Visual Cognitive Function Research Articles

Visual cognition in non-amnestic Alzheimer's disease: Relations to tau, amyloid, and cortical atrophy.

Heterogeneity within the Alzheimer's disease (AD) syndromic spectrum is typically classified in a domain-specific manner (e.g., language vs. visual cognitive function). The central aim of this study was to investigate whether impairment in visual cognitive tasks thought to be subserved by posterior cortical dysfunction in non-amnestic AD presentations is associated with tau, amyloid, or neurodegeneration in those regions using 18F-AV-1451 and 11C-PiB positron emission tomography (PET) and magnetic resonance imaging (MRI). Sixteen amyloid-positive patients who met criteria for either Posterior Cortical Atrophy (PCA; n = 10) or logopenic variant Primary Progressive Aphasia (lvPPA; n = 6) were studied. All participants underwent a structured clinical assessment, neuropsychological battery, structural MRI, amyloid PET, and tau PET. The neuropsychological battery included two visual cognitive tests: VOSP Number Location and Benton Facial Recognition. Surface-based whole-cortical general linear models were used to first explore the similarities and differences between these biomarkers in the two patient groups, and then to assess their regional associations with visual cognitive test performance. The results show that these two variants of AD have both dissociable and overlapping areas of tau and atrophy, but amyloid is distributed with a stereotyped localization in both variants. Performance on both visual cognitive tests were associated with tau and atrophy in the right lateral and medial occipital association cortex, superior parietal cortex, and posterior ventral occipitotemporal cortex. No cortical associations were observed with amyloid PET. We further demonstrate that cortical atrophy has a partially mediating effect on the association between tau pathology and visual cognitive task performance. Our findings show that non-amnestic variants of AD have partially dissociable spatial patterns of tau and atrophy that localize as expected based on symptoms, but similar patterns of amyloid. Further, we demonstrate that impairments of visual cognitive dysfunction are strongly associated with tau in visual cortical regions and mediated in part by atrophy.

Postmenopausal hormone treatment alters neural pathways but does not improve verbal cognitive function.

Cognitive outcomes in trials of postmenopausal hormone treatment have been inconsistent. Differing outcomes may be attributed to hormone formulation, treatment duration and timing, and differential cognitive domain effects. We previously demonstrated treatment benefits on visual cognitive function. In the present study, we describe the effects of hormone treatment on verbal outcomes in the same women, seeking to understand the effects of prior versus current hormone treatment on verbal function. This is a cross-sectional evaluation of 57 women (38 hormone users [25 prior long-term users and 13 current users] and 19 never-users). Hormone users took identical formulations of estrogen or estrogen + progestin (0.625 mg/d conjugated equine estrogens with or without medroxyprogesterone acetate) for at least 10 years, beginning within 2 years of menopause. Women were evaluated with tests of verbal function and functional magnetic resonance imaging (fMRI) of a verbal discrimination task. All women scored similarly on assessments of verbal function (Hopkins Verbal Learning Test and a verbal discrimination task performed during the fMRI scanning session); however, women ever treated with hormones had more left inferior frontal (T = 3.72; P < 0.001) and right prefrontal cortex (T = 3.53; P < 0.001) activation during the verbal task. Hormone-treated women performed slightly worse on the verbal discrimination task (mean accuracy 81.72 ± 11.57 ever-treated, 85.30 ± 5.87 never-treated, P = 0.14), took longer to respond (mean reaction time 1.10 ± 0.17 s ever-treated, 1.02 ± 0.11 never-treated, P = 0.03), and remembered fewer previously viewed words (mean accuracy 62.21 ± 8.73 ever-treated, 65.45 ± 7.49 never-treated, P = 0.18). Increased posterior cingulate activity was associated with longer response times (R = 0.323, P = 0.015) and worse delayed verbal recall (R = -0.328, P = 0.048), suggesting that increased activation was associated with less efficient cognitive processing. We did not detect between group differences in activation in the left prefrontal cortex, superior frontal cortex, thalamus, or occipital/parietal junction. Although current and past hormone treatment was associated with differences in neural pathways used during verbal discrimination, verbal function was not higher than never-users.

Diffusely Abnormal White Matter, T2 Burden of Disease, and Brain Volume in Relapsing-Remitting Multiple Sclerosis.

