Achromatopsia-Visual Cortex Stability and Plasticity in the Absence of Functional Cones

Purpose

Achromatopsia is a rare inherited disorder rendering retinal cone photoreceptors nonfunctional. As a consequence, the sizable foveal representation in the visual cortex is congenitally deprived of visual input, which prompts a fundamental question: is the cortical representation of the central visual field in patients with achromatopsia remapped to take up processing of paracentral inputs? Such remapping might interfere with gene therapeutic treatments aimed at restoring cone function.

Methods

We conducted a multicenter study to explore the nature and plasticity of vision in the absence of functional cones in a cohort of 17 individuals affected by autosomal recessive achromatopsia and confirmed biallelic disease-causing CNGA3 or CNGB3 mutations. Specifically, we tested the hypothesis of foveal remapping in human achromatopsia. For this purpose, we applied two independent functional magnetic resonance imaging (fMRI)-based mapping approaches, i.e. conventional phase-encoded eccentricity and population receptive field mapping, to separate data sets.

Results

Both fMRI approaches produced the same result in the group comparison of achromatopsia versus healthy controls: sizable remapping of the representation of the central visual field in the primary visual cortex was not apparent.

Conclusions

Remapping of the cortical representation of the central visual field is not a general feature in achromatopsia. It is concluded that plasticity of the human primary visual cortex is less pronounced than previously assumed. A pretherapeutic imaging workup is proposed to optimize interventions.

Structural changes to primary visual cortex in the congenital absence of cone input in achromatopsia

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Anatomy of primary visual cortex (V1) assessed with surface-based morphmetry in those with congenital achromatopsia (ACHM).

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Reduction in cortical surface area in foveal, parafoveal and paracentral representations of V1 in those with ACHM.

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In ACHM a localized thickening in the area of V1 that represents the region of retina occupied solely by cones.

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V1 changes in ACHM may limit its ability to take on normal properties if retinal function were to be restored.

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Early intervention, before the development plastic period is over, may offer better restoration of vision in ACHM.

Autosomal recessive Achromatopsia (ACHM) is a rare inherited disorder associated with dysfunctional cone photoreceptors resulting in a congenital absence of cone input to visual cortex. This might lead to distinct changes in cortical architecture with a negative impact on the success of gene augmentation therapies. To investigate the status of the visual cortex in these patients, we performed a multi-centre study focusing on the cortical structure of regions that normally receive predominantly cone input. Using high-resolution T1-weighted MRI scans and surface-based morphometry, we compared cortical thickness, surface area and grey matter volume in foveal, parafoveal and paracentral representations of primary visual cortex in 15 individuals with ACHM and 42 normally sighted, healthy controls (HC). In ACHM, surface area was reduced in all tested representations, while thickening of the cortex was found highly localized to the most central representation. These results were comparable to more widespread changes in brain structure reported in congenitally blind individuals, suggesting similar developmental processes, i.e., irrespective of the underlying cause and extent of vision loss. The cortical differences we report here could limit the success of treatment of ACHM in adulthood. Interventions earlier in life when cortical structure is not different from normal would likely offer better visual outcomes for those with ACHM.

Structural Differences Across Multiple Visual Cortical Regions in the Absence of Cone Function in Congenital Achromatopsia

Most individuals with congenital achromatopsia (ACHM) carry mutations that affect the retinal phototransduction pathway of cone photoreceptors, fundamental to both high acuity vision and colour perception. As the central fovea is occupied solely by cones, achromats have an absence of retinal input to the visual cortex and a small central area of blindness. Additionally, those with complete ACHM have no colour perception, and colour processing regions of the ventral cortex also lack typical chromatic signals from the cones. This study examined the cortical morphology (grey matter volume, cortical thickness, and cortical surface area) of multiple visual cortical regions in ACHM (n = 15) compared to normally sighted controls (n = 42) to determine the cortical changes that are associated with the retinal characteristics of ACHM. Surface-based morphometry was applied to T1-weighted MRI in atlas-defined early, ventral and dorsal visual regions of interest. Reduced grey matter volume in V1, V2, V3, and V4 was found in ACHM compared to controls, driven by a reduction in cortical surface area as there was no significant reduction in cortical thickness. Cortical surface area (but not thickness) was reduced in a wide range of areas (V1, V2, V3, TO1, V4, and LO1). Reduction in early visual areas with large foveal representations (V1, V2, and V3) suggests that the lack of foveal input to the visual cortex was a major driving factor in morphological changes in ACHM. However, the significant reduction in ventral area V4 coupled with the lack of difference in dorsal areas V3a and V3b suggest that deprivation of chromatic signals to visual cortex in ACHM may also contribute to changes in cortical morphology. This research shows that the congenital lack of cone input to the visual cortex can lead to widespread structural changes across multiple visual areas.

