Eye movements in the blind

Objectives : Eye movements are necessary to stabilize the retinal picture and to find a new object. This seems useless for blind people, so why do they nevertheless have them. We report on an EOG study on 29 blind volunteers and 5 volunteers with closed eyes. Material and methods: We recorded eye movements by EOG and let the volunteers fulfill different exercises by following an acoustic running point by gaze, pointing, imagining in the room, listing words that begin with the vocal U and a finger labyrinth. Results: We found slow eye movements as well as pathological eye movements in the blind subjects. We found that blind subjects have a horizontal preferency.The duration of fixation of pictures is shorter in the blind subjects. The blind could even modulate saccade amplitudes . Discussion: Eye movements seem to be structural properties of the brain which prepare the organism for certain situations-even if they do not take place. We think that eye movements are partially independent of the experience of view. We did not expect that the blind subjects could modify gaze according to the subject. This leads to the hypothesis of a preformed dimensional system.

Eye-tracking of nodule detection in lung CT volumetric data.

PURPOSE: Signal detection on 3D medical images depends on many factors, such as foveal and peripheral vision, the type of signal, and background complexity, and the speed at which the frames are displayed. In this paper, the authors focus on the speed with which radiologists and naïve observers search through medical images. Prior to the study, the authors asked the radiologists to estimate the speed at which they scrolled through CT sets. They gave a subjective estimate of 5 frames per second (fps). The aim of this paper is to measure and analyze the speed with which humans scroll through image stacks, showing a method to visually display the behavior of observers as the search is made as well as measuring the accuracy of the decisions. This information will be useful in the development of model observers, mathematical algorithms that can be used to evaluate diagnostic imaging systems. METHODS: The authors performed a series of 3D 4-alternative forced-choice lung nodule detection tasks on volumetric stacks of chest CT images iteratively reconstructed in lung algorithm. The strategy used by three radiologists and three naïve observers was assessed using an eye-tracker in order to establish where their gaze was fixed during the experiment and to verify that when a decision was made, a correct answer was not due only to chance. In a first set of experiments, the observers were restricted to read the images at three fixed speeds of image scrolling and were allowed to see each alternative once. In the second set of experiments, the subjects were allowed to scroll through the image stacks at will with no time or gaze limits. In both static-speed and free-scrolling conditions, the four image stacks were displayed simultaneously. All trials were shown at two different image contrasts. RESULTS: The authors were able to determine a histogram of scrolling speeds in frames per second. The scrolling speed of the naïve observers and the radiologists at the moment the signal was detected was measured at 25-30 fps. For the task chosen, the performance of the observers was not affected by the contrast or experience of the observer. However, the naïve observers exhibited a different pattern of scrolling than the radiologists, which included a tendency toward higher number of direction changes and number of slices viewed. CONCLUSIONS: The authors have determined a distribution of speeds for volumetric detection tasks. The speed at detection was higher than that subjectively estimated by the radiologists before the experiment. The speed information that was measured will be useful in the development of 3D model observers, especially anthropomorphic model observers which try to mimic human behavior.

An episode mimicking a versive seizure in acute bilateral pontine stroke.

Pontine ischemia usually results in focal deficits such as hemiparesis, facial palsy, dysarthria, disorders of eye movements or vertigo. Although rarely described, involuntary abnormal movements and "convulsions" due to pontine lesions can also occur. Here we describe a 67-year-old woman with hypertension who presented with a tonic movement mimicking a versive seizure in the acute phase of bilateral pontine ischemia. Post-stroke movement disorders are well known. They are usually associated with supratentorial lesions and rarely occur in the acute phase, but "seizure-like" episodes can be seen in pontine ischemia. Awareness of this rare phenomenon is useful for the management of acute stroke patients.

Congenital ataxia and hemiplegic migraine with cerebral edema associated with a novel gain of function mutation in the calcium channel CACNA1A.