Multiple sclerosis (MS) diffusely abnormal white matter (DAWM) is a mildly hyperintense magnetic resonance imaging abnormality distinct from typical lesions. Our goal was to investigate the prevalence and natural history of DAWM in a large cohort (n = 348) of relapsing-remitting MS (RRMS) patients. The presence of DAWM and relationship to changes in T2 burden of disease (BOD), brain volume (brain fractional ratio, BFR), and disability (Expanded Disability Status Scale, EDSS) were investigated at baseline and year 7-8 (long-term follow-up, LTF). DAWM was present in 25.3% (88 of 348) of patients at baseline. At LTF, DAWM was unchanged in 69.3% (61 of 88), decreased in 28.4% (25 of 88), and increased in 2.3% (2 of 88) of patients. Baseline BOD and change in BOD did not significantly differ between patients with and without DAWM. DAWM was associated with greater reduction in BFR at LTF (P = .038). DAWM and DAWM change did not predict EDSS or EDSS progression. DAWM is present in a quarter of RRMS patients, and rarely increases or develops de novo. DAWM predicts brain atrophy but does not predict physical disability. Because of its posterior periventricular location, further investigation is warranted to evaluate its relationship to other measures of disability, including visual spatial processing and cognitive function.

The functional state of magnocellular and parvocellular visual pathways and cognitive functions in first-episode of schizophrenia

During vocalization, efference copy/corollary discharge mechanisms suppress the auditory cortical response to self-generated sounds as reflected in the N1 component of the auditory event-related potential (ERP). N1 suppression during talking is reduced in patients with schizophrenia. We hypothesized that these deficits would recover with auditory training that targets the speech processing system.Forty-nine individuals early in the course of a schizophrenia-spectrum illness (ESZ) were randomly assigned to 40 h of Targeted Auditory Training (TAT; n = 23) or Computer Games (CG; n = 26). The N1 ERP component was elicited during production (Talk) and playback (Listen) of vocalization. Effects of Treatment on Global Cognition, N1 suppression (Talk-Listen), N1 during Talking and Listening were assessed. Simple effects of the passage of time were also assessed in the HC after 28 weeks.There was a Treatment × Time interaction revealing that N1 suppression was improved with TAT, but not with CG. TAT, but not CG, also improved Global Cognition. However, TAT and CG groups differed in their pre-treatment N1 suppression, and greater N1-suppression abnormalities were strongly associated with greater improvement in N1 suppression.In this sample of ESZ individuals, targeted auditory training appeared to improve the function of the efference copy/corollary discharge mechanism which tended to deteriorate with computer games. It remains to be determined if baseline N1 suppression abnormalities are necessary for TAT treatment to have a positive effect on efference copy/corollary discharge function or if improvements observed in this study represent a regression to the mean N1 suppression in ESZ.ClinicalTrials.gov NCT00694889. Registered 1 August 2007.

Structural and functional changes of the visual cortex in early Huntington's disease.

Huntington's disease (HD) is an autosomal‐dominant inherited neurodegenerative disorder characterized by motor disturbances, psychiatric disturbances, and cognitive impairment. Visual cognitive deficits and atrophy of the posterior cerebral cortex are additionally present in early disease stages. This study aimed to assess the extent of structural and functional brain alterations of the visual cortex in HD gene carriers using different neuroimaging modalities. Structural and functional magnetic resonance imaging data were acquired from 18 healthy controls, 21 premanifest, and 20 manifest HD gene carriers. Voxel‐based morphometry (VBM) analysis and cortical thickness measurements were performed to assess structural changes in the visual cortex. Brain function was measured by assessing neuronal connectivity changes in response to visual stimulation and at rest in visual resting‐state networks. Multiple linear regression analyses were performed to examine the relationship between visual cognitive function and structural imaging measures. Compared to controls, pronounced atrophy and decreased neuronal function at rest were present in associative visual cortices in manifest HD. The primary visual cortex did not show group differences in cortical thickness and in vascular activity after visual stimulation. Thinning of the associative visual cortex was related to worse visual perceptual function. Premanifest HD gene carriers did not show any differences in brain structure or function compared to controls. This study improves the knowledge on posterior brain changes in HD, as our findings suggest that the primary visual cortex remains preserved, both structurally and functionally, while atrophy of associative visual cortices is present in early HD and linked to clinical visual deficits.