Preserved Contextual Cueing in Realistic Scenes in Patients with Age-Related Macular Degeneration

Foveal vision loss has been shown to reduce efficient visual search guidance due to contextual cueing by incidentally learned contexts. However, previous studies used artificial (T- among L-shape) search paradigms that prevent the memorization of a target in a semantically meaningful scene. Here, we investigated contextual cueing in real-life scenes that allow explicit memory of target locations in semantically rich scenes. In contrast to the contextual cueing deficits in artificial scenes, contextual cueing in patients with age-related macular degeneration (AMD) did not differ from age-matched normal-sighted controls. We discuss this in the context of visuospatial working-memory demands for which both eye movement control in the presence of central vision loss and memory-guided search may compete. Memory-guided search in semantically rich scenes may depend less on visuospatial working memory than search in abstract displays, potentially explaining intact contextual cueing in the former but not the latter. In a practical sense, our findings may indicate that patients with AMD are less deficient than expected after previous lab experiments. This shows the usefulness of realistic stimuli in experimental clinical research.

Population receptive field and connectivity properties of the early visual cortex in human albinism

In albinism, the pathological decussation of the temporal retinal afferents at the optic chiasm leads to superimposed representations of opposing hemifields in the visual cortex. Here, we assessed the equivalence of the two representations and the cortico-cortical connectivity of the early visual areas. Applying fMRI-based population receptive field (pRF)-mapping (both hemifield and bilateral mapping) and connective field (CF)-modeling, we investigated the early visual cortex in 6 albinotic participants and 4 controls. In albinism, superimposed retinotopic representations of the contra- and ipsilateral visual hemifield were observed on the hemisphere contralateral to the stimulated eye. This was confirmed by the observation of bilateral pRFs during bilateral mapping. Hemifield mapping revealed similar pRF-sizes for both hemifield representations throughout V1 to V3. The typical increase of V1-sampling extent for V3 compared to V2 was not found for the albinotic participants. The similarity of the pRF-sizes for opposing visual hemifield representations highlights the equivalence of the two maps in the early visual cortex. The altered V1-sampling extent in V3 might indicate the adaptation of cortico-cortical connections to visual pathway abnormalities in albinism. These findings thus suggest that conservative developmental mechanisms are complemented by alterations of the extrastriate cortico-cortical connectivity.

Scotopic multifocal visual evoked potentials

OBJECTIVE

To investigate the scope of scotopic multifocal visual evoked potentials (mfVEP_S) for the assessment of scotopic visual fields.

METHODS

Pattern-reversal mfVEP for photopic (mfVEP_P) and scotopic conditions (mfVEP_S; 0.003 cd/m²) were recorded from 36 visual field locations of a circular checkerboard pattern (25° radius) in 9 participants with normal vision. MfVEP_P were recorded with a conventional central fixation cross, mfVEP_S were recorded (i) with (mfVEP_S+) and (ii) without (mfVEP_S-) an additional fixation aid. Latency shifts were determined using cross-correlations, mfVEP magnitudes were analysed in an eccentricity dependent manner using signal-to-noise ratios (SNRs).

RESULTS

In comparison to mfVEP_P, mfVEP_S- and mfVEP_S+ were delayed by 101 ms and 97 ms, respectively, and had smaller signal-to-noise-ratios. Both mfVEP_S were reduced down to noise level in the center and also severely reduced for the most peripheral stimulus eccentricity used. The visual-field-coverage for the paracentral eccentricities of mfVEP_S+ and mfVEP_S- was 76% and 65% [4°-9°], respectively, and 79% and 66% [9°-16°].

