Visual temporal discrimination is impaired in patients with migraine without aura

BACKGROUND AND OBJECTIVE

Dysfunctional sensory processing is described in migraine. This study aimed to evaluate visual perception in patients with migraine without aura using the visual temporal discrimination (VTD) test.

METHODS

A total of 45 participants were enrolled in this prospective exploratory study. In all, 15 patients had migraine without aura and 15 healthy volunteers were analyzed in the study. The VTD threshold (VTDT) was measured using light-emitting diode lights to perceive two separate visual stimuli as clearly distinct. VTD was tested during the attack and the interictal period. The disease duration, attack side, visual analog scale for pain, accompanying symptoms, and allodynia were recorded during the attack.

RESULTS

The VTDT of each visual field in both attack (mean [SD] 102.3 [38.4] ms for the right visual field and 106.3 [52.2] ms for the left) and the interictal periods (mean [SD] 75.2 [27.9] ms for the right and 78.2 [27.9] ms for the left) were significantly higher than in the control group (mean [SD] 45.3 [9.9] ms for the right and 48.2 [11.9] ms for the left) (p < 0.001, p < 0.001, p = 0.003, p < 0.001, respectively). The ipsilateral threshold during the attack was significantly prolonged compared to the interictal period (mean [SD] 143.8 [53.8] vs. 78 [19.6] ms, p = 0.025) and the contralateral threshold during the attack (mean [SD] 143.8 [53.8] vs. 71.9 [14.1] ms, p = 0.025). The ipsilateral threshold was significantly correlated with the visual analog score (r = 0.894, p < 0.001) and frequency of the attacks (r = 0.696, p = 0.004), but not correlated with photophobia.

CONCLUSION

The VTDTs are prolonged both ictally and interictally in patients with migraine without aura attacks. Ipsilateral threshold prolongation is more pronounced during lateralized migraine attacks. The results suggest dysfunctional visual perception is not limited to the migraine attack period, and a defective sensory processing/modulation in the visual pathways may involve the superior colliculus.

Characterizing the temporal discrimination threshold in musician's dystonia

The temporal discrimination threshold (TDT) has been established as a biomarker of impaired temporal processing and endophenotype in various forms of focal dystonia patients, such as cervical dystonia, writer's cramp or blepharospasm. The role of TDT in musician's dystonia (MD) in contrast is less clear with preceding studies reporting inconclusive results. We therefore compared TDT between MD patients, healthy musicians and non-musician controls using a previously described visual, tactile, and visual-tactile paradigm. Additionally, we compared TDT of the dystonic and non-dystonic hand and fingers in MD patients and further characterized the biomarker regarding its potential influencing factors, i.e. musical activity, disease variables, and personality profiles. Repeated measures ANOVA and additional Bayesian analyses revealed lower TDT in healthy musicians compared to non-musicians. However, TDTs in MD patients did not differ from both healthy musicians and non-musicians, although pairwise Bayesian t-tests indicated weak evidence for group differences in both comparisons. Analyses of dystonic and non-dystonic hands and fingers revealed no differences. While in healthy musicians, age of first instrumental practice negatively correlated with visual-tactile TDTs, TDTs in MD patients did not correlate with measures of musical activity, disease variables or personality profiles. In conclusion, TDTs in MD patients cannot reliably be distinguished from healthy musicians and non-musicians and are neither influenced by dystonic manifestation, musical activity, disease variables nor personality profiles. Unlike other isolated focal dystonias, TDT seems not to be a reliable biomarker in MD.

Inhibitory and Facilitatory Cueing Effects: Competition between Exogenous and Endogenous Mechanisms

Inhibition of return is characterized by delayed responses to previously attended locations when the cue-target onset asynchrony (CTOA) is long enough. However, when cues are predictive of a target’s location, faster reaction times to cued as compared to uncued targets are normally observed. In this series of experiments investigating saccadic reaction times, we manipulated the cue predictability to 25% (counterpredictive), 50% (nonpredictive), and 75% (predictive) to investigate the interaction between predictive endogenous facilitatory (FCEs) and inhibitory cueing effects (ICEs). Overall, larger ICEs were seen in the counterpredictive condition than in the nonpredictive condition, and no ICE was found in the predictive condition. Based on the hypothesized additivity of FCEs and ICEs, we reasoned that the null ICEs observed in the predictive condition are the result of two opposing mechanisms balancing each other out, and the large ICEs observed with counterpredictive cueing can be attributed to the combination of endogenous facilitation at uncued locations with inhibition at cued locations. Our findings suggest that the endogenous activity contributed by cue predictability can reduce the overall inhibition observed when the mechanisms occur at the same location, or enhance behavioral inhibition when the mechanisms occur at opposite locations.

