Long-Term Follow-Up of a Family with Retinal Dystrophy Caused by RPE65 Mutation.

We present here the case histories of two siblings, a boy and a girl, with Leber's congenital amaurosis (LCA). The diagnosis was based on non-recordable full-field electroretinogram (ffERG). The long-term ophthalmologic follow-up included kinetic perimetry (Goldmann), visual evoked potentials with flash stimulation, optical coherence tomography (OCT: B-scan images at the area of fovea), and multifocal ERG. The boy (sibling 1, born in 1986) was sent for electrophysiological examination at the age of four because he had nystagmus from birth. The diagnosis would be LCA based on non-recordable ffERG. Four years later, his visual acuity decreased rapidly due to vitreous opacification, caused by the autoimmune reaction of the retinal pigment epithelial cells. This was treated successfully with steroid injections, administered parabulbarly. Retinal autoimmune panel was not performed. Genetic testing became available only in 2019, and it revealed a RPE65 gene mutation: (NM_000329.2) c.{442G>A};{442G>A} (p.{Glu148Lys}; {Glu148Lys}). His sister (sibling 2, born in 1993) showed similar symptoms, caused by the same genetic mutation. Even though their parents were free of symptoms, it appeared that they were heterozygous carriers of the same mutation. Research of the family tree revealed a consanguineous marriage four generations before. Both siblings received successful gene therapy relatively late in their age: sibling 1 was 35 and sibling 2 was 28 years old, meaning that they were at an advanced stage of the disease. Nevertheless, follow-up examinations showed measurable improvements in their retinal function. The study shows that electrophysiological examinations, including flash-evoked responses, are useful in the objective evaluation of the progression in the central photoreceptor loss during the follow-up of LCA. The results also show that gene therapy can have beneficial effects even at an advanced stage of the disease.

Immunohistochemical Analysis of a Vitreous Membrane Removed from a Patient with Incontinentia Pigmenti-Related Retinal Detachment.

This is a case history of a 23-year-old woman suffering from incontinentia pigmenti (IP). The patient's vision in the left eye started to deteriorate due to cataract progression at the age of 22, and by the age of 23, it dropped from 0.9 to 0.04. Ultrasound examination confirmed tractional vitreoretinal membranes. Vitrectomy was performed, therefore, on her left eye. The histological evaluation of vitreous membrane revealed a complex immunophenotype (positivity for glial fibrillary acidic protein (GFAP), vimentin, S-100, anti-pan cytokeratin antibody (AE/AE3), and smooth muscle-specific actin (SMA) to various extents). The right eye remained unsymptomatic throughout this course. Besides being the first to analyze the tractional vitreoretinal membrane in IP with immunohistochemical methods, this case study points out that extreme cases of asymmetric side involvement in IP do exist, even to the point of one eye being completely unsymptomatic.

Cognitive training improves the disturbed behavioral architecture of schizophrenia-like rats, "Wisket".

Translational schizophrenia research depends on the relevance of animal models supported by reliable tests. Human data suggest that the intensive cognitive training in schizophrenia improves the memory impairments and decreases the chance of acute psychiatric remission. Here we examined the effects of a 10-day long training session in the behavioral architecture of a new schizophrenia-like rat substrain (Wisket) in a narrow square corridor with food rewards (AMBITUS). The instrument was designed to model the natural environment of rats and enable the simultaneous recording of multiple behavioral parameters. For the compact visualization of differences between the Wisket and control animals in several parameters (behavioromics), color-coded grid plots were applied. The Wisket animals exhibited an altered pattern and/or amount of locomotion, exploratory and food collecting activity at the first few days, revealing impaired motivation, attention, anxiety and learning ability (face validity). Most of the parameters normalized with training, except for the decreased exploratory activity. This resembles the effects of cognitive behavioral therapy in human schizophrenics providing a significant support for the predictive validity of this substrain as an animal model of schizophrenia. This study also highlights the importance of behavior tests that investigate the egocentric learning ability during reward-based tasks.

Impaired pupillary control in "schizophrenia-like" WISKET rats.

