Spatial vision in older adults: perceptual changes and neural bases

Visual dysfunction is a better predictor than retinal thickness for dementia in Parkinson's disease

BACKGROUND

Dementia is a common and devastating symptom of Parkinson's disease (PD). Visual function and retinal structure are both emerging as potentially predictive for dementia in Parkinson's but lack longitudinal evidence.

METHODS

We prospectively examined higher order vision (skew tolerance and biological motion) and retinal thickness (spectral domain optical coherence tomography) in 100 people with PD and 29 controls, with longitudinal cognitive assessments at baseline, 18 months and 36 months. We examined whether visual and retinal baseline measures predicted longitudinal cognitive scores using linear mixed effects models and whether they predicted onset of dementia, death and frailty using time-to-outcome methods.

RESULTS

Patients with PD with poorer baseline visual performance scored lower on a composite cognitive score (β=0.178, SE=0.05, p=0.0005) and showed greater decreases in cognition over time (β=0.024, SE=0.001, p=0.013). Poorer visual performance also predicted greater probability of dementia (χ² (1)=5.2, p=0.022) and poor outcomes (χ² (1) =10.0, p=0.002). Baseline retinal thickness of the ganglion cell-inner plexiform layer did not predict cognitive scores or change in cognition with time in PD (β=-0.013, SE=0.080, p=0.87; β=0.024, SE=0.001, p=0.12).

CONCLUSIONS

In our deeply phenotyped longitudinal cohort, visual dysfunction predicted dementia and poor outcomes in PD. Conversely, retinal thickness had less power to predict dementia. This supports mechanistic models for Parkinson's dementia progression with onset in cortical structures and shows potential for visual tests to enable stratification for clinical trials.

Influences of local and global context on local orientation perception

Visual context modulates perception of local orientation attributes. These spatially very localised effects are considered to correspond to specific excitatory-inhibitory connectivity patterns of early visual areas as V1, creating perceptual tilt repulsion and attraction effects. Here, orientation misperception of small Gabor stimuli was used as a probe of this computational structure by sampling a large spatio-orientation space to reveal expected asymmetries due to the underlying neuronal processing. Surprisingly, the results showed a regular iso-orientation pattern of nearby location effects whose reference point was globally modulated by the spatial structure, without any complex interactions between local positions and orientation. This pattern of results was confirmed by the two perceptual parameters of bias and discrimination ability. Furthermore, the response times to stimulus configuration displayed variations that further provided evidence of how multiple early visual stages affect perception of simple stimuli.

Neuroplasticity in older adults revealed by temporary occlusion of one eye

Occluding one eye for several hours alters visual experience. Specifically, occluding one eye shifts the balance of ocular dominance to favour the recently deprived eye, which can be measured using binocular rivalry. This ocular dominance shift demonstrates homeostatic neuroplasticity within the visual system and has been explored in detail in younger adults. Here we measure whether the strength and general features of neuroplasticity revealed by monocular patching are maintained in older adults. Thirty younger (18-35 years) and 30 older adults (60-81 years) participated. Binocular rivalry features were measured before and after 2 h of occlusion. Post-patching, perceptual dominance of the non-patched eye decreased (p < .001) in both age groups. The effect of occlusion on all features of binocular rivalry did not significantly differ between groups. The older visual system maintains the ability to rapidly adjust to changes in perceptual experience induced by eye occlusion. This preservation of neuroplasticity suggests that visual training methods designed to improve visual performance based on eye occlusion should maintain effectiveness into older age.

Decline of Orientation and Direction Sensitivity in the Aging Population

While the aging population is growing, our knowledge regarding age-related deterioration of visual perception remains limited. In the present study, we investigated the effects of aging on orientation and direction sensitivity in a healthy population using a weighted up–down adaptive method to improve the efficiency and reliability of the task. A total of 57 healthy participants aged 22–72 years were included and divided into old and young groups. Raw experimental data were processed using a psychometric method to determine the differences between the two groups. In the orientation task, the threshold of the discrimination angle and bias (i.e., the difference between the perceived midpoint from the logistic function and the reference point) was increased, while the lapsing rate (i.e., 1—the maximum logistic function) did not significantly change in the old group compared with the young group. In the motion direction task, the threshold, bias, and lapsing rate were significantly increased in the old group compared with the young group. These results suggest that the decreased ability of old participants in discrimination of stimulus orientation and motion direction could be related to the impaired function of visual cortex.