Retinal Thickness May Be a Cognitive Biomarker

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessRetinal Thickness May Be a Cognitive BiomarkerNick ZagorskiNick ZagorskiSearch for more papers by this authorPublished Online:3 Aug 2018https://doi.org/10.1176/appi.pn.2018.8a6AbstractTwo longitudinal studies have provided some of the first evidence that people with thinner retinal nerve fibers have higher risks of future cognitive problems and dementia.While an old proverb posits that eyes are windows to the soul, eyes are more technically windows to the brain. The retina—the rear portion of the eye—is a direct extension of the optic nerve, which is a component of the central nervous system. The thickness of the retina’s outer layer of nerve fibers might indicate future risk of cognitive problems. That this region can be easily imaged with current tools suggests a possible biomarker for early detection of Alzheimer’s and other dementias.iStock/CreVis2Numerous studies over the past decades have suggested that declines in vision and memory, both common with age, may be linked. Most recently, a study published in June in JAMA Ophthalmology concluded that worsening vision and declining cognitive function appear to change over time together. Vision problems had a stronger influence on future memory problems than the other way around, though, suggesting vision loss might predict future cognitive loss. Can information within the eyes be used by researchers and clinicians to predict those most likely to experience cognitive decline? Two studies published in June in JAMA Neurology suggest the answer to this question may be yes. Both studies pointed to retinal thickness as a potential biomarker for future cognitive decline, including Alzheimer’s disease.Both studies involved the use of a tool known as optical coherence tomography (OCT), which is widely used by clinicians to diagnose eye disorders such as glaucoma or macular degeneration. OCT uses light energy to reconstruct a 3-D model of the inner eye (similar to how an ultrasound works). In one of the studies, researchers at Erasmus University in the Netherlands looked directly at retinal changes and dementia. They assessed data from the Rotterdam Study, a large population-level aging study that has been monitoring older adults in the Rotterdam suburb of Ommoord since 1990. The participants received periodic eye exams and cognitive exams, allowing for a prospective analysis.The investigators identified about 3,300 adults who had taken an OCT and were free of any eye diseases at baseline. Over about 4.5 years, 86 of these adults developed some clinical dementia, including 68 who developed Alzheimer’s disease. The investigators found that the adults who had thinner retinas at baseline—specifically the layer of nerve fibers where retina and optic nerve meet—were more likely to subsequently develop dementia. When participants were divided into four groups based on retinal thickness, for example, those in the lowest quartile were more than two and a half times as likely to develop dementia as those in the highest quartile.For the other study, researchers at University College London analyzed the retinal nerve layer thickness and changes in cognitive performance in a group of adults aged 40 to 69, irrespective of cognitive disease. As with the Dutch group, the investigators made use of data available from a large aging study known as UK Biobank. The researchers examined clinical data from over 30,000 individuals who were both given an OCT scan and took multiple cognitive tests to measure their memory, reaction time, and reasoning skills every three years.The U.K. investigators stratified the participants into five groups (quintiles) based on retinal thickness. They found that compared with participants in the highest retinal quintile at baseline, participants in the second and third quintiles were about 1.5 times as likely to perform worse on at least one cognitive test after three years. Participants in the lowest two quintiles were about twice as likely to perform worse on follow-up cognitive tests.“Our study strengthens the argument of an association between neurodegenerative processes that affect the brain and the eye and indicates that OCT measurement of the [retinal nerve fiber layer] is a potential noninvasive, relatively low-cost, and time-efficient screening test for early cognitive changes,” wrote lead author Paul Foster, Ph.D., and colleagues.“However, one must be careful in [OCT] interpretation so as to avoid an unnecessary psychological burden for people who may not ultimately experience cognitive decline,” the authors continued. “Further, attempting to risk-stratify people would be most appropriate if there is a viable treatment or preventative measure available. Additional research is required to define a possible role for these observations in health policies and to determine the relevance at an individual level.” ■“Association of Retinal Nerve Fiber Layer Thinning With Current and Future Cognitive Decline” can be accessed here. “Association of Retinal Neurodegeneration on Optical Coherence Tomography With Dementia” is available here. “Longitudinal Associations Between Visual Impairment and Cognitive Functioning: The Salisbury Eye Evaluation Study” is located here. ISSUES NewArchived

