Závěrečná zpráva o řešení grantu Agentury pro zdravotnický výzkum MZ ČR
nestr.
Ztráta vidění je nejzávažnějším projevem selhání zrakového orgánu. Na kvalitu života postižených má ztráta zraku stejný dopad jako těžké choroby srdce či onkologická onemocnění. Makulární degenerace je v rozvinutých zemích nejčastější příčinou legální slepoty, protože pro většinu makulopatií neexistuje kauzální léčba. Jako velmi účinná kompenzační metoda výpadku centrálního vidění se jeví implantace nového typu makulární čočky (Scharioth Macula Lens - SML). Díky změněným optickým vlastnostem oka s implantovanou SML je třeba, aby pacient cílenou zrakovou rehabilitací upevnil své zrakové vnímání. V projektu budeme usilovat o zvýšení kvality života pacientů se stabilní makulopatií synergickým působením implantace SML a zrakovou rehabilitací. V dvojitě zaslepené studii ověříme efekt zrakové rehabilitace facilitované transkraniální přímou proudovou stimulací. Vedle hodnocení kvality života budeme sledovat zrakovou plasticitu ve stáří na úrovni neurální (zrakovými evokovanými potenciály), metabolické (funkční MRI) a strukturální (MRI a difúzně vážené MRI).; A sight loss is the most severe manifestation of the visual organ failure and it causes severity-dependent decrement in quality of life comparable to heart diseases or cancer. Macular degenerations are leading cause of legal blindness in the developed countries because there is no definite cure for most of maculopathies. Implantation of a new Scharioth Macula Lens (SML) could be effective in visual improvement. Due to the changed optical properties of the SML implanted eye, the patient needs a targeted visual rehabilitation to stabilize his visual perception. In the project, we will strive to improve the quality of life of patients with stable maculopathy through the synergistic effect of SML implantation and visual rehabilitation. In double-blind design, we verify the effect of visual rehabilitation facilitated by a transcranial direct current stimulation. In addition to assessing the quality of life, we will monitor visual plasticity in elderly at the level of neural (Visual Evoked Potentials), metabolic (functional MRI) and structural (MRI and Diffusion-weighted MRI).
- Klíčová slova
- kvalita života, quality of life, zrakové evokované potenciály, visual evoked potentials, makulární degenerace, intraokulární makulární čočka, transkraniální proudová stimulace, zraková rehabilitace, macular degenerations, intraocular macular lens, transcranial current stimulation, visual rehabilitation,
- NLK Publikační typ
- závěrečné zprávy o řešení grantu AZV MZ ČR
BACKGROUND: For patients with age-related macular degeneration (AMD), a special intraocular lens implantation partially compensates for the loss in the central part of the visual field. For six months, we evaluated changes in neurophysiological parameters in patients implanted with a "Scharioth macula lens" (SML; a center near high add + 10 D and peripheral plano carrier bifocal lens designed to be located between the iris and an artificial lens). METHODS: Fourteen patients (5 M, 9 F, 63-87 years) with dry AMD were examined prior to and at 3 days after, as well as 1, 2, and 6 months after, implantation using pattern-reversal, motion-onset, and cognitive evoked potentials, psychophysical tests evaluating distant and near visual acuity, and contrast sensitivity. RESULTS: Near visual acuity without an external aid was significantly better six months after implantation than before implantation (Jaeger table median (lower; upper quartile): 4 (1; 6) vs. 15 (13; 17)). Distant visual acuity was significantly altered between the pre- (0.7 (0.5; 0.8) logMAR) and last postimplantation visits (0.8 (0.7; 0.8) logMAR), which matched prolongation of the P100 peak time (147 (135; 151) ms vs. 161 (141; 166) ms) of 15 arc min pattern-reversal VEPs and N2 peak time (191.5 (186.5; 214.5) ms vs. 205 (187; 218) ms) of peripheral motion-onset VEPs. CONCLUSION: SML implantation significantly improved near vision. We also observed a slight but significant decrease in distant and peripheral vision. The most efficient electrophysiological approach to test patients with SML was the peripheral motion-onset stimulation, which evoked repeatable and readable VEPs.