Patients with schizophrenia show impairments in autonomic regulation, including pupillomotor control. The aim of this study was to explore the changes of pupillary light reflex in a new substrain (WISKET) with several schizophrenia-like alterations. Male WISKET rats housed individually (for four weeks) and treated with ketamine (for 3 × 5 days) after weaning and naive group-housed Wistar rats (controls) were involved in the study. The pupillary light reflex was studied in two series after sedation (diazepam) or anesthesia (chloral hydrate). Video recordings were evaluated with custom made video analyzer software. Several significant changes were observed between the two groups: the initial and minimum pupil diameters were greater, the degree of the constriction was lower, and the flatness of the curve and the total duration of constriction were shorter in the sedated WISKET rats. No other pupillary parameters (latency, amplitude and redilation) showed significant alterations. Chloral hydrate anesthesia prolonged the constriction and redilation processes compared to the sedated animals, and diminished the differences between the groups. In conclusion, WISKET rats showed disturbances in the pupillary light reflex, suggesting a general shift of autonomic balance towards a sympathetic predominance. The results provide further evidence to support the validity of WISKET rats as a complex, chronic animal model of schizophrenia.

Background activity and visual responsiveness of caudate nucleus neurons in halothane anesthetized and in awake, behaving cats.

This study focuses on the important question whether brain activity recorded from anesthetized, paralyzed animals is comparable to that recorded from awake, behaving ones. We compared neuronal activity recorded from the caudate nucleus (CN) of two halothane-anesthetized, paralyzed and two awake, behaving cats. In both models, extracellular recordings were made from the CN during static and dynamic visual stimulation. The anesthesia was maintained during the recordings by a gaseous mixture of air and halothane (1.0%). The behaving animals were trained to perform a visual fixation task. Based on their electrophysiological properties, the recorded CN neurons were separated into three different classes: phasically active (PANs), high firing (HFNs), and tonically active (TANs) neurons. Halothane anesthesia significantly decreased the background activity of the CN neurons in all three classes. The anesthesia had the most remarkable suppressive effect on PANs, where the background activity was consistently under 1 spike/s. The analysis of these responses was almost impossible due to the extremely low activity. The evoked responses during both static and dynamic visual stimulation were obvious in the behaving cats. On the other hand, only weak visual responses were found in some neurons of halothane anesthetized cats. These results show that halothane gas anesthesia has a marked suppressive effect on the feline CN. We suggest that for the purposes of the visual and related multisensory/sensorimotor electrophysiological exploration of the CN, behaving animal models are preferable over anesthetized ones.

Acquired equivalence and related memory processes in migraine without aura.

Introduction Interictal deficits of elementary visuo-cognitive functions are well documented in patients with migraine and are mostly explained in terms of neocortical hyperexcitability. It has been suggested that the basal ganglia and the hippocampi might also be affected in migraine. If so, a deterioration of learning and memory processes related to these structures is expected. Methods A visual learning paradigm thought to be capable of dissociating learning/memory processes mediated by the basal ganglia from processes mediated by the hippocampus (the Rutgers Acquired Equivalence Test) was applied to a group of patients with migraine without aura and to age- and sex-matched controls. Results Patients with migraine showed a significantly poorer performance in both main phases of the test and the deficit in the phase considered to be dependent on the hippocampi was especially marked. Conclusions These results can be interpreted as behavioural support for findings that have suggested the involvement of the basal ganglia and the hippocampi in migraine, but further research is needed to clarify these findings.

Electrophysiological alterations in a complex rat model of schizophrenia.

