Complex visual search in children and adolescents: effects of age and performance on fMRI activation

Visual search and childhood vision impairment: A GAMLSS-oriented multiverse analysis approach

The aim of this report was to analyze reaction times and accuracy in children with a vision impairment performing a feature-based visual search task using a multiverse statistical approach. The search task consisted of set sizes 4, 16, and 24, consisting of distractors (circle) and a target (ellipse) that were presented randomly to school-aged individuals with or without a vision impairment. Interactions and main effects of key variables relating to reaction times and accuracy were analyzed via a novel statistical method blending GAMLSS (generalized additive models for location, scale, and shape) and distributional regression trees. Reaction times for the target-present and target-absent conditions were significantly slower in the vision impairment group with increasing set sizes (p < .001). Female participants were significantly slower than were males for set sizes 16 and 24 in the target-absent condition (p < .001), with male participants being significantly slower than females in the target-present condition (p < .001). Accuracy was only significantly worse (p = .03) for participants less than 14 years of age for the target-absent condition with set sizes 16 and 24. There was a positive association between binocular visual acuity and search time (p < .001). The application of GAMLSS with distributional regression trees to the analysis of visual search data may provide further insights into underlying factors affecting search performance in case-control studies where psychological or physical differences may influence visual search outcomes.

Developmental changes in neural lateralization for visual-spatial function: Evidence from a line-bisection task

Studies of hemispheric specialization have traditionally cast the left hemisphere as specialized for language and the right hemisphere for spatial function. Much of the supporting evidence for this separation of function comes from studies of healthy adults and those who have sustained lesions to the right or left hemisphere. However, we know little about the developmental origins of lateralization. Recent evidence suggests that the young brain represents language bilaterally, with 4-6-year-olds activating the left-hemisphere regions known to support language in adults as well as homotopic regions in the right hemisphere. This bilateral pattern changes over development, converging on left-hemispheric activation in late childhood. In the present study, we ask whether this same developmental trajectory is observed in a spatial task that is strongly right-lateralized in adults-the line bisection (or "Landmark") task. We examined fMRI activation among children ages 5-11 years as they were asked to judge which end of a bisected vertical line was longer. We found that young children showed bilateral activation, with activation in the same areas of the right hemisphere as has been shown among adults, as well as in the left hemisphere homotopic regions. By age 10, activation was right-lateralized. This strongly resembles the developmental trajectory for language, moving from bilateral to lateralized activation. We discuss potential underlying mechanisms and suggest that understanding the development of lateralization for a range of cognitive functions can play a crucial role in understanding general principles of how and why the brain comes to lateralize certain functions.

Acquired visual agnosia as an uncommon presentation of epileptic encephalopathy in a 6-year-old boy with CSWS

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Acquired visual agnosia is an underrecognized and rare manifestation of CSWS.

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Highly specific spared and affected areas of visual performance may be seen.

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Methylprednisolone was found most effective to treat cognitive symptoms.

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Recovery on EEG (SWI) and neuropsychological results showed partial synchronicity.

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SWI is likely not the only neurophysiological marker of epileptic encephalopathy.

Background

Acquired visual agnosia in the context of continuous spikes and waves during slow sleep (CSWS) is rarely described. We present a case of an almost 7-year-old boy who lost his ability to name pictures and recognize familiar faces. Initial encephalography (EEG) revealed sleep induced epileptiform activity with a spike-wave index (SWI) of 100%, predominanting in the left posterior head region.

Methods

Serial neuropsychological testing with concomitant EEG was done during the first 18 months of treatment with intravenous methylprednisolone. We administered intelligence scales, verbal tasks (memory, fluency), visual tasks (drawings, search, face recognition), and tasks requiring visual-verbal integration (picture naming, visual closure).

Analyses

Neuropsychological recovery studied with reliable cognitive change cut-offs and 95% confidence intervals.

Results

With treatment, there was an improvement of the EEG pattern (SWI reduction to 45%), followed by a relapse (SWI 82%). Neuropsychological measures in part synchronized with improvement, stability, and fluctuating values. Significant increases were seen on Verbal Comprehension Index and semantic memory. Visual Spatial Index remained unchanged (67 to 73). Naming pictures showed only limited change. Interpreting degraded pictures remained extremely difficult.

Discussion

Acquired visual agnosia may be seen in children with CSWS. Early recognition, prompt accurate treatment and tailored neuropsychological assessment remain crucial.