Emotional faces guide the eyes in the absence of awareness

The ability to act quickly to a threat is a key skill for survival. Under awareness, threat-related emotional information, such as an angry or fearful face, has not only perceptual advantages but also guides rapid actions such as eye movements. Emotional information that is suppressed from awareness still confers perceptual and attentional benefits. However, it is unknown whether suppressed emotional information can directly guide actions, or whether emotional information has to enter awareness to do so. We suppressed emotional faces from awareness using continuous flash suppression and tracked eye gaze position. Under successful suppression, as indicated by objective and subjective measures, gaze moved towards fearful faces, but away from angry faces. Our findings reveal that: (1) threat-related emotional stimuli can guide eye movements in the absence of visual awareness; (2) threat-related emotional face information guides distinct oculomotor actions depending on the type of threat conveyed by the emotional expression.

Measurement & Analysis of the Temporal Discrimination Threshold Applied to Cervical Dystonia

The temporal discrimination threshold (TDT) is the shortest time interval at which an observer can discriminate two sequential stimuli as being asynchronous (typically 30-50 ms). It has been shown to be abnormal (prolonged) in neurological disorders, including cervical dystonia, a phenotype of adult onset idiopathic isolated focal dystonia. The TDT is a quantitative measure of the ability to perceive rapid changes in the environment and is considered indicative of the behavior of the visual neurons in the superior colliculus, a key node in covert attentional orienting. This article sets out methods for measuring the TDT (including two hardware options and two modes of stimuli presentation). We also explore two approaches of data analysis and TDT calculation. The application of the assessment of temporal discrimination to the understanding of the pathogenesis of cervical dystonia and adult onset idiopathic isolated focal dystonia is also discussed.

Informative Cues Facilitate Saccadic Localization in Blindsight Monkeys

Patients with damage to the primary visual cortex (V1) demonstrate residual visual performance during laboratory tasks despite denying having a conscious percept. The mechanisms behind such performance, often called blindsight, are not fully understood, but the use of surgically-induced unilateral V1 lesions in macaque monkeys provides a useful animal model for exploring such mechanisms. For example, V1-lesioned monkeys localize stimuli in a forced-choice condition while at the same time failing to report awareness of identical stimuli in a yes-no detection condition, similar to human patients. Moreover, residual cognitive processes, including saliency-guided eye movements, bottom-up attention with peripheral non-informative cues, and spatial short-term memory, have all been demonstrated in these animals. Here we examined whether post-lesion residual visuomotor processing can be modulated by top-down task knowledge. We tested two V1-lesioned monkeys with a visually guided saccade task in which we provided an informative foveal pre-cue about upcoming target location. Our monkeys fixated while we presented a leftward or rightward arrow (serving as a pre-cue) superimposed on the fixation point (FP). After various cue-target onset asynchronies (CTOAs), a saccadic target (of variable contrast across trials) was presented either in the affected (contra-lesional) or seeing (ipsi-lesional) hemifield. Critically, target location was in the same hemifield that the arrow pre-cue pointed towards in 80% of the trials (valid-cue trials), making the cue highly useful for task performance. In both monkeys, correct saccade reaction times were shorter during valid than invalid trials. Moreover, in one monkey, the ratio of correct saccades towards the affected hemifield was higher during valid than invalid trials. We replicated both reaction time and correct ratio effects in the same monkey using a symbolic color cue. These results suggest that V1-lesion monkeys can use informative cues to localize stimuli in the contra-lesional hemifield, consistent with reports of a human blindsight subject being able to direct attention in cueing paradigms. Because the superior colliculus (SC) may contribute to residual visual capabilities after V1 lesions, and because this structure is important for controlling attentional resources, we hypothesize that our results reflect, among others, SC involvement in integrating top-down task knowledge for guiding orienting behavior.