Differential Circuit Mechanisms of Young and Aged Visual Cortex in the Mammalian Brain

The main goal of this review is to summarize and discuss (1) age-dependent structural reorganization of mammalian visual cortical circuits underlying complex visual behavior functions in primary visual cortex (V1) and multiple extrastriate visual areas, and (2) current evidence supporting the notion of compensatory mechanisms in aged visual circuits as well as the use of rehabilitative therapy for the recovery of neural plasticity in normal and diseased aging visual circuit mechanisms in different species. It is well known that aging significantly modulates both the structural and physiological properties of visual cortical neurons in V1 and other visual cortical areas in various species. Compensatory aged neural mechanisms correlate with the complexity of visual functions; however, they do not always result in major circuit alterations resulting in age-dependent decline in performance of a visual task or neurodegenerative disorders. Computational load and neural processing gradually increase with age, and the complexity of compensatory mechanisms correlates with the intricacy of higher form visual perceptions that are more evident in higher-order visual areas. It is particularly interesting to note that the visual perceptual processing of certain visual behavior functions does not change with age. This review aims to comprehensively discuss the effect of normal aging on neuroanatomical alterations that underlie critical visual functions and more importantly to highlight differences between compensatory mechanisms in aged neural circuits and neural processes related to visual disorders. This type of approach will further enhance our understanding of inter-areal and cortico-cortical connectivity of visual circuits in normal aging and identify major circuit alterations that occur in different visual deficits, thus facilitating the design and evaluation of potential rehabilitation therapies as well as the assessment of the extent of their rejuvenation.

Orientation-dependency of perceptual surround suppression and orientation decoding of centre-surround stimuli are preserved with healthy ageing

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.

Differential aging effects in motion perception tasks for central and peripheral vision

The perception of motion is considered critical for performing everyday tasks, such as locomotion and driving, and relies on different levels of visual processing. However, it is unclear whether healthy aging differentially affects motion processing at specific levels of processing, or whether performance at central and peripheral spatial eccentricities is altered to the same extent. The aim of this study was to explore the effects of aging on hierarchically different components of motion processing: the minimum displacement of dots to perceive motion (Dmin), the minimum contrast and speed to determine the direction of motion, spatial surround suppression of motion, global motion coherence (translational and radial), and biological motion. We measured motion perception in both central vision and at 15° eccentricity, comparing performance in 20 older (60-79 years) and 20 younger (19-34 years) adults. Older adults had significantly elevated thresholds, relative to younger adults, for motion contrast, speed, Dmin, and biological motion. The differences between younger and older participants were of similar magnitude in central and peripheral vision, except for surround suppression of motion, which was weaker in central vision for the older group, but stronger in the periphery. Our findings demonstrate that the effects of aging are not uniform across all motion tasks. Whereas the performance of some tasks in the periphery can be predicted from the results in central vision, the effects of age on surround suppression of motion shows markedly different characteristics between central and peripheral vision.

Visual tests predict dementia risk in Parkinson disease

OBJECTIVE

To assess the role of visual measures and retinal volume to predict the risk of Parkinson disease (PD) dementia.

METHODS

In this cohort study, we collected visual, cognitive, and motor data in people with PD. Participants underwent ophthalmic examination, retinal imaging using optical coherence tomography, and visual assessment including acuity and contrast sensitivity and high-level visuoperception measures of skew tolerance and biological motion. We assessed the risk of PD dementia using a recently described algorithm that combines age at onset, sex, depression, motor scores, and baseline cognition.