BACKGROUND: Psychiatric disorders are frequently accompanied by changes in brain electrical oscillations and abnormal auditory event related potentials. The goal of this study was to characterize these parameters of a new rat substrain showing several alterations related to schizophrenia. METHODS: Male rats of the new substrain, developed by selective breeding after combined subchronic ketamine treatment and postweaning social isolation, and naive Wistar ones group-housed without any interventions were involved in the present study. At the age of 3 months, animals were implanted with cortical electroencephalography electrodes. Auditory evoked potentials during paired-click stimuli and power of oscillation in different frequency bands were determined with and without acute ketamine (20mg/kg) treatment. RESULTS: Regarding the auditory evoked potentials, the latency of P2 was delayed and the amplitude of N1 peak was lower in the new substrain. The new substrain showed increased power of oscillations in the theta, alpha and beta bands, while decreased power was detected in delta and gamma2 bands (52-70Hz) compared with control animals. Acute ketamine treatment increased the gamma1 band (30-48Hz) power in both groups, while it elicited significant changes only in the new substrain in the total power and in alpha, beta and gamma2 bands. CONCLUSIONS: The validation of the translational utility of this new rat substrain by electrophysiological investigations revealed that these rats show abnormalities that may model a part of the neurophysiological deficits observed in schizophrenia.

The Development and Aging of the Magnocellular and Parvocellular Visual Pathways as Indicated by VEP Recordings between 5 and 84 Years of Age.

It is well known that pattern reversal visual evoked potentials (VEPs) are age-sensitive. Through the use of this technique, it is possible to assess both of the major visual pathways (i.e., the magnocellular and parvocellular ones) in terms of function and development. What developmental path these pathways follow, and if they develop/age in parallel across the human lifespan is a matter of ongoing debate, yet, only a few VEP studies have dealt with this issue. This cross-sectional study examined a sample of 115 healthy volunteers aged 5 to 84 years. Beyond the standard checkerboard pattern reversal stimulation at 97% contrast, we recorded pattern-reversal VEPs at 6% contrast to selectively stimulate the M pathway and isoluminant red and green checkerboard stimulation was also used to selectively stimulate the P pathway. Our results do not support the developmental advantage of any of the pathways. The development of both pathways appear to take a remarkably long time (well into the 30s), and the signs of aging become marked over 50 years of age, especially in the case of the magnocellular pathway.

Further Evidence for the Utility of Electrophysiological Methods for the Detection of Subclinical Stage Retinal and Optic Nerve Involvement in Diabetes.

OBJECTIVE: To assess the utility of visual electrophysiological methods, visual evoked potentials (VEPs) and pattern electroretinograms (PERGs) were recorded for the detection of subclinical optic nerve and retinal involvement in patients with diabetes mellitus. SUBJECTS AND METHODS: The data of 63 patients (126 eyes) with no vascular retinopathy or optic neuropathy were retrospectively analyzed. The patients were divided into polyneuropathic/nonpolyneuropathic groups to differentiate between early and late subclinical stages. The recorded parameters were compared with local reference values. RESULTS: 116 eyes (92%) had VEP and 76 (60%) had PERG abnormalities. The most frequent alteration was latency delay, but waveform and amplitude irregularities were also observed. The simultaneous use of the two methods allowed us to differentiate abnormal VEPs of purely optic nerve origin from those reflecting retinal involvement. CONCLUSIONS: We suggest that regular electrophysiological screening should receive more attention in the ophthalmological care of diabetic patients.

Abnormal Motor Activity and Thermoregulation in a Schizophrenia Rat Model for Translational Science.

BACKGROUND: Schizophrenia is accompanied by altered motor activity and abnormal thermoregulation; therefore, the presence of these symptoms can enhance the face validity of a schizophrenia animal model. The goal was to characterize these parameters in freely moving condition of a new substrain of rats showing several schizophrenia-related alterations. METHODS: Male Wistar rats were used: the new substrain housed individually (for four weeks) and treated subchronically with ketamine, and naive animals without any manipulations. Adult animals were implanted with E-Mitter transponders intraabdominally to record body temperature and locomotor activity continuously. The circadian rhythm of these parameters and the acute effects of changes in light conditions were analyzed under undisturbed circumstances, and the effects of different interventions (handling, bed changing or intraperitoneal vehicle injection) were also determined. RESULTS: Decreased motor activity with fragmented pattern was observed in the new substrain. However, these animals had higher body temperature during the active phase, and they showed wider range of its alterations, too. The changes in light conditions and different interventions produced blunted hyperactivity and altered body temperature responses in the new substrain. Poincaré plot analysis of body temperature revealed enhanced short- and long-term variabilities during the active phase compared to the inactive phase in both groups. Furthermore, the new substrain showed increased short- and long-term variabilities with lower degree of asymmetry suggesting autonomic dysregulation. CONCLUSIONS: In summary, the new substrain with schizophrenia-related phenomena showed disturbed motor activity and thermoregulation suggesting that these objectively determined parameters can be biomarkers in translational research.