Mutations in the CACNA1A gene, encoding the α1 subunit of the voltage-gated calcium channel Ca(V)2.1 (P/Q-type), have been associated with three neurological phenotypes: familial and sporadic hemiplegic migraine type 1 (FHM1, SHM1), episodic ataxia type 2 (EA2), and spinocerebellar ataxia type 6 (SCA6). We report a child with congenital ataxia, abnormal eye movements and developmental delay who presented severe attacks of hemiplegic migraine triggered by minor head traumas and associated with hemispheric swelling and seizures. Progressive cerebellar atrophy was also observed. Remission of the attacks was obtained with acetazolamide. A de novo 3 bp deletion was found in heterozygosity causing loss of a phenylalanine residue at position 1502, in one of the critical transmembrane domains of the protein contributing to the inner part of the pore. We characterized the electrophysiology of this mutant in a Xenopus oocyte in vitro system and showed that it causes gain of function of the channel. The mutant Ca(V)2.1 activates at lower voltage threshold than the wild type. These findings provide further evidence of this molecular mechanism as causative of FHM1 and expand the phenotypic spectrum of CACNA1A mutations with a child exhibiting severe SHM1 and non-episodic ataxia of congenital onset.

Multisensory facilitation of behavior in monkeys: effects of stimulus intensity.

Multisensory stimuli can improve performance, facilitating RTs on sensorimotor tasks. This benefit is referred to as the redundant signals effect (RSE) and can exceed predictions on the basis of probability summation, indicative of integrative processes. Although an RSE exceeding probability summation has been repeatedly observed in humans and nonprimate animals, there are scant and inconsistent data from nonhuman primates performing similar protocols. Rather, existing paradigms have instead focused on saccadic eye movements. Moreover, the extant results in monkeys leave unresolved how stimulus synchronicity and intensity impact performance. Two trained monkeys performed a simple detection task involving arm movements to auditory, visual, or synchronous auditory-visual multisensory pairs. RSEs in excess of predictions on the basis of probability summation were observed and thus forcibly follow from neural response interactions. Parametric variation of auditory stimulus intensity revealed that in both animals, RT facilitation was limited to situations where the auditory stimulus intensity was below or up to 20 dB above perceptual threshold, despite the visual stimulus always being suprathreshold. No RT facilitation or even behavioral costs were obtained with auditory intensities 30-40 dB above threshold. The present study demonstrates the feasibility and the suitability of behaving monkeys for investigating links between psychophysical and neurophysiologic instantiations of multisensory interactions.

Altered vision during motion: an unusual symptom of cerebellar dysfunction, quantifiable by a simple clinical test.

PURPOSE: To report a series of patients with cerebellar dysfunction and altered vision during motion, and to quantify their visual impairment in motion with a simple clinical test. METHODS: Twenty consecutive patients suffering from cerebellar dysfunction and altered vision during motion were examined between 1994 and 2007. A control group consisted of 20 age- and sex-matched healthy people. All patients had a full neuro-ophthalmic examination. Near visual acuity (NVA) was measured at rest (static NVA) and during chair rotation (dynamic NVA). Distance visual acuity (DVA) was measured at rest (static DVA) and during rotation of the patient's head (dynamic DVA). RESULTS: Only four of the 20 patients reported altered vision during motion spontaneously. The remaining 16 patients admitted this unusual visual disturbance only when asked specifically. All patients exhibited abnormal eye movements, including saccadic smooth pursuit (20/20), dysmetric saccades (15/20), nystagmus (19/20) and impaired suppression of vestibulo-ocular reflex (VOR) (20/20). During rotation of the examination chair (dynamic NVA), the drop in NVA averaged 5.6 lines (range 1-10 lines). During rotation of the patient's head (dynamic DVA), the drop in DVA averaged only 2.5 lines (range 0-10 lines). For the control group, there was no significant drop in NVA under dynamic conditions. CONCLUSION: Patients with cerebellar dysfunction rarely complain spontaneously of altered vision during motion. However, specific questioning may bring up this unusual symptom. The use of a simple clinical test, consisting of NVA measurement during rotation of the examination chair (dynamic NVA), allows practitioners to quantify the level of visual impairment in patients presenting altered VOR modulation.

