Temporal and spatial frequencies interact in the contrast transfer function of the pattern electroretinogram

Replication of Reduced Pattern Electroretinogram Amplitudes in Depression With Improved Recording Parameters

Background: The retina has gained increasing attention in non-ophthalmological research in recent years. The pattern electroretinogram (PERG), a method to evaluate retinal ganglion cell function, has been used to identify objective correlates of the essentially subjective state of depression. A reduction in the PERG contrast gain was demonstrated in patients with depression compared to healthy controls with normalization after remission. PERG responses are not only modulated by stimulus contrast, but also by check size and stimulation frequency. Therefore, the rationale was to evaluate potentially more feasible procedures for PERG recordings in daily diagnostics in psychiatry.

Methods: Twenty-four participants (12 patients with major depression (MDD) and 12 age- and sex-matched healthy controls) were examined in this pilot study. We investigated PERG amplitudes for two steady-state pattern reversal frequencies (12.5/18.75 rps) and four sizes of a checkerboard stimulus (0.8°, 1.6°, 3.2°, and 16°) to optimize the PERG recordings in MDD patients.

Results: Smaller PERG amplitudes in MDD patients were observed for all parameters, whereby the extent of the reduction appeared to be stimulus-specific. The most pronounced decline in the PERG of MDD patients was observed at the higher stimulation frequency and the finest pattern, whilst responses for the largest check size were less affected. Following the PERG ratio protocol for early glaucoma, where similar stimulus dependent modulations have been reported, we calculated PERG ratios (0.8°/16°) for all participants. At the higher frequency (18.75 rps), significantly reduced ratios were observed in MDD patients.

Conclusion: The “normalization” of the PERG responses—via building a ratio—appears to be a very promising approach with regard to the development of an objective biomarker of the depressive state, facilitating inter-individual assessments of PERG recordings in patients with psychiatric disorders.

The electrophysiological response to polarization-modulated patterned visual stimuli

Recent reports indicate that the subjective ability of humans to discriminate between polarization E-vector orientations approaches that of many invertebrates. Here, we show that polarization-modulated patterned stimuli generate an objectively recordable electrophysiological response in humans with normal vision. We investigated visual evoked potential (VEP) and electroretinographic (ERG) responses to checkerboard patterns defined solely by their polarization E-vector orientation alternating between ± 45°. Correcting for multiple comparisons, paired-samples t-tests were conducted to assess the significance of post-stimulus deflections from baseline measures of noise. Using standard check pattern sizes for clinical electrophysiology, and a pattern-reversal protocol, participants showed a VEP response to polarization-modulated patterns (PolVEP) with a prominent and consistent positive component near 150 ms (p < 0.01), followed by more variable negative components near 200 ms and 300 ms. The effect was unrecordable with visible wavelengths >550 nm. Further, pseudo-depolarization negated the responses, while control studies provided confirmatory evidence that the PolVEP response was not the product of luminance artefacts. Polarization-modulated patterns did not elicit a recordable ERG response. The possible origins of the PolVEP signals, and the absence of recordable ERG signals, are discussed. We conclude that evoked cortical responses to polarization-modulated patterns provide an objective measure of foveal function, suitable for both humans and non-human primates with equivalent macular anatomy.

Comparison of the uniform-field electroretinogram and the pattern electroretinogram to checkerboard and bar gratings

PURPOSE

To compare the electroretinal response associated with the uniform-field electroretinogram (UF-ERG) to that of the pattern electroretinogram (PERG) to checkerboard and bar-grating stimuli.

METHODS

UF-ERG and PERG to bars and checkerboard were recorded for 18 visually normal subjects (36 eyes) of mean age 45 years (range 20-75). UF-ERG was recorded to the increment and decrement of a 200-ms duration luminance modulation. Luminance onset and offset UF-ERG responses were averaged to produce a simulation of the PERG response. The mean amplitude and implicit time for the P₅₀ and N₉₅ potentials of actual and simulated PERG responses were recorded for each eye in the cohort.

RESULTS

The simulated PERG waveform resulting from arithmetic averaging of the UF-ERG to luminance increment and decrement was characterized by prominent positive and negative components resembling those of the P₅₀ and N₉₅ PERG potentials. Implicit timing of the P₅₀ potential was lengthened in the actual PERG to bars and checks relative to that of the simulation (P < 0.05, P < 0.001). Amplitude of the N95 potential was greater in the PERG to bars than in the PERG to checks (P < 0.05) or the simulated PERG (P < 0.001). The amplitude and implicit timing of all waveform components were significantly correlated between the actual and simulated PERG.