Activity of Caudate Nucleus Neurons in a Visual Fixation Paradigm in Behaving Cats.

Beside its motor functions, the caudate nucleus (CN), the main input structure of the basal ganglia, is also sensitive to various sensory modalities. The goal of the present study was to investigate the effects of visual stimulation on the CN by using a behaving, head-restrained, eye movement-controlled feline model developed recently for this purpose. Extracellular multielectrode recordings were made from the CN of two cats in a visual fixation paradigm applying static and dynamic stimuli. The recorded neurons were classified in three groups according to their electrophysiological properties: phasically active (PAN), tonically active (TAN) and high-firing (HFN) neurons. The response characteristics were investigated according to this classification. The PAN and TAN neurons were sensitive primarily to static stimuli, while the HFN neurons responded primarily to changes in the visual environment i.e. to optic flow and the offset of the stimuli. The HFNs were the most sensitive to visual stimulation; their responses were stronger than those of the PANs and TANs. The majority of the recorded units were insensitive to the direction of the optic flow, regardless of group, but a small number of direction-sensitive neurons were also found. Our results demonstrate that both the static and the dynamic components of the visual information are represented in the CN. Furthermore, these results provide the first piece of evidence on optic flow processing in the CN, which, in more general terms, indicates the possible role of this structure in dynamic visual information processing.

In vivo potency of different ligands on voltage-gated sodium channels.

The Ranvier nodes of thick myelinated nerve fibers contain almost exclusively voltage-gated sodium channels (Navs), while the unmyelinated fibers have several receptors (e.g., cannabinoid, transient receptor potential vanilloid receptor 1), too. Therefore, a nerve which contains only motor fibers can be an appropriate in vivo model for selective influence of Navs. The goals were to evaluate the potency of local anesthetic drugs on such a nerve in vivo; furthermore, to investigate the effects of ligands with different structures (arachidonic acid, anandamide, capsaicin and nisoxetine) that were proved to inhibit Navs in vitro with antinociceptive properties. The marginal mandibular branch of the facial nerve was explored in anesthetized Wistar rats; after its stimulation, the electrical activity of the vibrissae muscles was registered following the perineural injection of different drugs. Lidocaine, bupivacaine and ropivacaine evoked dose-dependent decrease in electromyographic activity, i.e., lidocaine had lower potency than bupivacaine or ropivacaine. QX-314 did not cause any effect by itself, but its co-application with lidocaine produced a prolonged inhibition. Nisoxetine had a very low potency. While anandamide and capsaicin in high doses caused about 50% decrease in the amplitude of action potential, arachidonic acid did not influence the responses. We proved that the classical local anesthetics have high potency on motor nerves, suggesting that this method might be a reliable model for selective targeting of Navs in vivo circumstances. It is proposed that the effects of these endogenous lipids and capsaicin on sensory fibers are not primarily mediated by Navs.

The effect of simultaneous flickering light stimulation on global form and motion perception thresholds.

The question regarding the exact function of the primary visual cortex (V1) in vision has been around ever since the description of residual vision after damage to this cortical area by Riddoch in 1917. In 2002, Schoenfeld and colleagues proposed that V1 can be saturated by flashes of light, by which the function of V1-bypassing visual pathways can be "unmasked". The Schoenfeld group found that light flashes applied on stimulus onset led to the elevation of brightness increment detection thresholds, but left motion detection thresholds unaltered. Although the proposed method (i.e. the use of light flashes to induce refractoriness in V1) could be a simple, cheap and elegant way of exploring V1 functions, no study has followed up on this. Therefore it is not known if it works at all with other types of stimuli. For that reason, we decided to revisit the idea in a modified form. Global form and motion perception thresholds were assessed with static Glass pattern stimuli and random dot kinematograms, with and without 12Hz flickering light stimulation. Global motion thresholds were almost unaltered by flickering stimulation, while a significant threshold elevation was caused in the global form perception task. The strongest conclusion allowed by our data is that simultaneous flickering photostimulation elevates global form perception thresholds but not global motion perception thresholds. This is in some way related to the refractoriness generated in an unsatisfactorily defined part of V1. We suggest that this does not necessarily reflect the activity of V1-bypassing pathways, and propose that the application of light flashes is a method that deserves more attention in the exploration of the V1-dependent and independent elements of visual consciousness in human subjects.