Dépendances [Addictions]

This year reviews on the addictions emphasizes five aspects, on a bio-psycho-social perspective: (1) The relationship between methadone and cardiotoxicity. (2) The introduction of Eye Movement Desensibilization and Reprocessing (EMDR). (3) The apparition of a possible specific pharmacotherapy for excessive gambling. (4) A better knowledge of the relationship between cannabis and psychoses. (5) Resistance to treatment in the doctor-patient relationship.

Contribution à la compréhension du rôle de la mémoire de travail visuospatiale et de ses altérations dans la schizophrénie à l'aide d'un nouveau paradigme qui présente des stimuli dynamiques et statiques

Abstract Working memory has been defined as the ability to maintain and manipulate on-line a limited amount of information. A large number of studies have investigated visuospatial working memory in schizophrenia. However, today, the available data concerning the functioning of these processes in schizophrenia are largely controversial. These inconclusive results are due to incomplete knowledge on processes involved in visuospatial working memory tasks. Recent studies suggest that visuospatial working memory processes may be divided into an active monitoring and a storing components. Furthermore, it has been shown that visuospatial working memory processes are strongly interconnected with early encoding processes (perceptual organization). In our view, the two working memory components, and the relationship that they entertain with early encoding processes, may be investigated using dynamic and static visuospatial stimuli in a working memory paradigm. In this thesis we aim at comparing dynamic and static visuospatial working memory processes in patients with schizophrenia and first-episode of psychosis patients. This analysis may clarify the functioning of visuospatial working memory and the dysfunction of these processes in schizophrenia. Our results are in accord with the hypothesis of two visuospatial working memory subcomponents. Dynamic, rather than static, stimuli are strongly involved in the visuospatial working memory encoding process. Indeed, the results are congruent with the idea that static stimuli may be strongly encoded by parallel perceptual organization processes. Patients with schizophrenia show important deficits in both working memory and perceptual organization encoding processes. In contrast, perceptual organization processes seem spared in firstepisodepsychosis patients. Considering our findings, we propose a model to explain the degradation of visuospatial processes involved in a working memory task during schizophrenia. Résumé: La mémoire de travail est définie comme la capacité à maintenir et manipuler « on-line » un nombre limité d'informations pour une courte période de temps (de l'ordre de quelques dizaines de secondes). Un grand nombre d'études a montré que les processus de mémoire de travail visuo spatiale peuvent être affectés dans la schizophrénie. Malgré cela, les données concernant les déficits de ces processus chez des patients qui souffrent de schizophrénie sont contradictoires. La difficulté de comprendre la nature des déficits de mémoire de travail visuospatiale dans la schizophrénie est en grande partie imputable aux connaissances encore lacunaires sur le fonctionnement de ces processus dans un état non pathologique. Dans cette thèse, on cherche à élucider le fonctionnement des processus de mémoire de travail visuospatiale. Pour cela, on a créé un nouveau paradigme qui sollicite ce type de mémoire. Dans ce paradigme, on présente des stimuli dynamiques et statiques. Après un court délai, le sujet doit reconnaître le stimulus qu'il a visualisé parmi six possibilités. Sur la base de récentes études neurophysiologiques, neuroanatomiques et psychologiques, nous avançons l'hypothèse que l'encodage de stimuli dynamiques et statiques repose sur deux processus distincts de mémoire de travail : un processus d'organisation qui manipule les informations sensorielles et un processus dé stockage qui est responsable du maintien de l'information au cours de la manipulation. Ces processus sont en relation directe avec les processus responsables d'une organisation de l'information à un niveau précoce du traitement visuel. Les études présentées dans cette thèse ont pour but de vérifier la pertinence de la distinction entre les processus de mémoire de travail visuospatiale, selon la modalité «dynamique » ou «statique ». L'investigation des processus dynamiques et statiques de mémoire de travail dans la schizophrénie présente deux avantages principaux. Premièrement, 1a pathologie pourrait permettre de mettre en évidence, par les dysfonctionnements qu'elle présente, la pertinence des hypothèses sur le fonctionnement des processus de mémoire de travail visuospatiale et de leur interaction avec les processus sensoriels. Deuxièmement, ces investigations rendent possible une analyse des dysfonctions des différents processus dans la schizophrénie. Dans cette thèse, on analyse aussi les processus de mémoire de travail «dynamiques » et «statiques » chez des sujets dans une phase initiale de la psychose. Les résultats de cette étude permettent de faire une comparaison avec ceux obtenus avec des patients qui souffrent de schizophrénie. Cette comparaison peut apporter des informations intéressantes sur l'évolution des dysfonctions dans les processus impliqués dans les fonctions de mémoire de travail visuospatiale au cours de la schizophrénie. Les résultats obtenus dans les différentes études sont cohérents avec l'hypothèse d'une implication différente des processus d'organisation de la mémoire de travail sur des stimuli dynamiques et statiques. -Nos résultats montrent que les processus de mémoire de travail responsables de l'organisation (manipulation active) des informations est déficitaire dans la schizophrénie. Ce déficit semble jouer un rôle de premier plan dans la dégradation des processus visuospatiaux au cours de la schizophrénie.