Development of bilateral parietal activation for complex visual-spatial function: Evidence from a visual-spatial construction task

The neural representation of visual-spatial functions has traditionally been ascribed to the right hemisphere, but little is known about these representations in children, including whether and how lateralization of function changes over the course of development. Some studies suggest bilateral activation early in life that develops toward right-lateralization in adulthood, while others find evidence of right-hemispheric dominance in both children and adults. We used a complex visual-spatial construction task to examine the nature of lateralization and its developmental time course in children ages 5-11 years. Participants were shown two puzzle pieces and were asked whether the pieces could fit together to make a square; responses required either mental translation of the pieces (Translation condition) or both mental translation and rotation of the pieces (Rotation condition). Both conditions were compared to a matched Luminance control condition that was similar in terms of visual content and difficulty but required no spatial analysis. Group and single-subject analyses revealed that the Rotation and Translation conditions elicited strongly bilateral activation in the same parietal and occipital locations as have been previously found for adults. These findings show that visual-spatial construction consistently elicits robust bilateral activation from age 5 through adulthood. This challenges the idea that spatial functions are all right-lateralized, either during early development or in adulthood. More generally, these findings provide insights into the developmental course of lateralization across different spatial skills and how this may be influenced by the computational requirements of the particular functions involved.

The Working Memory Network and Its Association with Working Memory Performance in Survivors of non-CNS Childhood Cancer

Childhood cancer and its treatment puts survivors at risk of low working memory capacity. Working memory represents a core cognitive function, which is crucial in daily life and academic tasks. The aim of this functional MRI (fMRI) study was to examine the working memory network of survivors of childhood cancer without central nervous system (CNS) involvement and its relation to cognitive performance. Thirty survivors (aged 7-16 years, ≥ 1 year after cancer treatment) and 30 healthy controls performed a visuospatial working memory task during MRI, including a low- and a high-demand condition. Working memory performance was assessed using standardized tests outside the scanner. When cognitive demands increased, survivors performed worse than controls and showed evidence for slightly atypical working memory-related activation. The survivor group exhibited hyperactivation in the right-hemispheric superior parietal lobe (SPL) in the high- compared to the low-demand working memory condition, while maintaining their performance levels. Hyperactivation in the right SPL coincided with poorer working memory performance outside the scanner in survivors. Even in survivors of childhood cancer without CNS involvement, we find neural markers pointing toward late effects in the cerebral working memory network.AbbreviationsfMRI: Functional magnetic resonance imaging; CNS: Central nervous system; MNI: Montreal Neurological Institute; SES: Socioeconomic status; SPL: Superior parietal lobe.

Research on intervention methods for children's street-crossing behaviour: Application and expansion of the theory of "behaviour spectrums"

Due to immaturity in their physical and cognitive development, children are particularly vulnerable to road traffic injuries as pedestrians. Child pedestrian injury primarily occurs in urban areas, with a significant share at crosswalks. The aim of this study is to explore whether an intervention programme based on the theory of "behaviour spectrums" can improve the street-crossing skills of primary school children. Children were recruited near a local primary school through invitation letters and were randomly divided into two groups: a control group (n = 10, no intervention) and an experimental group (n = 10, intervention). The children in the experimental group received 30-45 min of training. The child participants were asked to wear an eye tracker and performed a crossing test in a real-world street environment; in this test, they were required to successively pass through an unsignalised intersection, an unsignalised T-intersection and a signalised intersection on a designated test route. A high-definition camera was used to record the children's crossing behaviour, and the Tobii Pro Glasses 2 eye tracker was used to derive indicators of the children's visual behaviour in the areas of interest (AOIs) in the street. The evaluation was conducted on children's crossing behaviour in the control group (which received no intervention) and the experimental group (tested at two time points after the intervention: children tested immediately after the intervention and children retested one month after the intervention). The results showed that compared with the control group, the children in the experimental group no longer focused on the small area around the body (e.g., the zebra crossing area) and the area in front of the eyes (e.g., the sidewalk area), which increased their visual attention to the traffic areas on the left and right sides of the zebra crossing; thus, unsafe crossing behaviour was reduced in the experimental group. Compared with the experimental group immediately after the intervention, the intervention effect on some indicators showed a significant weakening trend in the retest of the experimental group one month later. Overall, the results show that an intervention programme based on the theory of "behaviour spectrums" can improve children's crossing skills. This study provides valuable information for the development and evaluation of intervention programmes to improve children's street-crossing skills.

Visual Perceptual Skills in Very Preterm Children: Developmental Course and Associations With Neural Activation

BACKGROUND

The objective of this study was to examine how nonverbal skills at age five years relate to visual perception and brain activation during visual perception tasks at age 12 years in very preterm subjects without visual or other neurodevelopmental impairments or major brain pathologies.

METHODS

At age five years, 36 prematurely born (birth weight ≤1500 g or gestational age less than 32 weeks) and 31 term-born control children were assessed with the nonverbal subtests of the Wechsler Preschool and Primary Scale of Intelligence-Revised and the NEPSY-Second Edition. At age 12 years the same children were re-assessed with tasks from the Motor-Free Visual Perception Test, Third Edition, during functional magnetic resonance imaging.

