Long-term maturation of visual pathways

Chromatic visual evoked potentials: A review of physiology, methods and clinical applications

Objective assessment of the visual system can be performed electrophysiologically using the visual evoked potential (VEP). In many clinical circumstances, this is performed using high contrast achromatic patterns or diffuse flash stimuli. These methods are clinically valuable but they may only assess a subset of possible physiological circuitries within the visual system, particularly those involved in achromatic (luminance) processing. The use of chromatic VEPs (cVEPs) in addition to standard VEPs can inform us of the function or dysfunction of chromatic pathways. The chromatic VEP has been well studied in human health and disease. Yet, to date our knowledge of their underlying mechanisms and applications remains limited. This likely reflects a heterogeneity in the methodology, analysis and conclusions of different works, which leads to ambiguity in their clinical use. This review sought to identify the primary methodologies employed for recording cVEPs. Furthermore cVEP maturation and application in understanding the function of the chromatic system under healthy and diseased conditions are reviewed. We first briefly describe the physiology of normal colour vision, before describing the methodologies and historical developments which have led to our understanding of cVEPs. We thereafter describe the expected maturation of the cVEP, followed by reviewing their application in several disorders: congenital colour vision deficiencies, retinal disease, glaucoma, optic nerve and neurological disorders, diabetes, amblyopia and dyslexia. We finalise the review with recommendations for testing and future directions.

Direct brain recordings reveal occipital cortex involvement in memory development

Processing of low-level visual information shows robust developmental gains through childhood and adolescence. However, it is unknown whether low-level visual processing in the occipital cortex supports age-related gains in memory for complex visual stimuli. Here, we examined occipital alpha activity during visual scene encoding in 24 children and adolescents, aged 6.2-20.5 years, who performed a subsequent memory task while undergoing electrocorticographic recording. Scenes were classified as high- or low-complexity by the number of unique object categories depicted. We found that recognition of high-complexity, but not low-complexity, scenes increased with age. Age was associated with decreased alpha power and increased instantaneous alpha frequency during the encoding of subsequently recognized high- compared to low-complexity scenes. Critically, decreased alpha power predicted improved recognition of high-complexity scenes in adolescents. These findings demonstrate how the functional maturation of the occipital cortex supports the development of memory for complex visual scenes.

Impairments of Visual Function and Ocular Structure in Patients With Unilateral Posterior Lens Opacity

PURPOSE

We investigate visual function impairment and ocular structure in patients with unilateral posterior lens opacity, a type of congenital cataract (CC) in our novel CC category system.

METHODS

We studied patients aged 3 to 15 years who were diagnosed with unilateral posterior CC. Best corrected visual acuity (BCVA) and visual evoked potentials (VEP) were examined. Corneal astigmatism (CA), mean keratometry, central corneal thickness, anterior chamber depth (ACD), and axial length were measured by Pentacam and IOL-Master. Variations between two eyes were compared by paired t-tests.

RESULTS

Among the 25 patients involved, BCVAs (logMAR) of cataractous and contralateral healthy eyes were 0.8 ± 0.4 (range, 0.1-1.7) and 0.1 ± 0.1 (range, -0.1 to 0.4). Compared to contralateral healthy eyes, larger CA (1.8 ± 1.2 vs. 0.9 ± 0.4 diopters [D], P = 0.002) and deeper ACD (3.7 ± 0.3 vs. 3.5 ± 0.4 mm, P = 0.009) were found in cataractous eyes. No significant positive or negative linear relationship was found between BCVA and parameters of VEP. Peak time of P100 of pattern VEP-60' in cataractous eyes was longer than that in contralateral healthy eyes (114.9 ± 18.8 vs. 105.0 ± 12.4 ms, P = 0.013). Amplitudes of P100 of patterns VEP-60' and -15' in cataractous eyes were smaller than those in contralateral healthy eyes (PVEP-60', 15.2 ± 5.3 vs. 19.9 ± 10.4 μV, P = 0.023; PVEP-15', 10.4 ± 7.0 vs. 22.1 ± 11.9 μV, P = 0.012).

CONCLUSIONS

Impaired visual function and ocular structure were detected in patients with posterior lens opacities.

TRANSLATIONAL RELEVANCE

This study provides evidence-based clinical recommendations for unilateral posterior CC patients with controversial treatment options.