Spectral characteristics of phase sensitivity and discharge rate of neurons in the ascending tectofugal visual system.

Drifting gratings can modulate the activity of visual neurons at the temporal frequency of the stimulus. In order to characterize the temporal frequency modulation in the cat's ascending tectofugal visual system, we recorded the activity of single neurons in the superior colliculus, the suprageniculate nucleus, and the anterior ectosylvian cortex during visual stimulation with drifting sine-wave gratings. In response to such stimuli, neurons in each structure showed an increase in firing rate and/or oscillatory modulated firing at the temporal frequency of the stimulus (phase sensitivity). To obtain a more complete characterization of the neural responses in spatiotemporal frequency domain, we analyzed the mean firing rate and the strength of the oscillatory modulations measured by the standardized Fourier component of the response at the temporal frequency of the stimulus. We show that the spatiotemporal stimulus parameters that elicit maximal oscillations often differ from those that elicit a maximal discharge rate. Furthermore, the temporal modulation and discharge-rate spectral receptive fields often do not overlap, suggesting that the detection range for visual stimuli provided jointly by modulated and unmodulated response components is larger than the range provided by a one response component.

An investigation of the white matter microstructure in motion detection using diffusion MRI.

One of the most widely investigated functions of the brain is vision. Whereas special attention is often paid to motion detection and its modulation by attention, comparatively still little is known about the structural background of this function. We therefore, examined the white matter microstructural background of coherent motion detection. A random-dot kinematogram paradigm was used to measure the sensitivity of healthy individuals׳ to movement coherence. The potential correlation was investigated between the motion detection threshold and the white matter microstructure as measured by high angular resolution diffusion MRI. The Track Based Spatial Statistics method was used to address this correlation and probabilistic tractography to reveal the connection between identified regions. A significant positive correlation was found between the behavioural data and the local fractional anisotropy in the posterior part of the right superior frontal gyrus, the right juxta-cortical superior parietal lobule, the left parietal white matter, the left superior temporal gyrus and the left optic radiation. Probabilistic tractography identified pathways that are highly similar to the segregated attention networks, which have a crucial role in the paradigm. This study draws attention to the structural determinant of a behavioural function.

Interocular amplitude and latency differences of pattern ERG and pattern VEP parameters.

PURPOSE: To determine the normal interocular differences in amplitudes and peak times of the pattern electroretinograms (PERGs) and pattern visual evoked potentials (PVEPs) and to investigate whether the PERG and PVEP parameters correspond in lateral dominance or whether the eye-side distributions of the functional parameters are similar. METHODS: The PERGs and PVEPs were recorded in healthy subjects (N = 77) according to the standards of the International Society for Clinical Electrophysiology of Vision, with the modification of the check size of the PERG to 0.5 degrees. This allows stimulation of the macular ganglion cells and their corresponding visual pathways in healthy subjects. RESULTS: Comparison of the averaged higher and lower response amplitudes and the shorter and longer response peak times showed significant differences (p < 0.001) in both the PERG and the PVEP parameters (median [5 to 95%]): the P50 (1.92% [0 to 5.48%]) and N95 (2.06% [0 to 13.95%]) peak times and the P50 (11.82% [1.32 to 29.93%) and N95 (9.45% [1.17 to 30.38%]) amplitudes of the PERGs and the P100 (1.04% [0 to 4.15%]) and N135 (1.96% [0 to 12.36%]) peak times and the P100 (9.86% [1.26 to 29.76%]) and N135 (11.19% [1.18 to 29.99%]) amplitudes of the PVEPs. No significant correlation was found concerning the eye dominance of the PERG and PVEP parameters. CONCLUSIONS: Our results reveal a significant interocular difference on PERG and PVEP recording, but this could not be ascribed to the anatomy of the retina and related visual pathways. If the difference between the eyes is not taken into account, misinterpretation may occur in a pathological process.