Functional and cognitive vision assessment in children with autism spectrum disorder

To assess functional vision in children with autism spectrum disorder (ASD) with a cognitive visual function battery in addition to standard ophthalmic examinations. Subjects were recruited from a school for children with ASD. In addition to a comprehensive ophthalmic examination, all children underwent cognitive vision assessment at a tertiary ophthalmological care center in India. A total of 30 children were included. The distribution of the number of children with mild to moderate versus severe ASD was nearly equal based on CARS autism scores. The majority of subjects had normal color vision (16/18), contrast (24), shape discrimination (26), and perception of directionality (28). Most were not able to identify optical illusions or differentiate tests of emotions. Ocular pursuits, saccades, and recognition of size differences were often abnormal. Poor visual closure was noted in (11) subjects. The duration of fixation to Heidi face target was inversely proportional to the severity of ASD. The study further established that cognitive visual impairment was present in children with ASD irrespective of their severity of ASD. All subjects had some form of cognitive visual impairment independent of ASD severity.

Remediation of perceptual organisation in schizophrenia

ABSTRACTIntroductionImpaired perceptual organisation in schizophrenia has been repeatedly described in clinical and research literatures. It has also been associated with problems in more complex aspects of visual function, including visuospatial and visual cognitive test performance. Two therapeutic interventions were developed here that target perceptual organisation: (1) Computer-based training, which emphasized stimulus-driven processing (bottom-up approach), and (2) Instrumental Enrichment therapy, which is a therapist-guided interactive learning method (top-down approach).MethodsTwenty-eight patients diagnosed with schizophrenia or schizoaffective disorder participated in a 12-week programme. For both forms of interventions, task difficulty increased progressively, based upon successful performance. The third group of patients, which served as controls, received a similar therapeutic intervention that did not include a perceptual organisation component. Before and after intervention, participants received tests of perceptual organisation, as well as a battery of neuropsychological tests.ResultsResults indicate that both forms of intervention improved perceptual organisation ability relative to the control condition. In addition, the improvement was found for select neuropsychological tests, although the pattern of improvement did not favour capacities more closely associated with visual organisational or visuospatial function.ConclusionsTogether, results demonstrate the effectiveness of new remediation protocols that target mid-level visual processing, which generalized to select visual cognitive functions.

Visual Acuity and Cognition in Older Adults With and Without Hearing Loss: Evidence For Late-Life Sensory Compensation?

Relationships between cognitive and sensory functioning become stronger with advancing age, and the debate on underlying mechanisms continues. Interestingly, the potential mechanism of compensation by the unaffected sensory modality has so far been investigated in younger age groups with congenital sensory impairment but not in older adults with late-life sensory loss. We compared associations between visual acuity and cognitive functioning in hearing-impaired older adults (HI), and sensory-unimpaired controls (UI). We expected stronger associations in the HI group as compared with the UI group. Our study sample was drawn from the pools of outpatients from regional university clinics and city registries and consisted of n = 266 older adults (mean age = 82.45 years, SD = 4.76 years; HI: n = 116; UI: n = 150). For the assessment of cognitive performance, multiple established tests (e.g., subtests of the revised Wechsler Adult Intelligence Scale) were used. Moreover, objective visual acuity (distance vision) was assessed. As expected, bivariate correlations between vision and cognitive abilities were stronger in the HI group compared with the UI group. In regression models controlling for age, sex, education, subjective health and number of chronic diseases, distance visual acuity was a significant predictor of general cognitive ability in the HI group only. Our findings suggest that visual acuity may play an important compensatory role for maintaining cognitive ability when hearing impairment sets in, which may reflect an adaptive process of late-life sensory compensation.

