Exploring sensory sensitivity, cortical excitability, and habituation in episodic migraine, as a function of age and disease severity, using the pattern-reversal task

BACKGROUND

Migraine is a cyclic, neurosensory disorder characterized by recurrent headaches and altered sensory processing. The latter is manifested in hypersensitivity to visual stimuli, measured with questionnaires and sensory thresholds, as well as in abnormal cortical excitability and a lack of habituation, assessed with visual evoked potentials elicited by pattern-reversal stimulation. Here, the goal was to determine whether factors such as age and/or disease severity may exert a modulatory influence on sensory sensitivity, cortical excitability, and habituation.

METHODS

Two similar experiments were carried out, the first comparing 24 young, episodic migraine patients and 28 healthy age- and gender-matched controls and the second 36 middle-aged, episodic migraine patients and 30 healthy age- and gender-matched controls. A neurologist confirmed the diagnoses. Migraine phases were obtained using eDiaries. Sensory sensitivity was assessed with the Sensory Perception Quotient and group comparisons were carried out. We obtained pattern-reversal visual evoked potentials and calculated the N1-P1 Peak-to-Peak amplitude. Two linear mixed-effects models were fitted to these data. The first model had Block (first block, last block) and Group (patients, controls) as fixed factors, whereas the second model had Trial (all trials) and Group as fixed factors. Participant was included as a random factor in both. N1-P1 first block amplitude was used to assess cortical excitability and habituation was defined as a decrease of N1-P1 amplitude across Blocks/Trials. Both experiments were performed interictally.

RESULTS

The final samples consisted of 18 patients with episodic migraine and 27 headache-free controls (first experiment) and 19 patients and 29 controls (second experiment). In both experiments, patients reported increased visual hypersensitivity on the Sensory Perception Quotient as compared to controls. Regarding N1-P1 peak-to-peak data, there was no main effect of Group, indicating no differences in cortical excitability between groups. Finally, significant main effects of both Block and Trial were found indicating habituation in both groups, regardless of age and headache frequency.

CONCLUSIONS

The results of this study yielded evidence for significant hypersensitivity in patients but no significant differences in either habituation or cortical excitability, as compared to headache-free controls. Although the alterations in patients may be less pronounced than originally anticipated they demonstrate the need for the definition and standardization of optimal methodological parameters.

Seeing invisible light: 2-photon microperimetry to measure visual function

Purpose

The accuracy of conventional visual function tests, which emit visible light, decreases in patients with corneal scars, cataracts, and vitreous hemorrhages. In contrast, infrared (IR) light exhibits greater tissue penetrance than visible light and is less susceptible to optical opacities. We therefore compared conventional visual function tests against infrared 2-phton microperimetry (2PM-IR) in a subject with a brunescent nuclear sclerotic and posterior subcapsular cataract before and after cataract surgery.

Methods

Testing using infrared light microperimetry from a novel device (2PM-IR), visible light microperimetry from a novel device (2PM-Vis), conventional microperimetry, and the cone contrast threshold (CCT) test were performed before and after cataract surgery.

Results

Retinal sensitivity assessed using 2PM-IR, 2PM-Vis, and cMP improved by 3.4 dB, 17.4 dB, and 18 dB, respectively. Cone contrast threshold testing improved for the S-cone, M-cone, and l-cone by 111, 14, and 30.

Conclusions and Importance

2PM-IR, unlike conventional visual function tests, showed minimal variability in retinal sensitivity before and after surgery. Thus, IR visual stimulation may provide a more accurate means of measuring neurosensory retinal function by circumventing optical media opacities, aiding in the diagnosis of early macular disease.

Temporal context modulates sensory attenuation magnitude

In studies with self-produced sensory events, sensitivity for these events has been found to be reduced. This phenomenon is called sensory attenuation, and it has been assumed that the crucial factor is the self-production of the event. However, this factor may be confounded with the temporal predictability of the event, as well as with attentional focus on the event. In this study, we wondered about the influence of temporal stimulus predictably on sensory attenuation. We asked observers to discriminate the orientation of Gabor patches that were presented randomly at various times around a button press. Despite the unpredictability of stimulus occurrence, attenuation for these stimuli was tuned to the time of the button press. However, temporal expectations determined attenuation magnitude. Sensory attenuation was stronger when stimuli were expected to occur more often before the button press. When stimuli were expected to occur more often after the button press, no sensory attenuation was found. Our results show first that sensory attenuation occurs mandatorily even if stimulus occurrence cannot be predicted temporally. Second, temporal attention, guided by temporal stimulus probabilities, modulates sensory attenuation magnitude.