Maturation of Binocular, Monocular Grating Acuity and of the Visual Interocular Difference in the First 2 Years of Life

The sweep visual evoked potential method (sVEP) is a powerful tool for measurement of visual acuity in infants. Despite the applicability and reliability of the technique in measuring visual functions the understanding of sVEP acuity maturation and how interocular difference of acuity develops in early infancy, as well as the availability of normality ranges, are rare in the literature. We measured binocular and monocular sVEPS acuities in 481 healthy infants aged from birth to 24 months without ophthalmological diseases. Binocular sVEP acuity was significantly higher than monocular visual acuities for almost all ages. Maturation of monocular sVEP acuity showed 2 longer critical periods while binocular acuity showed three maturation periods in the same age range. We found a systematic variation of the mean interocular acuity difference (IAD) range according to age from 1.45 cpd at birth to 0.31 cpd at 24 months. An additional contribution was the determination of sVEP acuity norms for the entire age range. We conclude that binocular and monocular sVEP acuities have distinct growth curves reflecting different maturation profiles for each function. Differences in IAD range shorten according to age and they should be considered in using the sVEP acuity measurements for clinical diagnosis as amblyopia.

Development of color vision discrimination during childhood: differences between Blue-Yellow, Red-Green, and achromatic thresholds

Nonvisual demands of tests affect vision test results in children. 150 children (79 females and 71 males, 5.3-12.7 years of age) were examined. Isoluminant Blue, Yellow, Red, Green, and Black and White thresholds were established with a four-alternative forced-choice and pseudo-10-bit system with adaptive staircase and gaming elements. Where Threshold=b₀+b₁*age^-1, b₁ for RG=6.26±1.90 (95% confidence limits), Achr=3.96±1.07 and BY=12.48±2.76 were significantly different. The noncolor demands of the test are the same for RG, BY, and Achr, so the later development of BY discrimination is not an artifact of the test.

Proficient use of low spatial frequencies facilitates face memory but shows protracted maturation throughout adolescence

Face perception is characterized by configural processing, which depends on visual information in the low spatial frequency (LSF) ranges. However, it is unclear whether LSF content is equally important for face memory. The present study investigated how face information in the low and high SF range plays a role in the configural encoding of faces for short-term and long-term recall. Moreover, we examined how SF-dependent face memorization develops in female adolescence, by comparing children (9-10-year-olds), adolescents (12-13-year-olds and 15-16-year-olds), and young adults (21-32-year-olds). Results show that similar to face perception, delayed face recognition was consistently facilitated by LSF content. However, only adults were able to adequately employ configural LSF cues for short-term recall, analogous to the slow maturation of LSF-driven configural face perception reported by previous studies. Moreover, the insensitivity to face inversion of early adolescents revealed their inadequate use of configural face cues regardless of SF availability, corroborating previous reports on an adolescent "dip" in face recognition. Like face perception, face recognition has a protracted maturational course. In (female) adolescence, sensitivity to configural LSF cues is developed, which aids not only configural face perception but also face memorization.

Distinct Visual Evoked Potential Morphological Patterns for Apparent Motion Processing in School-Aged Children

Measures of visual cortical development in children demonstrate high variability and inconsistency throughout the literature. This is partly due to the specificity of the visual system in processing certain features. It may then be advantageous to activate multiple cortical pathways in order to observe maturation of coinciding networks. Visual stimuli eliciting the percept of apparent motion and shape change is designed to simultaneously activate both dorsal and ventral visual streams. However, research has shown that such stimuli also elicit variable visual evoked potential (VEP) morphology in children. The aim of this study was to describe developmental changes in VEPs, including morphological patterns, and underlying visual cortical generators, elicited by apparent motion and shape change in school-aged children. Forty-one typically developing children underwent high-density EEG recordings in response to a continuously morphing, radially modulated, circle-star grating. VEPs were then compared across the age groups of 5-7, 8-10, and 11-15 years according to latency and amplitude. Current density reconstructions (CDR) were performed on VEP data in order to observe activated cortical regions. It was found that two distinct VEP morphological patterns occurred in each age group. However, there were no major developmental differences between the age groups according to each pattern. CDR further demonstrated consistent visual generators across age and pattern. These results describe two novel VEP morphological patterns in typically developing children, but with similar underlying cortical sources. The importance of these morphological patterns is discussed in terms of future studies and the investigation of a relationship to visual cognitive performance.