CONCLUSIONS

The UF-ERG to light onset and offset can be reliably recorded in human subjects. The extent to which the simulated PERG recapitulates the actual PERG response is better with checkerboard rather than bar-grating stimuli.

Retinal dysfunction of contrast processing in major depression also apparent in cortical activity

Depressive disorder is often associated with the subjective experience of altered visual perception. Recent research has produced growing evidence for involvement of the visual system in the pathophysiology of depressive disorder. Using the pattern electroretinogram (PERG), we found reduced retinal contrast response in patients with major depression. Based on this observation, the question arises whether this change has a cortical correlate. To evaluate this, we analyzed the visual evoked potential (VEP) of the occipital cortex in 40 patients with depressive disorder and 28 healthy controls. As visual stimuli, checkerboard stimuli of 0.51° check size, 12.5 reversals per second and a contrast of 3-80% was used. In addition to the PERG, we recorded the VEP with an Oz versus FPz derivation. The amplitude versus contrast transfer function was compared across the two groups and correlated with the severity of depression, as measured by the Hamilton Depression Rating Scale and the Beck Depression Inventory. Patients with major depression displayed significantly reduced VEP amplitudes at all contrast levels compared to control subjects (p = 0.029). The VEP amplitude correlated with psychometric measures for severity of depression. The degree of depression reduced the contrast transfer function in the VEP to a lesser extent than in the PERG: While the PERG is reduced to ≈50%, the VEP is reduced to 75%. Our results suggest that depression affects the cortical response in major depression, but less so than the retinal responses. Modified contrast adaptation in the lateral geniculate nucleus or cortex possibly moderates the increased losses in the retina.

Relationship between transient and steady-state pattern electroretinograms: theoretical and experimental assessment

PURPOSE

We determined if the overlap of transient (tr) pattern electroretinograms (PERG(tr)) can explain the generation of the steady-state (SS) pattern electroretinogram (PERG(SS)), and investigated the relationship between the two types of responses.

METHODS

Slightly jittered pattern reversals were used to generate quasi SS (QSS) PERG(SS) responses from eight normal subjects, recorded using lower eyelid skin electrodes, at rates between 6.9 and 26.5 reversals per second (rps). Jittered quasi PERG(SS) were deconvolved using the frequency domain continuous loop averaging deconvolution method. Additionally, conventional PERG(tr) at 2.2 rps and PERG(SS) at each of the QSS stimulation rates were obtained from all subjects. Two synthetic PERG(SS) responses were constructed at each stimulation rate, one using the PERG(tr) obtained at that rate, and the other using the conventional 2.2 rps PERG(tr). Synthetic responses then were compared to the recorded PERG(SS) using amplitude, latency, and spectral measurements.

RESULTS

Findings indicate that the PERG(SS) obtained at SS rates can be predicted using the superposition of deconvolved tr PERGs at each particular rate. Although conventional PERG(tr) can explain PERG(SS) obtained at rates below 15.4 rps (≥ 97% correlation), for higher reversal rates only deconvolved responses obtained at that rate can produce the recorded SS responses (96% vs. 65% correlation at 26.5 rps).

CONCLUSIONS

The study shows that PERG(SS) results from the overlapping of tr PERG(tr) waveforms generated at that reversal rate. The first two peaks (N(SS) and P(SS)) of the PERG(SS) reflect N35 and P50 waves of the tr PERG(tr). The N95 amplitude is reduced at conventional (16 rps) SS rates, but contributes to the overall PERG(SS) amplitude.

Effect of antidepressive therapy on retinal contrast processing in depressive disorder

BACKGROUND

Recently, we reported a reduced retinal contrast gain in unmedicated and medicated patients with major depression.

AIMS

To analyse whether the contrast gain normalises after successful antidepressive therapy by recording the pattern electroretinogram (PERG) in healthy controls and patients with depression before and after antidepressive therapy.

METHOD

Fourteen patients diagnosed with major depression were repeatedly scanned and the results compared with that from 40 matched controls.

RESULTS

The retinal contrast gain was lower at baseline in patients with depression, was normalised with remission and correlated with the severity of depression. Patients who did not achieve remission retained significantly lower contrast gain at follow-up.

CONCLUSIONS

The study provides evidence for a state-dependent modulation of retinal contrast gain in patients with major depression. Reduced contrast gain normalised after therapy. A PERG-based contrast gain could serve as a state marker of depression.