The peripheral sensitivity profile at the saccade target reshapes during saccade preparation

Goal-directed eye movements (saccades) bring peripheral objects of interest into high-acuity foveal vision. In preparation for the incoming foveal image, the perception of the saccade target may sharpen gradually before the eye movement is executed. Indeed, previous studies suggest that pre-saccadic attention shifts enhance sensitivity to high spatial frequencies (SFs) more than sensitivity to lower SFs. This pattern, however, was observed within a narrow frequency range and may reflect local changes in the shape of a broader underlying sensitivity profile. Depending on the development of the profile's shape, SFs above the previously examined range may profit less from saccade preparation. To assess the impact of saccade preparation on the shape of a broader sensitivity profile, we prompted observers to discriminate the orientation of a sinusoidal grating (the probe) presented briefly at the target of an impending saccade, at 10 dva (degree of visual angle) eccentricity. The probe's SF ranged from 1 to 5.5 cycles per dva (cpd) and was unpredictable on a given trial. We fitted observers' response accuracies across SFs with a log-parabolic, that is, inverted U-shaped function. Long before saccade onset, the profile peaked at .6 cpd and dropped off towards lower and higher SFs with broad bandwidth. During saccade preparation, the peak of the profile increased and shifted towards higher SFs while the bandwidth of the profile decreased. As a consequence of this reshaping process, pre-saccadic enhancement increased with SF up to 2.5 cpd, corroborating previous findings. Sensitivities to higher SFs, however, profited less from saccade preparation. We conclude that the extent of pre-saccadic enhancement to a particular SF is governed by its position on a broader sensitivity profile which reshapes substantially during saccade preparation. The shift of the profile's peak towards higher SFs increases resolution at the saccade target even when the features of relevant visual information are unpredictable.

Quantification of photophobia in visual snow syndrome: A case-control study

OBJECTIVE

To quantify photophobia in visual snow syndrome (VSS), a debilitating migraine-associated visual disturbance manifesting with continuous "TV snow-like" flickering dots in the entire visual field and additional visual symptoms, such as photophobia.

METHODS

Photophobia was compared between 19 patients with VSS and 19 controls matched for age, sex, migraine and aura using the Leiden Visual Sensitivity Scale (L-VISS).

RESULTS

Patients with VSS had an increased L-VISS-score compared to matched controls [(22.2 ± 5.9 vs. 4.4 ± 4.8; ANOVA, factors VSS and comorbid migraine: Main effect for VSS (F = 100.70; p < 0.001), but not for migraine (F < 0.01; p = 1.00) or the interaction (F = 1.93; p = 0.16)]. An L-VISS-score of 14 identified VSS with a sensitivity and specificity of 95% (Receiver Operating Characteristic analysis, 0.986 ± 0.014, p ≤ 0.001).

CONCLUSION

Patients with VSS suffer continuously from photophobia at a level similar to chronic migraineurs during attacks. Although migraine and VSS share dysfunctional visual processing, patients with VSS might be more severely affected.

Circadian regulation of phosphodiesterase 6 genes in zebrafish differs between cones and rods: Implications for photopic and scotopic vision

A correlation is known to exist between visual sensitivity and oscillations in red opsinand rhodopsin gene expression in zebrafish, both regulated by the clock gene. This indicates that an endogenous circadian clock regulates behavioural visual sensitivity, apart from the regulation exerted by the pineal organ. However, the specific mechanisms for cones (photopic vision) and rods (scotopic vision) are poorly understood. In this work, we performed gene expression, cosinor and immunohistochemical analyses to investigate other key genes involved in light perception, encoding the different subunits of phosphodiesterase pde6 and transducin Gα_T, in constant lighting conditions and compared to normal light-dark conditions. We found that cones display prominent circadian oscillations in mRNA levels for the inhibitory subunit gene pde6ha that could contribute to the regulation of photopic sensitivity by preventing overstimulation in photopic conditions. In rods, the mRNA levels of the inhibitory subunit gene pde6ga oscillate under normal conditions and dampen down in constant light but continue oscillating in constant darkness. There is an increase in total relative expression for pde6gb in constant conditions. These observations, together with previous data, suggest a complex regulation of the scotopic sensitivity involving endogenous and non-endogenous components, possibly present also in other teleost species. The Gα_T genes do not display mRNA oscillations and therefore may not be essential for the circadian regulation of photosensitivity. In summary, our results support different regulation for the zebrafish photopic and scotopic sensitivities and suggest circadian regulation of pde6ha as a key factor regulating photopic sensitivity, while the regulatory mechanisms in rods appear to be more complex.