The effects of juvenile capsaicin desensitization in rats: behavioral impairments.

Capsaicin desensitization leads to behavioral changes, some of which are related to schizophrenia, but investigations into these effects have been scarce. The goal of this study was to characterize the consequences of juvenile capsaicin desensitization on different functions: acute and inflammation-induced thermal and mechanical sensitivity, urinary bladder capacity and thermoregulation, and also on the potentially schizophrenia-related impairments in sensory-motor gating, motor activity and cognitive functioning. Male Wistar rats desensitized with increasing doses of subcutaneous capsaicin after weaning were investigated. Heat and mechanical pain sensitivity did not change significantly; however, morphine produced a prolonged decrease in the nociceptive response to inflammation in desensitized animals. Ultrasound examination of the bladder revealed enhanced bladder volume in treated animals. Capsaicin-treated animals had higher body temperature at 22 °C in both dark and light periods, and they also showed prolonged hyperthermia in new environmental circumstances. Warm environment induced a profound impairment of thermoregulation in desensitized animals. The treated animals also showed higher levels of activity during the active phase and at both cool and warm temperatures. The amplitude of the responses to auditory stimuli and prepulse inhibition did not differ between the two groups, but the desensitized animals showed learning impairments in the novel object recognition test. These results suggest that juvenile capsaicin desensitization leads to sustained changes in several functions that may be related to schizophrenia. We propose that capsaicin desensitization, together with other interventions, may lead to an improved chronic animal model of schizophrenia.

Achromatic luminance contrast sensitivity in X-linked color-deficient observers: an addition to the debate.

It is a matter of debate whether X-linked dichromacy is accompanied by enhanced achromatic processing. In the present study, we used sinusoidally modulated achromatic gratings under photopic conditions to compare the contrast sensitivity (CS) of protanopes, deuteranopes, and normal trichromats. 36 male volunteers were examined. CS was tested in static and dynamic conditions at nine different spatial frequencies. The results support the assumption that X-linked color-defective observers are at an advantage in terms of achromatic processing. Both protanopes and deuteranopes had significantly better CS than controls in both the static and the dynamic conditions. In the static condition, the advantage was observed especially at higher spatial frequencies, whereas in the dynamic condition, it was seen also at lower frequencies. The results are interpreted in terms of decreased chromatic modulation of the luminance channel and the early plasticity of the parvocellular system.

A new, behaving, head restrained, eye movement-controlled feline model for chronic visual electrophysiological recordings.

BACKGROUND: Anesthetized, paralyzed domestic cats are often used as model organisms in visual neurophysiology. However, in the last few decades, behaving animal models have gathered ground in neurophysiology, due to their advantages over anesthetized, paralyzed models. NEW METHOD: In the present study a new, behaving, awake feline model is described, which is suitable for chronic visual electrophysiological recordings. Two trained, head- fixed cats were suspended in a canvas harness in a specially designed stand. The animals had been trained to fixate the center of a monitor during static and dynamic visual stimulation. Eye movements were monitored with implanted scleral coil in a magnetic field. Cell-level activity was recorded with eight electrodes implanted in the caudate nucleus. RESULTS: Our two trained cats could maintain accurate fixation, even during optic flow stimulation, in an acceptance window of ±2.5° and ±1.5°, respectively. The model has yielded accurate recordings for over two years. COMPARISON WITH EXISTING METHOD(S): To our knowledge, this is the first awake, behaving feline model with rigorous eye movement control for chronic, cell-level visual electrophysiological recordings, which has actually proven to work during a longer period. CONCLUSIONS: The new model is optimal for chronic visual electrophysiological recordings in the awake, behaving domestic cat.