Cognitive determinants of visual search in patients with Parkinson's disease

Visual search impairments may negatively affect activities of daily living. Few studies explored the cognitive deficits that contribute to impaired visual search in Parkinson's disease (PD). The aim was to investigate the associations between visual search performance and cognitive functions in PD. Twenty patients with PD [age: 69 ± 8 yo; sex (Men/Women): 16/4] and 15 controls (age: 61 ± 11 yo; sex: 8/7) performed a visual search task where they were instructed to search for a target stimulus (road sign) among distractor stimuli (other road signs). Neuropsychological tests were also administered. Partial correlations (r or r) were analyzed to investigate associations between correct detection times (cDT) of the visual search task with cognitive variables whilst controlling for age. In patients, significant partial correlations were found between cDT and Montreal Cognitive Assessment scores (ρ = −0.65, P = 0.002), divided attention of the Useful Field Of View test (ρ = 0.60, P = 0.007), interference condition of the Stroop test ( r = −0.58, P = 0.023), Figure of Rey (ρ = −0.74, P < 0.001), errors and completion times on the Dot Cancellation test (errors: ρ=0.83, P < 0.001; completion times: r = 0.53, P = 0.018), response times on Trail Making Test-part A (ρ = 0.56, P = 0.013) and part B ( r = 0.58, P = 0.015). In controls, only one significant partial correlation was found, between cDT and completion times of dot cancellation test ( r = 0.88, P = 0.001). This study shows that visual search is affected by cognitive functions of individuals living with PD. Our findings may have implications for the assessment of cognitive functions and the development of training programs in patients with PD. Further study in PD will develop dynamic visual search task in driving conditions to better understand cognitive functions that may affect real-world activities.

Longitudinal Associations Between Visual Impairment and Cognitive Functioning

Worsening vision and declining cognitive functioning are common conditions among elderly individuals. Understanding the association between them could be beneficial in mitigating age-related cognitive changes. To evaluate the longitudinal associations between visual impairment and cognitive function over time in a population-based study of older US adults. Prospective longitudinal population-based study of older adults in the greater Salisbury area in Maryland. Overall, 2520 community-residing adults aged 65 to 84 years were assessed at baseline between September 1993 and August 1995 (round 1) and 2 (round 2), 6 (round 3), and 8 (round 4) years later. Visual acuity (VA) was measured using Early Treatment Diabetic Retinopathy Study charts, and cognitive status was assessed using the Mini-Mental State Examination (MMSE). Of 2520 individuals, the mean (SD) age was 73.5 (5.1) years, 1458 (58%) were women, and 666 (26%) were black. There were 2240 (89%), 1504 (61%), and 1250 (50%) participants in the second, third, and fourth round of study, respectively, with more than half of the loss being due to death. Both VA and MMSE score worsened over time. The mean biannual decline of VA was 0.022 logMAR (approximately 1 line during 8 years; 95% CI, 0.018-0.026), and the mean biannual worsening of MMSE score was -0.59 (95% CI, -0.64 to -0.54; both P < .001). Worse baseline VA was associated with worse baseline MMSE score (r = -0.226; 95% CI, -0.291 to -0.16; P < .001). The rate of worsening VA was associated with the rate of declining MMSE score (r = -0.139; 95% CI, -0.261 to -0.017; P = .03). Cross-lagged models indicated VA in the previous round was associated with MMSE score in the subsequent round (β = -0.995, P < .001), and MMSE score in the previous round was associated with VA in the following round (β = -0.003, P < .001). However, the standardized effect size of VA on MMSE score (β = -0.074; SE, 0.015; P < .001) is larger relative to the reverse effect (β = -0.038; SE, 0.013; P < .001), demonstrating VA is likely the driving force in these dynamic associations. In a population-based sample of older US adults, visual impairment measured at distance is associated with declining cognitive function both cross-sectionally and longitudinally over time with worsening vision having a stronger association with declining cognition than the reverse. Worsening vision in older adults may be adversely associated with future cognitive functioning. Maintaining good vision may be an important interventional strategy for mitigating age-related cognitive declines.

Poorer Visual Acuity Is Associated with Declines in Cognitive Performance Across Multiple Cognitive Domains: The Maine-Syracuse Longitudinal Study.