RESULTS

One hundred forty-six people were included in the study (112 with PD and 34 age-matched controls). The mean disease duration was 4.1 (±2·5) years. None of these participants had dementia. Higher risk of dementia was associated with poorer performance in visual measures (acuity: ρ = 0.29, p = 0.0024; contrast sensitivity: ρ = -0.37, p < 0.0001; skew tolerance: ρ = -0.25, p = 0.0073; and biological motion: ρ = -0.26, p = 0.0054). In addition, higher risk of PD dementia was associated with thinner retinal structure in layers containing dopaminergic cells, measured as ganglion cell layer (GCL) and inner plexiform layer (IPL) thinning (ρ = -0.29, p = 0.0021; ρ = -0.33, p = 0.00044). These relationships were not seen for the retinal nerve fiber layer that does not contain dopaminergic cells and were not seen in unaffected controls.

CONCLUSION

Visual measures and retinal structure in dopaminergic layers were related to risk of PD dementia. Our findings suggest that visual measures and retinal GCL and IPL volumes may be useful to predict the risk of dementia in PD.

Priming of grasping muscles when viewing a safety handle is diminished with age

Merely viewing objects within reachable space can activate motor cortical networks and potentiate movement. This holds potential value for smooth interaction with objects in our surroundings, and could offer an advantage for quickly generating targeted hand movements (e.g. grasping a support rail to maintain stability). The present study investigated if viewing a wall-mounted safety handle resulted in automatic activation of motor cortical networks, and if this effect changes with age. Twenty-five young adults (18-30 years) and seventeen older adults (65+ years) were included in this study. Single-pulse, transcranial magnetic stimulation was applied over the motor cortical hand representation of young and older adults shortly after they viewed a safety handle within reaching distance. Between trials, vision was occluded and the environment was unpredictably altered to reveal either a safety handle, or no handle (i.e. covered). Modulation of intrinsic hand muscle activity was evident in young adults when viewing a handle, and this was selective in terms of both the muscles activated and the time at which it emerged. By contrast, older adults failed to show any changes when viewing the safety handle. Specifically, the presence of a handle increased corticospinal activity in hand muscles of young adults when TMS was applied 120 ms after opening the goggles (p = .014), but not in the older adults (p > .954). The fact that the visual priming observed in younger adults was absent in older adults suggests that aging may diminish the ability to quickly put our visual world into automatic motor terms.

An Electrophysiological Comparison of Contrast Response Functions in Younger and Older Adults, and Those With Glaucoma

Purpose

Aging and glaucoma both result in contrast processing deficits. However, it is unclear the extent to which these functional deficits arise from retinal or post-retinal neuronal changes. This study aims to disentangle the effects of healthy human aging and glaucoma on retinal and post-retinal contrast processing using visual electrophysiology.

Methods

Steady-state pattern electroretinograms (PERG) and pattern visual evoked potentials (PVEP) were simultaneously recorded across a range of contrasts (0%, 4%, 9%, 18%, 39%, 73%, 97%; 0.8° diameter checks, 31° diameter checkerboard) in 13 glaucoma patients (67 ± 6 years), 15 older (63 ± 8 years) and 14 younger adults (27 ± 3 years). PERG and PVEP contrast response functions were fit with a linear and saturating hyperbolic model, respectively. PERG and PVEP magnitude, timing (phase), and model fit parameters (slope, semi-saturation constant) were compared between groups.

Results

PERG responses were reduced and delayed in older adults relative to younger adults, and further reduced and delayed in glaucoma patients across all contrasts. PVEP signals were also reduced and delayed in glaucoma patients, relative to age-similar (older) controls. However, despite having reduced PERG magnitudes, older adults did not demonstrate reduced PVEP magnitudes.

Conclusions

Older adults with healthy vision demonstrate reduced magnitude and delayed timing in the PERG that is not reflected in the PVEP. In contrast, glaucoma produces functional deficits in both PERG and PVEP contrast response functions. Our results suggest that glaucomatous effects on contrast processing are not a simple extension of those that arise as part of the aging process.