Neuronal correlates of attention and its disengagement in the superior colliculus of rat

Orienting attention to a new target requires prior disengagement of attention from the current focus. Previous studies indicate that the superior colliculus (SC) plays an important role in attention. However, recordings of responses of SC neurons during attentional disengagement have not yet been reported. Here, we analyzed rat SC neuronal activity during performance of an attention-shift task with and without disengagement. In this task, conditioned stimuli (CSs; right and/or left light-flash or sound) were sequentially presented. To obtain an intracranial self-stimulation reward, rats were required to lick a spout when an infrequent conditioned stimulus appeared (reward trials). In the disengagement reward trials, configural stimuli consisting of an infrequent stimulus and frequent stimulus in the former trials were presented; in the non-disengagement reward trials, only an infrequent stimulus was presented. Of the 186 SC neurons responding to the CSs, 41 showed stronger responses to the CSs in the disengagement reward trials than in the non-disengagement reward trials (disengagement-related neurons). Furthermore, lick latencies in the disengagement reward trials were negatively correlated with response magnitudes to the CSs in half of the disengagement-related neurons. These disengagement-related neurons were located mainly in the deep layers of the SC. Another 70 SC neurons responded to the CSs in both disengagement and non-disengagement reward trials, suggesting that these neurons were involved in attention engagement. Our results suggest complementary mechanisms of attentional shift based on two subpopulations of neurons in the SC.

Trial-type probability and task-switching effects on behavioral response characteristics in a mixed saccade task

Eye movement circuitry involved in saccade production offers a model for studying cognitive control: visually guided prosaccades are stimulus-directed responses, while goal-driven antisaccades rely upon more complex control processes to inhibit the prepotent tendency to look toward a cue, transform its spatial location, and generate a volitional saccade in the opposite direction. By manipulating the relative probability of these saccade types, we measured participants' behavioral responses to different levels of implicit trial-type probability and task-switching demands in conditions with relatively long inter-trial fixation and trial-type cue lengths. Results indicated that when prosaccades were less probable in a run, more prosaccade errors were generated; however, for antisaccades, trial-type probability had no effect on the percent of correct responses. For reaction times, specifically in runs with a larger probability of antisaccade trials, latencies increased for both anti- and pro-saccades. Furthermore, task switching resulted in a lower percentage of correct responses on switched trials, but a prior antisaccade trial led to slower reaction times for both trial types (i.e., a task switch cost for prosaccades and switch benefit for antisaccades). These findings indicate that cognitive control demands and residual inhibition from antisaccades alter performance relative to trial-type probability and task switching within a run, with the prosaccade task showing greater susceptibility to the influence of a large probability of cognitively complex antisaccades.

Attention modulates saccadic inhibition magnitude

Visual transient events during ongoing eye movement tasks inhibit saccades within a precise temporal window, spanning from around 60-120 ms after the event, having maximum effect at around 90 ms. It is not yet clear to what extent this saccadic inhibition phenomenon can be modulated by attention. We studied the saccadic inhibition induced by a bright flash above or below fixation, during the preparation of a saccade to a lateralized target, under two attentional manipulations. Experiment 1 demonstrated that exogenous precueing of a distractor's location reduced saccadic inhibition, consistent with inhibition of return. Experiment 2 manipulated the relative likelihood that a distractor would be presented above or below fixation. Saccadic inhibition magnitude was relatively reduced for distractors at the more likely location, implying that observers can endogenously suppress interference from specific locations within an oculomotor map. We discuss the implications of these results for models of saccade target selection in the superior colliculus.

The role of a midbrain network in competitive stimulus selection

A midbrain network interacts with the well-known frontoparietal forebrain network to select stimuli for gaze and spatial attention. The midbrain network, containing the superior colliculus (SC; optic tectum, OT, in non-mammalian vertebrates) and the isthmic nuclei, helps evaluate the relative priorities of competing stimuli and encodes them in a topographic map of space. Behavioral experiments in monkeys demonstrate an essential contribution of the SC to stimulus selection when the relative priorities of competing stimuli are similar. Neurophysiological results from the owl OT demonstrate a neural correlate of this essential contribution of the SC/OT. The multi-layered, spatiotopic organization of the midbrain network lends itself to the analysis and modeling of the mechanisms underlying stimulus selection for gaze and spatial attention.