Prior studies have found associations between visual acuity (VA) and cognitive function. However, these studies used a limited range of cognitive measures and did not control for cardiovascular disease risk factors (CVD-RFs) and baseline function. The primary objective of this study was to analyze the associations of VA and cognitive performance using a thorough neuropsychological test battery. This study used community-dwelling sample data across the sixth (2001-2006) and seventh (2006-2010) waves of the Maine-Syracuse Longitudinal Study (n=655). Wave 6 VA as measured by the Snellen Eye Test was the primary predictor of wave 6 and wave 7 Global cognitive performance, Visual-Spatial Organization and Memory, Verbal Episodic Memory, Working Memory, Scanning and Tracking, and Executive Function. Additionally, VA was used to predict longitudinal changes in wave 7 cognitive performance (wave 6 performance adjusted). We analyzed these relationships with multiple linear and logistic regression models adjusted for age, sex, education, ethnicity, depressive symptoms, physical function deficits in addition to CVD-RFs, chronic kidney disease, homocysteine, continuous systolic blood pressure, and hypertension status. Adjusted for demographic covariates and CVD-RFs, poorer VA was associated with concurrent and approximate 5-year declines in Global cognitive function, Visual-Spatial Organization and Memory, and Verbal Episodic Memory. VA may be used in combination with other screening measures to determine risk for cognitive decline. (JINS, 2018, 24, 746-754).

Subacute onset leukodystrophy and visual-spatial disorders revealing phenylketonuria combined with homocysteinmia in adulthood: A case report.

Rationale:Phenylketonuria (PKU) is a metabolic disorder, which manifests a progressive irreversible neurological impairment during infancy and childhood. Hyperhomocysteinemia also showed that it might be involved in pathophysiology of many neuropsychiatric disorders. The late-onset clinical manifestations of these 2 diseases have not been reported elsewhere. We speculated that the late-onset PKU is caused by 2 kinds of metabolic dysfunction synergistically, especially a short period of irregular diet directly caused clinical symptoms.Patient concerns:A 21-year old Asian male patient demonstrated subacute leukodystrophy and visual-spatial disorders of late onset in adulthood.Diagnoses:Phenylketonuria combined with homocysteinmia, who presented with heterozygous mutations in gene encoding PAH p.G247R (c.739G>C) and p.Y204C (c.611A>G), along with homozygous mutation of gene encoding MTHFR c.677C>T.Interventions:The patient was treated with cobalamine (500 μg/day), vitamin B6 (30 mg/day), folate (5 mg/day) and encouraged to follow a protein-restricted diet.Outcomes:Visual disorientation and cognitive function showed improvement. Head MR showed similar resolution with the original lesion. Serum homocysteine and folate analysis were normal with decreased phenylalanine level.Lessons:This case suggests that neurological involvement of progressive nervous system dysfunction could be caused by more than one kind of inherited metabolic disturbances, and each one can induce or deteriorate the manifestations of another metabolic disorders.

Neural activation patterns and connectivity in visual attention during Number and Non-number processing: An ERP study using the Ishihara pseudoisochromatic plates.

Visual cognitive function is important to build up executive function in daily life. Perception of visual Number form (e.g., Arabic digit) and numerosity (magnitude of the Number) is of interest to cognitive neuroscientists. Neural correlates and the functional measurement of Number representations are complex occurrences when their semantic categories are assimilated with other concepts of shape and colour. Colour perception can be processed further to modulate visual cognition. The Ishihara pseudoisochromatic plates are one of the best and most common screening tools for basic red-green colour vision testing. However, there is a lack of study of visual cognitive function assessment using these pseudoisochromatic plates. We recruited 25 healthy normal trichromat volunteers and extended these studies using a 128-sensor net to record event-related EEG. Subjects were asked to respond by pressing Numbered buttons when they saw the Number and Non-number plates of the Ishihara colour vision test. Amplitudes and latencies of N100 and P300 event related potential (ERP) components were analysed from 19 electrode sites in the international 10-20 system. Abrain topographic map, cortical activation patterns and Granger causation (effective connectivity) were analysed from 128 electrode sites. No major significant differences between N100 ERP components in either stimulus indicate early selective attention processing was similar for Number and Non-number plate stimuli, but Non-number plate stimuli evoked significantly higher amplitudes, longer latencies of the P300 ERP component with a slower reaction time compared to Number plate stimuli imply the allocation of attentional load was more in Non-number plate processing. Adifferent pattern of asymmetric scalp voltage map was noticed for P300 components with a higher intensity in the left hemisphere for Number plate tasks and higher intensity in the right hemisphere for Non-number plate tasks. Asymmetric cortical activation and connectivity patterns revealed that Number recognition occurred in the occipital and left frontal areas where as the consequence was limited to the occipital area during the Non-number plate processing. Finally, the results displayed that the visual recognition of Numbers dissociates from the recognition of Non-numbers at the level of defined neural networks. Number recognition was not only a process of visual perception and attention, but it was also related to a higher level of cognitive function, that of language.