CONCLUSIONS

MfVEP_S were delayed compared to mfVEP_P and demonstrated the expected central response drop-out typical for scotopic vision.

SIGNIFICANCE

MfVEP_S may hold promise of an objective, spatially resolved visual field test which motivates testing it in patients with diseases affecting scotopic vision.

Natural visual behavior in individuals with peripheral visual-field loss

Retinitis pigmentosa (RP) is an inherited disease that causes progressive peripheral visual-field loss. In this study, we investigated how such loss affects visual exploration of natural images. Individuals with varying degrees of visual-field loss and healthy control participants freely observed images of different sizes while eye movements were recorded. We examined whether visual behavior differed when the scene content was shown in various extents of the visual field, and investigated the spatial bias, saccade amplitudes, and number and duration of fixations. We found that the healthy control group showed a central spatial bias during image viewing. The RP group showed similar biases on the group level, but with reproducible individual exploration patterns. For saccade amplitudes, the healthy control group and the RP group showed similar behavior throughout all image sizes. The RP group with severe loss of peripheral vision thus tended to target saccades toward blind areas of their visual field. The number of fixations did not change between the two groups, although fixation durations decreased in the RP group. In conclusion, the RP group scanned the images surprisingly similarly to the healthy control group; however, they showed individual idiosyncratic explorative strategies when the observed scene exceeded their visible field. Thus, although RP leads to a severe loss of the visual field, there is no general adaptive mechanism to change visual exploration. Instead, individuals rely on individual strategies, leading to high heterogeneity in the RP group.

Prediction of higher visual function in macular degeneration with multifocal electroretinogram and multifocal visual evoked potential

OBJECTIVE

Visual search can be guided by past experience of regularities in our visual environment. This search guidance by contextual memory cues is impaired by foveal vision loss. Here we compared retinal and cortical visually evoked responses in their predictive value for contextual cueing impairment and visual acuity.

METHODS

Multifocal electroretinograms to flash stimulation (mfERGs; 103 locations; 55.8° diameter) and visual evoked potentials to pattern-reversal stimulation (mfVEPs; 60 locations; 48.6° diameter) were recorded monocularly in participants with age-related macular degeneration (n = 14 and 16, respectively). Response magnitudes were calculated as the respective signal-to-noise ratios for each eccentricity. Visual acuities (logMAR, range: 0.0-1.2) and contextual cueing effects on visual search (reaction time gain, range: -0.14-0.15) were correlated with the signal-to-noise ratios. A step-wise regression analysis was applied separately to the mfERG- and mfVEP-dataset to determine the eccentricity range and the processing stage that is critical for these visual functions.

RESULTS

Central mfERGs (1.0-3.2°) were the sole predictor of contextual cueing of visual search (p = 0.006), but they were not significant predictors of visual acuity. In contrast, central mfVEPs (1.3-3.2°) were the sole predictor of visual acuity (p < 0.001), but they were not significant predictors of contextual cueing.

CONCLUSIONS

Contextual cueing is more dependent on parafoveal mfERG magnitude while visual acuity is more dependent on parafoveal mfVEP magnitude. The relation of contextual cueing to parafoveal mfERG magnitudes indicates the predictive value of retinal bipolar cell activity for this advanced level of visual function.

Differential effects of optic media opacities on mfERGs and mfVEPs

OBJECTIVE

To assess different effects of image degradation that could result from optic media opacities on multifocal retinal (mfERG) and cortical responses (mfVEP).

METHODS

Monocular flash-mfERGs and pattern-reversal mfVEPs were recorded. MfERG-P1 amplitudes and implicit times and mfVEP root-mean-square values (RMS) and delays were compared for different filter conditions (none, 8% luminance, 50% luminance, 50% luminance plus blur) in a total of ten participants with normal vision.