Multisensory anatomical pathways.

In order to interact with the multisensory world that surrounds us, we must integrate various sources of sensory information (vision, hearing, touch...). A fundamental question is thus how the brain integrates the separate elements of an object defined by several sensory components to form a unified percept. The superior colliculus was the main model for studying multisensory integration. At the cortical level, until recently, multisensory integration appeared to be a characteristic attributed to high-level association regions. First, we describe recently observed direct cortico-cortical connections between different sensory cortical areas in the non-human primate and discuss the potential role of these connections. Then, we show that the projections between different sensory and motor cortical areas and the thalamus enabled us to highlight the existence of thalamic nuclei that, by their connections, may represent an alternative pathway for information transfer between different sensory and/or motor cortical areas. The thalamus is in position to allow a faster transfer and even an integration of information across modalities. Finally, we discuss the role of these non-specific connections regarding behavioral evidence in the monkey and recent electrophysiological evidence in the primary cortical sensory areas.

Congenital ataxia and hemiplegic migraine with cerebral edema associated with a novel gain of function mutation in the calcium channel CACNA1A.

Mutations in the CACNA1A gene, encoding the α1 subunit of the voltage-gated calcium channel CaV2.1 (P/Q-type), have been associated with three neurological phenotypes: familial and sporadic hemiplegic migraine type 1 (FHM1, SHM1), episodic ataxia type 2 (EA2), and spinocerebellar ataxia type 6 (SCA6). We report a child with congenital ataxia, abnormal eye movements and developmental delay who presented severe attacks of hemiplegic migraine triggered by minor head traumas and associated with hemispheric swelling and seizures. Progressive cerebellar atrophy was also observed. Remission of the attacks was obtained with acetazolamide. A de novo 3bp deletion was found in heterozygosity causing loss of a phenylalanine residue at position 1502, in one of the critical transmembrane domains of the protein contributing to the inner part of the pore. We characterized the electrophysiology of this mutant in a Xenopus oocyte in vitro system and showed that it causes gain of function of the channel. The mutant CaV2.1 activates at lower voltage threshold than the wild type. These findings provide further evidence of this molecular mechanism as causative of FHM1 and expand the phenotypic spectrum of CACNA1A mutations with a child exhibiting severe SHM1 and non-episodic ataxia of congenital onset.

Visuospatial working memory deficits and visual pursuit impairments are not directly related in schizophrenia.