Eyetracking Metrics in Young Onset Alzheimer's Disease: A Window into Cognitive Visual Functions.

Young onset Alzheimer’s disease (YOAD) is defined as symptom onset before the age of 65 years and is particularly associated with phenotypic heterogeneity. Atypical presentations, such as the clinic-radiological visual syndrome posterior cortical atrophy (PCA), often lead to delays in accurate diagnosis. Eyetracking has been used to demonstrate basic oculomotor impairments in individuals with dementia. In the present study, we aim to explore the relationship between eyetracking metrics and standard tests of visual cognition in individuals with YOAD. Fifty-seven participants were included: 36 individuals with YOAD (n = 26 typical AD; n = 10 PCA) and 21 age-matched healthy controls. Participants completed three eyetracking experiments: fixation, pro-saccade, and smooth pursuit tasks. Summary metrics were used as outcome measures and their predictive value explored looking at correlations with visuoperceptual and visuospatial metrics. Significant correlations between eyetracking metrics and standard visual cognitive estimates are reported. A machine-learning approach using a classification method based on the smooth pursuit raw eyetracking data discriminates with approximately 95% accuracy patients and controls in cross-validation tests. Results suggest that the eyetracking paradigms of a relatively simple and specific nature provide measures not only reflecting basic oculomotor characteristics but also predicting higher order visuospatial and visuoperceptual impairments. Eyetracking measures can represent extremely useful markers during the diagnostic phase and may be exploited as potential outcome measures for clinical trials.

Visual Sensory and Visual-Cognitive Function and Rate of Crash and Near-Crash Involvement Among Older Drivers Using Naturalistic Driving Data.

PurposeAn innovative methodology using naturalistic driving data was used to examine the association between visual sensory and visual-cognitive function and rates of future crash or near-crash involvement among older drivers.MethodsThe Strategic Highway Research Program (SHRP2) Naturalistic Driving Study was used for this prospective analysis. The sample consisted of N = 659 drivers aged ≥70 years and study participation lasted 1 or 2 years for most participants. Distance and near visual acuity, contrast sensitivity, peripheral vision, visual processing speed, and visuospatial skills were assessed at baseline. Crash and near-crash involvement were based on video recordings and vehicle sensors. Poisson regression models were used to generate crude and adjusted rate ratios (RRs) and 95% confidence intervals, while accounting for person-miles of travel.ResultsAfter adjustment, severe impairment of the useful field of view (RR = 1.33) was associated with an increased rate of near-crash involvement. Crash, severe crash, and at-fault crash involvement were associated with impaired contrast sensitivity in the worse eye (RRs = 1.38, 1.54, and 1.44, respectively) and far peripheral field loss in both eyes (RRs = 1.74, 2.32, and 1.73, respectively).ConclusionsNaturalistic driving data suggest that contrast sensitivity in the worse eye and far peripheral field loss in both eyes elevate the rates of crash involvement, and impaired visual processing speed elevates rates of near-crash involvement among older drivers. Naturalistic driving data may ultimately be critical for understanding the relationship between vision and driving safety.

Post-exercise syncope: Wingate syncope test and visual-cognitive function.

Adequate cerebral perfusion is necessary to maintain consciousness in upright humans. Following maximal anaerobic exercise, cerebral perfusion can become compromised and result in syncope. It is unknown whether post‐exercise reductions in cerebral perfusion can lead to visual‐cognitive deficits prior to the onset of syncope, which would be of concern for emergency workers and warfighters, where critical decision making and intense physical activity are combined. Therefore, the purpose of this experiment was to determine if reductions in cerebral blood velocity, induced by maximal anaerobic exercise and head‐up tilt, result in visual‐cognitive deficits prior to the onset of syncope. Nineteen sedentary to recreationally active volunteers completed a symptom‐limited 60° head‐up tilt for 16 min before and up to 16 min after a 60 sec Wingate test. Blood velocity of the middle cerebral artery was measured using transcranial Doppler ultrasound and a visual decision‐reaction time test was assessed, with independent analysis of peripheral and central visual field responses. Cerebral blood velocity was 12.7 ± 4.0% lower (mean ± SE; P < 0.05) after exercise compared to pre‐exercise. This was associated with a 63 ± 29% increase (P < 0.05) in error rate for responses to cues provided to the peripheral visual field, without affecting central visual field error rates (P = 0.46) or decision‐reaction times for either visual field. These data suggest that the reduction in cerebral blood velocity following maximal anaerobic exercise contributes to visual‐cognitive deficits in the peripheral visual field without an apparent affect to the central visual field.