- MeSH
- elektroretinografie MeSH
- implantace nitrooční čočky MeSH
- lidé MeSH
- makulární degenerace * MeSH
- nitrooční čočky * MeSH
- zraková ostrost MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
A previous experiment showed that there was a strong correlation between conservatism/liberalism and brain activity, linked to an error response (r = 0.59, p < 0.001) in the USA political environment. We re-ran the experiment on a larger and age-homogeneous group (n = 100, 50 females and 50 males, aged 20-26 years) in the Czech Republic; a European country with a different sociocultural environment and history. We did not find a relationship between the brain activity connected to conflict monitoring and self-reported conservatism/liberalism orientation (ρ = -0.11, p = 0.297) or conservatism/liberalism validated for the USA agenda (ρ = -0.01, p = 0.910). Instead of replicating the previous study, we decided to test the hypothesis under a different socio-cultural context. Our results support a view of self-reported or validated, conservative or liberal attitudes as a complex behavioral pattern. Such a behavioral pattern cannot be determined with statistical significance, using a simple Go-NoGo detection task, without accounting for confounding factors such as age and socio-cultural conditions. Sufficiently powered studies are warranted to evaluate this neuro-political controversy.
- Publikační typ
- časopisecké články MeSH
PURPOSE: The implantation of an intraocular telescope increases life quality in patients with end-stage age-related macular degeneration (AMD). The present study monitored changes in electrophysiological markers of visual processing before and during seventeen months after a novel mirror telescope implantation in two patients (OV-male 90 years, MZ-female 70 years) with the final-stage form of AMD. METHODS: Visual evoked potentials were recorded to high-contrast pattern-reversal (PR-VEP for check size 40' and 10'), low-contrast motion-onset stimuli (in visual periphery M-VEP M20°, and in central part M-VEP C8°), and event-related potentials (ERPs) in the oddball visual paradigm. RESULTS: MZ's more systematic responses showed attenuation and prolongation of the M-VEP M20° and the PR-VEP 40' immediately after the telescope implantation with a slow amplitude recovery with unchanged prolonged latency. The implantation completely eradicated the M-VEP C8° without any restoration. The PR-VEP 10' were not readable. Only a part of OV's PR-VEP 40' and M-VEP M20' were of a repeatable and expected morphology. These OV's VEPs were consistent with MZ's findings. The ERPs did not show any effect of implantation in both patients. Post-implantation visual acuity and reaction time overcame the pre-implantation levels. CONCLUSIONS: The mirror telescope preserved peripheral vision in contrast to classic telescopes; however, the telescope concurrently reduced the luminance of the magnified retinal image, which was likely responsible for the prolongation of the VEP latencies.
- MeSH
- čočky * MeSH
- lidé MeSH
- makulární degenerace * patofyziologie rehabilitace MeSH
- rozpoznávání obrazu fyziologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- teleskopy * MeSH
- zraková ostrost MeSH
- zraková percepce fyziologie MeSH
- zrakové evokované potenciály * MeSH
- zrakové protézy * normy MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The visual mismatch negativity (vMMN) response is an event-related potential (ERP) component, which is automatically elicited by events that violate predictions based on prior events. VMMN experiments use visual stimulus repetition to induce predictions, and vMMN is obtained by subtracting the response to rare unpredicted stimuli from those to frequent stimuli. One increasingly popular interpretation of the mismatch response postulates that vMMN, similar to its auditory counterpart (aMMN), represents a prediction error response generated by cortical mechanisms forming probabilistic representations of sensory signals. Here we discuss the physiological and theoretical basis of vMMN and review thirty-three studies from the emerging field of its clinical applications, presenting a meta-analysis of findings in schizophrenia, mood disorders, substance abuse, neurodegenerative disorders, developmental disorders, deafness, panic disorder and hypertension. Furthermore, we include reports on aging and maturation as they bear upon many clinically relevant conditions. Surveying the literature we found that vMMN is altered in several clinical populations which is in line with aMMN findings. An important potential advantage of vMMN however is that it allows the investigation of deficits in predictive processing in cognitive domains which rely primarily on visual information; a principal sensory modality and thus of vital importance in environmental information processing and response, and a modality which arguably may be more sensitive to some pathological changes. However, due to the relative infancy of research in vMMN compared to aMMN in clinical populations its potential for clinical application is not yet fully appreciated. The aim of this review and meta-analysis therefore is to present, in a detailed systematic manner, the findings from clinically-based vMMN studies, to discuss their potential impact and application, to raise awareness of this measure and to improve our understanding of disease upon fundamental aspects of visual information processing.