Dim-light vision in jumping spiders (Araneae, Salticidae): identification of prey and rivals

Jumping spiders (family Salticidae) are known for their intricate vision-based behavior during encounters with prey and conspecific individuals. This is achieved using eyes specialized for discerning fine detail, but there has been minimal research on the capacity that salticids might have for visual performance under low ambient light levels. Here, we investigated the capacity of two salticid species, Cyrba algerina from Portugal and Cyrba ocellata from Kenya, to perform two specific visual tasks under low ambient light levels. We used lures made from spiders and midges in prey-identification experiments and mirror images (virtual conspecifics) in rival-identification experiments. These experiments were implemented under a range of ambient light levels (234, 1.35, 0.54, 0.24 cd m^-2). In most instances, C algerina and C ocellata were proficient at performing both of these visual tasks when ambient light was 234 and 1.35 cd m^-2, and a minority performed these tasks at 0.54 cd m^-2, but none succeeded when the light level was 0.24 cd m^-2 Cyrba algerina and C. ocellata showed vision-based discrimination under low ambient light levels previously associated with nocturnal species.

Rod and frame test and posture under optokinetic stimulation used to explore two complementary aspects of the visual influence in postural control after stroke

BACKGROUND

Balance rehabilitation should consider individual comportments according to visual input (VI). Indeed, visual dependence (VD), defined as the predominance given to the VI whatever the circumstances, frequent after stroke it could disturb balance. Because the term VD is a bit restrictive and cannot be deduced from clinical tests, the term visual sensitivity (VS) is preferred here.

HYPOTHESIS

VI could have different influence depending on the task for a given individual.

METHODS

We retrospectively compared 2 VS tests routinely used: the rod and frame test (RFT) and optokinetic stimulation (OKS). In RFT, VS was defined by a misperception of the visual verticality induced by a tilted frame (VS RFT) and in OKS by tilted sitting posture induced by rotational OKS (VS OKS). We studied the relations between VS RFT and VS OKS.

RESULTS

We analysed data for 84 patients, mean age 55±10years, 45±30days after stroke. Scores for both tests were correlated with autonomy measured by the functional independence measure (r=-0.3, p=0.01 and r=-0.2, p=0.02). VS OKS score was also correlated with balance measured by the postural assessment scale for stroke (r=-0.3, p=0.03). VS RFT score was not correlated with VS OKS score (p=0.4, r=0.04).

DISCUSSION - CONCLUSION

A patient may display VS for one test without sensitivity for the other because these tests investigate different neural organisation - perception for RFT or action for OKS. Their relation to balance disorders should be further investigated to build individualized rehabilitation programs.

Very preterm infants can detect small variations in light levels in incubators

AIM

This prospective observational study was designed to improve our understanding of the responses of very preterm infants to light level variations in incubators and to evaluate what determined those reactions.

METHODS

The physiological responses of 27 very preterm infants were analysed following variations in the light level environments of their incubators over 10 hours. Heart and respiratory rates, systemic oxygen saturation and regional cerebral oxygen saturations were recorded using near-infrared spectroscopy, and the variation of each parameter was analysed.

RESULTS

We analysed 332 light level changes. Heart rate increased by 3.8 beats per minute (range -2.6 to 12.6), respiratory rate by six cycles per minute (-1.5 to 26) and regional cerebral oxygen saturation by 1.1% (-0.5% to 3.9%) (p < 0.05 each) when delta lux was over 50. Only respiratory rate decreased significantly, by -8.4 cycles per minute (-28 to -0.4), when delta lux was 50 or lower (p < 0.05). The initial level of illumination altered the very preterm infants' responses, with higher reactivity for higher ambient light levels.

CONCLUSION

Very preterm infants reacted to moderate variations in illumination in their incubator, within recommended ranges of light levels, suggesting that they may detect even small light level variations.

Patients with schizophrenia show deficits on spatial frequency doubling

There are pieces of evidence indicating that visual deficits in patients with schizophrenia can be attributed to a deficiency in the magnocellular portion of the early visual system. The main objective of this study was to investigate the neurological dysfunction of the magnocellular pathway in patients with schizophrenia using the frequency doubling technology perimetry (FDT). The FDT has been developed based on particular neural magnocellular characteristics and can examine the magnocellular dysfunction hypothesis in schizophrenia. Twenty patients with schizophrenia (12 males and 8 females) and 20 normal subjects (10 males and 10 females) participated in this study. The spatial frequency doubling task was presented via the Humphrey perimetry instrument in order to examine the magnocellular pathway of the participants. Patients with schizophrenia showed less visual field sensitivity than normal controls and their standardized age cohort in both eyes (p<0.001). The results indicated impaired visual field sensitivity deficits in patients with schizophrenia that can be attributed to a deficit in the magnocellular neural pathways. This Magnocellular pathway defect may provide a physiological base to explain some of the deficits caused by schizophrenia such as cognitive deficits.