Commentary: Visual Fixation in Human Newborns Correlates with Extensive White Matter Networks and Predicts Long-Term Neurocognitive Development.

Commentary: Visual Fixation in Human Newborns Correlates with Extensive White Matter Networks and Predicts Long-Term Neurocognitive Development.

The Change of Visual Perceptual and Cognitive Function and Social Skill of the Adult with Intellectual Disabilities According to General Characteristics - Application of Handicraft Activity Program -

본 연구는 수공예 활동이 성인 지적장애인의 시지각 및 인지 기능과 사회적 기술에 미치는 영향을 알아보고, 수공예 활동의 치료적 가치와 효율성을 제안하고자 하였다. 연구기간은 2015년 6월 9일부터 8월 27일까지 G광역시 S구 건강생활지원센터에 등록된 성인 지적장애인 중 연구의 목적을 이해하고 자발적으로 참여에 동의한 23명을 대상으로 하였다. 연구결과, 수공예 활동에 따른 시지각 기능은 연령 40-49세에서 가장 높았고, 더불어 인지기능도 가장 높았다. 사회적 기술은 일상생활활동이 최소 의존적이고, 가족과 함께 사는 경우에서 가장 높았다. 인지기능은 사회적 기술과 양적 상관관계를 나타내었다. 수공예 활동에 따른 시지각 및 인지 기능과 사회적 기술은 모두 증진을 나타내었다. 따라서 수공예는 시지각 및 인지 기능, 사회적 기술 증진을 이끄는 목적 지향적 활동으로 치료적 가치와 효율성이 높기에, 신체적, 정신적, 사회적 문제를 지니고 있는 이들을 위한 재활 중재로 제안하는 바이다.

Visual Impairment, Hearing Loss and Cognitive Function in an Older Population: Longitudinal Findings from the Blue Mountains Eye Study.

The presence of visual impairment (VI) and hearing loss (HL) with may be a marker for subsequent cognitive decline over time in older people. A prospective, longitudinal population-based study of the 3654 participants of the Blue Mountains Eye Study were assessed for the associations between VI and HL and a decline in mini-mental state examination (MMSE) scores over a duration of 10 years from the 5-year (baseline of this report) to the 15-year follow-up visits. MMSE was assessed at the 5-, 10- and 15-year follow-up visits. A decline ≥3 scores from 5-year to 10- or 15-year visits indicated possible cognitive decline. VI was defined as best-corrected visual acuity <6/12 in the worse-eye, HL was defined as pure-tone average >40 decibels in the worse-ear and dual sensory impairment (DSI) was defined by the co-presence of VI and HL, detected at 5-year follow-up (baseline of this report). Participants with no VI and HL over the same 5- or 10-year corresponding period were controls. Associations of VI, HL and DSI with possible cognitive decline were assessed using logistic regression models adjusting for age and sex after excluding subjects with a stroke history. The presence of VI, HL or DSI was not associated with possible cognitive decline over 5 years (odds ratio (OR) 0.84, 95% confidence-intervals (CI) 0.40–1.79, OR 1.02, 95% CI 0.61–1.70 and 1.41, 95% CI 0.54–3.72, respectively) or 10 years (OR 1.09, 95% CI 0.52–2.30, OR 1.09, 95% CI 0.65–1.82 and 1.15, 95% CI 0.28–4.73, respectively). There were no changes to these findings after adjustment for other potential confounders. Age was significantly associated with possible cognitive decline (OR 1.07, 95% CI 1.04–1.10 for both periods). Neither visual impairment, hearing loss nor dual sensory impairment was independently associated with subsequent decline in cognition.