Optometry and Vision Sciences - Research Publications
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ItemVisual contrast perception in visual snow syndrome reveals abnormal neural gain but not neural noise.(Oxford University Press, 2022-04-01)Visual snow syndrome is a neurological condition characterized by a persistent visual disturbance, visual snow, in conjunction with additional visual symptoms. Cortical hyperexcitability is a potential pathophysiological mechanism, which could be explained by increased gain in neural responses to visual input. Alternatively, neural noise in the visual pathway could be abnormally elevated. We assessed these two potential competing neural mechanisms in our studies of visual contrast perception. Cortical hyperexcitation also occurs in migraine, which commonly co-occurs with visual snow syndrome. Therefore, to determine whether the effect of visual snow syndrome can be distinguished from interictal migraine, we recruited four participant groups: controls, migraine alone, visual snow syndrome alone and visual snow syndrome with migraine. In the first experiment, we estimated internal noise in 20 controls, 21 migraine participants and 32 visual snow syndrome participants (16 with migraine) using a luminance increment detection task. In the second experiment, we estimated neural contrast gain in 21 controls, 22 migraine participants and 35 visual snow syndrome participants (16 with migraine) using tasks assessing sensitivity to changes in contrast from a reference. Contrast gain and sensitivity were measured for the putative parvocellular and 'on' and 'off' magnocellular pathways, respectively. We found that luminance increment thresholds and internal noise estimates were normal in both visual snow syndrome and migraine. Contrast gain measures for putative parvocellular processing and contrast sensitivity for putative off magnocellular processing were abnormally increased in visual snow syndrome, regardless of migraine status. Therefore, our results indicate that visual snow syndrome is characterized by increased neural contrast gain but not abnormal neural noise within the targeted pathways.
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ItemRelating the cortical visual contrast gain response to spectroscopy-measured excitatory and inhibitory metabolites in people who experience migraine(PUBLIC LIBRARY SCIENCE, 2022)OBJECTIVE: This study aimed to determine whether the visual response to flickering checkerboard patterns measured using electroencephalography (EEG) relate to excitatory or inhibitory metabolite levels measured using ultra-high (7Tesla/7T) magnetic resonance spectroscopy (MRS). BACKGROUND: Electrophysiological studies have shown altered visual cortical response amplitudes and contrast gain responses to high contrast flickering patterns in people with migraine. These contrast response anomalies have been argued to represent an imbalance between cortical inhibition and excitation, however the specific mechanism has not been elucidated. METHODS: MRS-measured metabolite levels were obtained from the occipital cortex of 18 participants with migraine and 18 non-headache controls. EEG contrast gain response functions were collected on separate days from a subset of 10 participants with migraine and 12 non-headache controls. Case-control outcome measures were statistically compared between groups both before and after checkboard exposure. RESULTS: No significant difference in GABA and glutamate levels were found between groups nor checkerboard timepoint. Glucose levels were significantly reduced after checkerboard exposure in both participant groups. There was no metabolic signature in visual cortex in response to high-contrast flickering checkboards that distinguished those with migraine and without. There was also no correlation between MRS and EEG measurements in response to the flickering checkerboard. CONCLUSION: Our findings suggest that the mechanisms driving contrast-flickering stimulus aversion are not simplistically reflected by gross changes in metabolic activity in the primary visual cortex.