OBJECTIVE: Patients with schizophrenia show deficits in visuospatial working memory and visual pursuit processes. It is currently unclear, however, whether both impairments are related to a common neuropathological origin. The purpose of the present study was therefore to examine the possible relations between the encoding and the discrimination of dynamic visuospatial stimuli in schizophrenia. METHOD: Sixteen outpatients with schizophrenia and 16 control subjects were asked to encode complex disc displacements presented on a screen. After a delay, participants had to identify the previously presented disc trajectory from a choice of six static linear paths, among which were five incorrect paths. The precision of visual pursuit eye movements during the initial presentation of the dynamic stimulus was assessed. The fixations and scanning time in definite regions of the six paths presented during the discrimination phase were investigated. RESULTS: In comparison with controls, patients showed poorer task performance, reduced pursuit accuracy during incorrect trials and less time scanning the correct stimulus or the incorrect paths approximating its global structure. Patients also spent less time scanning the leftmost portion of the correct path even when making a correct choice. The accuracy of visual pursuit and head movements, however, was not correlated with task performance. CONCLUSIONS: The present study provides direct support for the hypothesis that active integration of visuospatial information within working memory is deficient in schizophrenia. In contrast, a general impairment of oculomotor mechanisms involved in smooth pursuit did not appear to be directly related to lower visuospatial working memory performance in schizophrenia.

Vision, spatial cognition and intellectual disability.

Vision is the most synthetic sensory channel and it provides specific information about the relative position of distant landmarks during visual exploration. In this paper we propose that visual exploration, as assessed by the recording of eye movements, offers an original method to analyze spatial cognition and to reveal alternative adaptation strategies in people with intellectual disabilities (ID). Our general assumption is that eye movement exploration may simultaneously reveal whether, why, and how, compensatory strategies point to specific difficulties related to neurological symptoms. An understanding of these strategies will also help in the development of optimal rehabilitation procedures.

Once and for all - How people change strategy to ignore irrelevant information in visual tasks

Ignoring irrelevant visual information aids efficient interaction with task environments. We studied how people, after practice, start to ignore the irrelevant aspects of stimuli. For this we focused on how information reduction transfers to rarely practised and novel stimuli. In Experiment 1, we compared competing mathematical models on how people cease to fixate on irrelevant parts of stimuli. Information reduction occurred at the same rate for frequent, infrequent, and novel stimuli. Once acquired with some stimuli, it was applied to all. In Experiment 2, simplification of task processing also occurred in a once-for-all manner when spatial regularities were ruled out so that people could not rely on learning which screen position is irrelevant. Apparently, changes in eye movements were an effect of a once-for-all strategy change rather than a cause of it. Overall, the results suggest that participants incidentally acquired knowledge about regularities in the task material and then decided to voluntarily apply it for efficient task processing. Such decisions should be incorporated into accounts of information reduction and other theories of strategy change in skill acquisition.

Orthoptic Sequelae Following Conservative Management of Pure Blowout Orbital Fractures: Anecdotal or Clinically Relevant?

The aim of this study was to prospectively assess the prevalence of orthoptic anomalies following conservative management of pure blowout orbital fractures and to evaluate their clinical relevance. Clinical and radiologic data of patients with unilateral conservatively managed pure blowout orbital fractures with a minimum follow-up of 6 months were reviewed. Eligible patients were contacted and invited to undergo an extended ophthalmologic examination as follows: distance and near visual acuities, Hertel exophthalmometry, corneal light reflex (Hirschberg test), ductions and versions in the 6 cardinal fields of gaze, eye deviation with prisms and alternate cover test in all of the 9-gaze directions with Maddox rod, degrees of incyclo/excyclotorsion with right and left eye fixation, horizontal and vertical deviation with Hess-Weiss coordimetry, degree of horizontal/vertical and incyclo/excyclotorsion deviation with Harms wall deviometry, and vertical deviation with Bielschowsky head-tilt test. Of the 69 patients contacted, 49 declined to participate given that they were asymptomatic. Twenty patients agreed to undergo the examination. One patient complained of minimal double vision limited to the extreme downgaze. Four patients had asymptomatic ocular motility disturbances limited to the extreme gaze. Seven patients had asymptomatic horizontal heterophoria. These disturbances did not interfere with daily or professional activities in any of the patients. The current study demonstrated that conservative management of pure orbital blowout fractures can result in orthoptic anomalies. These sequelae were restricted to a very limited portion of the binocular field of the vision and were not found to be clinically relevant.