RESULTS

Test performance at age five years was significantly poorer in the very preterm group than the control subjects, but at age 12 years performance was similar in both groups. In the very preterm group, better nonverbal skills at age five years were significantly associated with stronger neural activation during the visual perception task at age 12 years. No associations between nonverbal skills at age five years and brain activation at age 12 years appeared in the control group.

CONCLUSIONS

The associations between better nonverbal skills and stronger neural activation during visual perception task only observed in the very preterm group may reflect delayed development of the visual perception network and/or prematurity-related neural plasticity. The developmental follow-up of very preterm children should include psychological assessment of nonverbal skills at least until age five years.

A preliminary study on prenatal polybrominated diphenyl ether serum concentrations and intrinsic functional network organization and executive functioning in childhood

BACKGROUND

The prenatal period is a period of vulnerability during which neurotoxic exposures exert persistent changes in brain development and behavior. Polybrominated diphenyl ethers (PBDEs), used as flame retardants in commercial products, are known to be developmental neurotoxicants. PBDEs were phased out of use in the United States a decade ago, but exposure remains widespread due to their release from existing products and biopersistence. Despite consistent animal and epidemiological evidence of developmental neurotoxicity, the neural substrates linking prenatal PBDE serum concentrations to impaired neurodevelopment are poorly understood.

METHODS

In the present study, we used resting state functional magnetic resonance imaging (fMRI) to examine associations between prenatal PBDE concentrations measured in maternal serum and intrinsic functional network organization (i.e., global and local efficiency; estimated using a graph-theoretical approach) in 5-year-old children (n = 34). We explored whether PBDE serum concentrations were associated with executive functioning (EF) assessed using a parent-report questionnaire (BRIEF-P) (n = 106) and whether changes in intrinsic functional network organization linked the association between prenatal PBDE serum concentrations and EF problems.

RESULTS

Children with higher prenatal PBDE serum concentrations showed: (a) increased global efficiency of brain areas involved in visual attention (e.g., inferior occipital gyrus) (β's = .01, FDR-corrected p's ≤ .05); (b) more reported EF problems (β's = .001, FDR-corrected p's ≤ .05). Higher global efficiency of brain areas involved in visual attention was associated with more EF problems (β's = .01, FDR-corrected p's < .05).

CONCLUSIONS

Intrinsic functional network organization of visual attention brain areas linked prenatal PBDE concentrations to EF problems in childhood. Visual attention may contribute to the development of higher-order cognitive functions, such as EF, which could be explored in future studies.

Impairments of Visuospatial Attention in Children with Unilateral Spastic Cerebral Palsy

Aim

This observational study aimed at assessing the prevalence of visuospatial attention deficits in children with unilateral spastic cerebral palsy (USCP), taking into consideration the affected hemibody and the localization of the brain lesion.

Method

Seventy-five children with USCP were assessed with four visuospatial attention tests: star cancellation, Ogden figure copy, line bisection, and proprioceptive pointing.

Results

A majority (64%) of children with USCP presented a deficit in at least one test compared to the reference values. The alterations observed in children with left or right USCP were related to egocentric or allocentric neglect, respectively. Children with cortico/subcortical lesion presented more often visuospatial attention deficits than children with periventricular lesion. Visuospatial attention deficits were not associated with brain lesion locations.

Interpretation

Visuospatial attention deficits are prevalent in children with USCP and should be taken into account during their rehabilitation process. The present results shed new light on the interpretation of motor impairments in children with USCP as they may be influenced by the frequent presence of visuospatial deficits.

Common and distinct neural mechanisms of the fundamental dimensions of social cognition

In the present study, we used a valence classification task to investigate the common and distinct neural basis of the two fundamental dimensions of social cognition (agency and communion) using functional magnetic resonance imaging (fMRI). The results showed that several brain areas associated with mentalizing, along with the inferior parietal gyrus in the mirror system, showed overlap in response to both agentic and communal words. These findings suggest that both content categories are related to the neural basis of social cognition; further, several areas in the default mode network (DMN) showed similar deactivations between agency and communion, reflecting task-induced deactivation (TID). In terms of distinct activations, the findings indicated greater deactivations for communal than agentic content in the ventral anterior cingulate (vACC) and medial orbitofrontal cortex (mOFC). Communion also showed greater activation in some visual areas compared to agentic content, including occipital gyrus, lingual gyrus, and fusiform gyrus. These activations may reflect greater allocation of attentional resources to visual areas when processing communal content, or inhibition of cognitive activity irrelevant to task performance. If so, this suggests greater attention and engagement with communion-related content. The present research thus suggests common and differential activations for agency- versus communion-related content.