy model. A similar pattern was found in region LOC, where it may reflect the role of disparity as a cue for 3D shape. These findings provide insight into the binocular receptive field properties underlying processing for human stereoscopic vision.

GABAergic inhibition in the human visual cortex relates to eye dominance.

Binocular vision is created by fusing the separate inputs arriving from the left and right eyes. 'Eye dominance' provides a measure of the perceptual dominance of one eye over the other. Theoretical models suggest that eye dominance is related to reciprocal inhibition between monocular units in the primary visual cortex, the first location where the binocular input is combined. As the specific inhibitory interactions in the binocular visual system critically depend on the presence of visual input, we sought to test the role of inhibition by measuring the inhibitory neurotransmitter GABA during monocular visual stimulation of the dominant and the non-dominant eye. GABA levels were measured in a single volume of interest in the early visual cortex, including V1 from both hemispheres, using a combined functional magnetic resonance imaging and magnetic resonance spectroscopy (combined fMRI-MRS) sequence on a 7-Tesla MRI scanner. Individuals with stronger eye dominance had a greater difference in GABAergic inhibition between the eyes. This relationship was present only when the visual system was actively processing sensory input and was not present at rest. We provide the first evidence that imbalances in GABA levels during ongoing sensory processing are related to eye dominance in the human visual cortex. Our finding supports the view that intracortical inhibition underlies normal eye dominance.

Neural modulation by binocular disparity greatest in human dorsal visual stream.

Although cortical activation to binocular disparity can be demonstrated throughout occipital and parietal cortices, the relative contributions to depth perception made by different human cortical areas have not been established. To investigate whether different regions are optimized for specific disparity ranges, we have measured the responses of occipital and parietal areas to different magnitudes of binocular disparity. Using stimuli consisting of sinusoidal depth modulations, we measured cortical activation when the stimuli were located at pedestal disparities of 0, 0.1, 0.35, and 0.7 degrees from fixation. Across all areas, occipital and parietal, there was an increase in BOLD signal with increasing pedestal disparity, compared with a plane at zero disparity. However, the greatest modulation of response by the different pedestals was found in the dorsal visual areas and the parietal areas. These differences contrast with the response to the zero disparity plane, compared with fixation, which is greatest in the early visual areas, smaller in the ventral and dorsal visual areas, and absent in parietal areas. Using the simultaneously acquired psychophysical data we also measured a greater response to correct than to incorrect trials, an effect that increased with rising pedestal disparity and was greatest in dorsal visual and parietal areas. These results illustrate that the dorsal stream, along both its occipital and parietal branches, can reliably discriminate a large range of disparities.

Concurrent Pituicytoma, Meningioma, and Cavernomas After Cranial Irradiation for Childhood Acute Lymphoblastic Leukemia.

BACKGROUND: The majority of patients with acute lymphoblastic leukaemia develop disease relapse in the central nervous system in the absence of central nervous system-directed prophylactic therapy. In the past, prophylactic cranial irradiation was commonly used in the form of whole-brain radiotherapy in patients with acute lymphoblastic leukemia to prevent the development of intracranial diseases. However, in addition to the inherent risk of toxicity, this type of therapy has several delayed side effects including the development of secondary intracranial tumors. CASE DESCRIPTION: We report a rare case of a patient with concurrent pituicytoma, meningioma, and cavernomas 44 years after prophylactic cranial irradiation for childhood acute lymphoblastic leukemia. The patient presented with visual disturbance, headache, and features of hypopituitarism. Endoscopic transsphenoidal resection of the pituicytoma and meningioma was performed. Subsequent regrowth of the residual meningioma necessitated further surgery and adjuvant treatment with radiotherapy. CONCLUSIONS: This case report highlights the unusual case of a patient with 3 concurrent intracranial lesions of distinct pathologies after prophylactic cranial irradiation therapy for childhood acute lymphoblastic leukemia.

Humans ignore motion and stereo cues in favor of a fictional stable world.

As we move through the world, our eyes acquire a sequence of images. The information from this sequence is sufficient to determine the structure of a three-dimensional scene, up to a scale factor determined by the distance that the eyes have moved. Previous evidence shows that the human visual system accounts for the distance the observer has walked and the separation of the eyes when judging the scale, shape, and distance of objects. However, in an immersive virtual-reality environment, observers failed to notice when a scene expanded or contracted, despite having consistent information about scale from both distance walked and binocular vision. This failure led to large errors in judging the size of objects. The pattern of errors cannot be explained by assuming a visual reconstruction of the scene with an incorrect estimate of interocular separation or distance walked. Instead, it is consistent with a Bayesian model of cue integration in which the efficacy of motion and disparity cues is greater at near viewing distances. Our results imply that observers are more willing to adjust their estimate of interocular separation or distance walked than to accept that the scene has changed in size.

Recognition for Vision.

When children grow up, the first word or first step in walking is always a significant event [...].

Preserved extrastriate visual network in a monkey with substantial, naturally occurring damage to primary visual cortex.

Lesions of primary visual cortex (V1) lead to loss of conscious visual perception with significant impact on human patients. Understanding the neural consequences of such damage may aid the development of rehabilitation methods. In this rare case of a Rhesus macaque (monkey S), likely born without V1, the animal's in-group behaviour was unremarkable, but visual task training was impaired. With multi-modal magnetic resonance imaging, visual structures outside of the lesion appeared normal. Visual stimulation under anaesthesia with checkerboards activated lateral geniculate nucleus of monkey S, while full-field moving dots activated pulvinar. Visual cortical activation was sparse but included face patches. Consistently across lesion and control monkeys, functional connectivity analysis revealed an intact network of bilateral dorsal visual areas temporally correlated with V5/MT activation, even without V1. Despite robust subcortical responses to visual stimulation, we found little evidence for strengthened subcortical input to V5/MT supporting residual visual function or blindsight-like phenomena.

Disparity channels in early vision.

The past decade has seen a dramatic increase in our knowledge of the neural basis of stereopsis. New cortical areas have been found to represent binocular disparities, new representations of disparity information (e.g., relative disparity signals) have been uncovered, the first topographic maps of disparity have been measured, and the first causal links between neural activity and depth perception have been established. Equally exciting is the finding that training and experience affects how signals are channeled through different brain areas, a flexibility that may be crucial for learning, plasticity, and recovery of function. The collective efforts of several laboratories have established stereo vision as one of the most productive model systems for elucidating the neural basis of perception. Much remains to be learned about how the disparity signals that are initially encoded in primary visual cortex are routed to and processed by extrastriate areas to mediate the diverse capacities of three-dimensional vision that enhance our daily experience of the world.