RESULTS

Reducing stimulus luminance down to 50% and 8% reduced mfERG amplitudes to 86% and 42%, respectively, with no significant effect on mfVEP amplitude. Implicit times were increased for mfERGs by 0.9 ms and 6.0 ms, respectively, and for mfVEPs by 1.0 ms and 6.3 ms, respectively. For '50% luminance plus blur' mfERG amplitudes were significantly reduced centrally and enhanced peripherally and delayed by 1.3 ms. MfVEPs were reduced close to noise level independent of eccentricity.

CONCLUSIONS

Degradation of the retinal image is a potential source of discrepancies between mfERGs and mfVEPs. Image blur suppresses the mfVEP at all locations and changes mfERG topography, resulting in a selective loss of central responses.

SIGNIFICANCE

Considering optic media opacities is of importance for the correct interpretation of mfERG and mfVEP recordings, particularly in elderly patients.

Isolation, characterization and cDNA cloning of nicotianamine synthase from barley. A key enzyme for iron homeostasis in plants

Basic cellular processes such as electron transport in photosynthesis and respiration require the precise control of iron homeostasis. To mobilize iron, plants have evolved at least two different strategies. The nonproteinogenous amino acid nicotianamine which is synthesized from three molecules of S-adenosyl-L-methionine, is an essential component of both pathways. This compound is missing in the tomato mutant chloronerva, which exhibits severe defects in the regulation of iron metabolism. We report the purification and partial characterization of the nicotianamine synthase from barley roots as well as the cloning of two corresponding gene sequences. The function of the gene sequence has been verified by overexpression in Escherichia coli. Further confirmation comes from reduction of the nicotianamine content and the exhibition of a chloronerva-like phenotype due to the expression of heterologous antisense constructs in transgenic tobacco plants. The native enzyme with an apparent Mr of approximately 105 000 probably represents a trimer of S-adenosyl-L-methionine-binding subunits. A comparison with the recently cloned chloronerva gene of tomato reveals striking sequence homology, providing support for the suggestion that the destruction of the nicotianamine synthase encoding gene is the molecular basis of the tomato mutation.

A root-specific iron-regulated gene of tomato encodes a lysyl-tRNA-synthetase-like protein

The tomato mutant chloronerva exhibits a defect in iron-uptake regulation. Despite high apoplastic and symplastic iron concentrations, the mutant shows characteristic symptoms of iron deficiency. Using a subtractive-hybridisation approach, we have screened for cDNA clones specific for genes with altered expression in wild-type versus mutant root tissue. Based on this clone collection, we have isolated and characterised a 2075-bp full-length cDNA encoding a lysyl-tRNA-synthetase-like protein. The corresponding gene is localised as a single copy on chromosome 10. Its expression is strongly induced by changes in the iron status of the plant. This iron-dependent regulation is superimposed upon a strict root specificity of gene expression. Possible functions of the gene product other than in protein biosynthesis will be discussed.

Iron and copper nutrition-dependent changes in protein expression in a tomato wild type and the nicotianamine-free mutant chloronerva

The nicotianamine-deficient mutant chloronerva resembles phenotypically an Fe-deficient plant despite the high accumulation of Fe in the leaves, whereas if suffers from Cu deficiency in the shoot. Two-dimensional electrophoretic separation of proteins from root tips and leaves of wild-type Lycopersicon esculentum Mill. cv Bonner Beste and the mutant grown with and without Fe showed a number of consistent differences. In root tips of the Fe-deficient wild type and the Fe-sufficient as well as the Fe-deficient mutant, the expression of glyceraldehyde-3-phosphate dehydrogenase, formate dehydrogenase, and ascorbate peroxidase was increased. In leaves of the Fe-sufficient and -deficient mutant, Cu-containing chloroplastic and cytosolic superoxide dismutase (Cu-Zn) and plastocyanin (Cu) were nearly absent. This low plastocyanin content could be restored by supplying Cu via the xylem, but the superoxide dismutase levels could not be increased by this treatment. The differences in the protein patterns between wild type and mutant indicate that the apparent Fe deficiency of mutant plants led to an increase in enzymes involved in anaerobic metabolism as well as enzymes involved in stress defense. The biosynthesis of plastocyanin was diminished in mutant leaves, but it was differentially induced by increased Cu content.