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ItemA Study Protocol for an Open-Label Feasibility Treatment Trial of Visual Snow Syndrome With Transcranial Magnetic Stimulation(FRONTIERS MEDIA SA, 2021-09-24)Background: Visual Snow (VS) syndrome is believed to be due to aberrant central visual processing. Positron Emission Tomography (PET) brain imaging and visual evoked potential studies provide evidence for excessive neuronal activity in the medial temporal lobe, specifically the lingual gyrus, and suggest the VS syndrome is a hyperexcitability syndrome. These data provide the basis for consideration of repetitive transcranial magnetic stimulation (rTMS) as a potential treatment for the VS syndrome. Objective: To publish the study protocol for a pilot study underway at the University of Colorado School of Medicine to investigate the use of rTMS intervention to improve symptoms and visual dysfunction associated with VS. The study aims to determine the adverse events and drop-out rate, evaluate performance of outcome measures, including a novel VS symptom scale, and describe changes in outcomes associated with treatment. Methods and Design: Up to 10 participants meeting criteria for VS syndrome, age 19-65 years, will undergo an open-label intervention consisting of 10 rTMS sessions, occurring 5 days a week over a 2-week period. Participants will complete pre-treatment and post-treatment assessments that include: the Colorado Visual Snow Scale (CVSS), the National Eye Institute Visual Functional Questionnaire-25 (VFQ-25), the General Anxiety Disorder-7 scale (GAD-7), and three psychophysical visual processing tasks. Discussion: Knowledge gained from this pilot study will inform future study planning and provide valuable lessons for future investigation of rTMS for the VS syndrome. An overview of study proceedings thus far demonstrates recruitment challenges associated with the COVID-19 pandemic, and additional challenges that are unique to the VS syndrome and to treatment schedules associated with TMS. Registration: This study has been approved by the Colorado Multiple Institutional Review Board. ClinicalTrials.gov Identifier: NCT04925232.
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ItemIllusory Motion Perception Is Associated with Contrast Discrimination but Not Motion Sensitivity, Self-Reported Visual Discomfort, or Migraine Status(ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2020-07-01)PURPOSE: Altered visual processing of motion and contrast has been previously reported in people with migraine. One possible manifestation of this altered visual processing is increased self-reported susceptibility to visual illusions of contrast and motion. Here, we use the Fraser-Wilcox illusion to explore individual differences in motion illusion strength in people with and without migraine. The motion-inducing mechanisms of the Fraser-Wilcox illusion are purported to be contrast dependent. To better understand the mechanisms of the illusion, as well as visual processing anomalies in migraine, we explored whether migraine status, susceptibility to visual discomfort, contrast discrimination, or motion sensitivity are related to quantified motion illusion strength. METHODS: Thirty-six (16 with aura, 20 without aura) people with migraine and 20 headache-free controls participated. Outcome measures were motion illusion strength (the physical motion speed that counterbalanced the illusory motion), motion sensitivity, and contrast discrimination thresholds (measured for each contrast pair that formed part of the illusory motion stimulus). Typical daily visual discomfort was self-reported via questionnaire. RESULTS: Motion illusion strength was negatively correlated with contrast discrimination threshold (r = -0.271, P = 0.04) but was not associated with motion sensitivity or migraine status. People with migraine with aura reported experiencing visual discomfort more frequently than the control group (P = 0.001). Self-reported visual discomfort did not relate to quantified perceptual motion illusion strength. CONCLUSIONS: Individuals with better contrast discrimination tend to perceive faster illusory motion regardless of migraine status.
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ItemOrientation-dependency of perceptual surround suppression and orientation decoding of centre-surround stimuli are preserved with healthy ageing(Elsevier BV, 2020-11)A key visual neuronal property that is mirrored in human behaviour is centre-surround contrast suppression, which is orientation-dependent. When a target is embedded in a high-contrast surround, the centre appears reduced in contrast, the magnitude of which depends on the relative orientation between centre and surround. Previous reports demonstrate changes in perceptual surround suppression with ageing; however, whether the orientation-dependency of surround suppression is impacted by ageing has not been explored. Here, we tested 18 younger (aged 19–33) and 18 older (aged 60–77) adults. Perceptual surround suppression was stronger for parallel than orthogonal stimuli; however contrary to previous work, here we found no difference in perceptual suppression strength between age-groups. In the same participants, we measured event-related potentials (ERPs) and conducted multivariate pattern analysis to confirm that parallel and orthogonal centre-surround stimuli elicit distinguishable brain activity, predominantly over occipital areas. Despite a delay in the first prominent ERP component (P1) in response to each pattern, older adults showed similar decoding of orientation information (i.e. distinguish between parallel and orthogonal centre-surround stimuli from 70 ms post-stimulus onset) as younger adults. This suggests that sufficient information to distinguish orientation in centre-surround stimuli becomes available to the older human brain as early as in younger adults.