- MeSH
- duševní poruchy patofyziologie MeSH
- elektroencefalografie metody MeSH
- evokované potenciály fyziologie MeSH
- lidé MeSH
- mozek fyziologie patofyziologie MeSH
- nemoci nervového systému patofyziologie MeSH
- zraková percepce fyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- metaanalýza MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
The manipulation of attention can produce mismatch negativity-like components that are not necessarily connected to the unintentional sensory registration of the violation of probability-based regularity. For clinical purposes, attentional bias should be quantified because it can vary substantially among subjects and can decrease the specificity of the examination. This experiment targets the role of attention in the generation of visual mismatch negativity (vMMN). The visual regularity was generated by a sequence of two radial motions while subjects focused on visual tasks in the central part of the display. Attentional load was systematically varied and had three levels, no-load, easy, and difficult. Rare, deviant, and frequent standard motions were presented with a 10/60 ratio in oddball sequences. Data from 12 subjects was recorded from 64 channels and processed. vMMN was identified within the interval of 142-198 ms. The mean amplitude was evaluated during the aforementioned interval in the parietal and fronto-central regions. A general linear model for repeated measures was applied to the mean amplitude with a three-factor design and showed a significant difference [F (1, 11) = 17.40, p = 0.002] between standard and deviant stimuli and between regions [F (1, 11) = 8.40, p = 0.01]; however, no significant effect of the task [F (2, 22) = 1.26, p = 0.30] was observed. The unintentional detection of irregularity during the processing of the visual motion was independent of the attentional load associated with handling the central visual task. The experiment did not demonstrate an effect of attentional load manipulation on mismatch negativity (MMN) induced by the motion-sequence, which supports the clinical utility of this examination. However, used stimulation paradigm should be further optimized to generate mismatch negativity that is stable enough to be usable not only for group comparisons but also for a single subject assessment.
- Publikační typ
- časopisecké články MeSH
We examined the visual and cognitive functions of a 72-year-old subject, KP, who recovered his sight after 53 years of visual deprivation. We used visual evoked potentials (VEPs) to pattern-reversal and motion-onset stimuli and cognitive responses (ERPs) during the oddball paradigm to assess the effect of long-term deprivation on a mature visual system. KP lost his sight at the age of 17 years, and light projection onto his right retina was restored at 71 years by a corneal implant. Nine months after sight recovery we recorded reproducible responses to all examined stimuli. The response to pattern reversal contained two P100-like peaks with the later peak being dominant and significantly delayed (260 ms) when compared to the P100s of two control subjects, to whom the stimuli were adjusted in size and contrast to mimic KP's vision. KP's motion-onset VEPs to full-field and peripheral stimuli had a characteristic shape with a well-defined N2 peak; however, both peaks were significantly delayed (262 and 272 ms) compared to control responses. Unlike the P100 and N2 peaks, which represent sensory detection, the P3b/P300 component of the ERP to a target event in the oddball paradigm was not further delayed. In spite of degraded vision and sensory deprivation lasting 53 years, KP displayed reproducible responses to all reported stimuli. Long-term visual deprivation and retinal detachment degraded KP's visual sensory processing, assessed by pattern-reversal and motion-onset VEPs, whereas the cognitive processing of appropriate visual stimuli was not compromised.
- MeSH
- časové faktory MeSH
- kognice fyziologie MeSH
- lidé MeSH
- obnova funkce fyziologie MeSH
- senioři MeSH
- senzorické prahy fyziologie MeSH
- slepota patofyziologie MeSH
- vnímání pohybu fyziologie MeSH
- zraková percepce fyziologie MeSH
- zrakové evokované potenciály fyziologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- práce podpořená grantem MeSH