Maturation of Early Visual Processing Investigated by a Pattern-Reversal Habituation Paradigm is Altered in Migraine

Evidence for a disturbed maturation of information processing in migraine came recently from evoked and event-related potential studies during childhood. In adult migraineurs, deficient habituation is proposed as principal interictal abnormality and was found inter alia for Visual Evoked Potentials (VEPs). This study investigated response and habituation to pattern-reversal VEPs and its maturation in 102 children with primary headache (migraine with and without aura, tension-type headache) and 79 healthy controls from 6 to 18 years. A reduction of N180 latency from pre- to postpubertal age reflects maturation and was clearly present in controls but lessened in migraineurs. N180 latency was prolonged in migraineurs without aura from 12 years onwards. Habituation did not differ between groups. In conclusion, diminished N180 latency reduction with age in migraineurs gives further evidence that maturation of visual information processing is altered in migraine. Deficient habituation to pattern-reversal VEPs could not be confirmed during childhood migraine.

Visual evoked potential latencies of three-year-old children prenatally exposed to buprenorphine or methadone compared with non-opioid exposed children: The results of a longitudinal study

This study compared the latency of pattern reversal visual evoked potentials (VEP) of 36-month old children exposed to opioid pharmacotherapy in utero to that of a group of non-exposed children. Pregnant women were enrolled as part of an open-label non-randomised flexible dosing longitudinal study. Participants were 21 children whose mothers were treated with buprenorphine- (n=11) or methadone-pharmacotherapy (n=10) during pregnancy, and 15 children not exposed to opioids in pregnancy. One-way between groups analyses of variance (ANOVA) were conducted to test the statistical significance of differences between the mean latencies of the peak response to two different sized checkerboard patterns (48' and 69' of retinal arc). Standard multiple regression analyses were conducted to determine whether there was a significant relationship between group status and VEP latencies after adjusting for the effect of covariates. VEP latencies ranged from 98 to 112 milliseconds (ms) for checks of 48' arc, and from 95 to 113ms for checks of 69' arc. Latencies were comparable across groups. After adjusting for covariates children prenatally exposed to methadone or buprenorphine did not differ significantly from non-opioid exposed children in their responses to either check size. Nor were there any significant differences in VEP latencies between children prenatally exposed to methadone and children prenatally exposed to buprenorphine. Head circumference (HC) was significantly associated with P100 latencies for both check sizes. Data from this controlled, non-randomised study suggest that neither buprenorphine nor methadone appear to have any long-term effects on visual maturity assessed at 36months of age.

Visual Development and Neuropsychological Profile in Preterm Children from 6 Months to School Age

The aim of this semilongitudinal study was to investigate the development of central visual pathways in children born preterm but without major neurologic impairments and to establish their cognitive and behavioral profile at school age. Ten children born preterm were assessed at 6 months and at school age, using visual evoked potentials at both time points and cognitive and behavioral tests at school age. We also tested 10 age-matched children born full-term. At 6 months' corrected age, we found no significant differences between preterm and full-term groups for either amplitude or latency of N1 and P1 components. At school age, the preterm group manifested significantly higher N1 amplitudes and tended to show higher P1 amplitudes than the full-term group. We found no significant differences in cognitive and behavioral measures at school age. These results suggest that preterm birth affects visual pathways development, yet the children born preterm did not manifest cognitive problems.

Chromatic visual evoked potentials in young patients with demyelinating disease

The purpose of this study was to evaluate color vision in young patients with demyelinating disease both clinically and electrophysiologically. Thirty young patients (8-28 years, mean age 19 years) with demyelinating disease with or without a history of optic neuritis (ON) were investigated. Color vision was evaluated clinically with the Ishihara test and the Farnsworth-Munsell 100 hue (FM 100 hue) test and electrophysiologically with chromatic visual evoked potentials (cVEPs). Color deficiency axis and error score (ES) obtained with the FM 100 hue test were analyzed. cVEPs to isoluminant red-green (R-G) and blue-yellow (B-Y) stimuli were recorded. The stimulus was a 7 deg circle composed of horizontal sinusoidal gratings with a spatial frequency of 2 cycles/deg and 90% chromatic contrast. Onset-offset mode of stimulation (ON:OFF=300∶700  ms) was used. Since the majority of the patients were adults (>18  years), the negative wave (N wave) of the cVEP respones is the prominent part and therefore was analyzed. Sixty eyes were studied-22 with at least one episode of ON (ON group) and 38 without any clinically evident episode of ON (nON group). The average ES in the ON group was 179.18±171.8, whereas in the nON group it was 87.60±65.34. The average N-wave latency in the ON group was 144±44  ms for the R-G stimulus and 146±56  ms for the B-Y stimulus, whereas in the nON group, it was 117±13  ms for the R-G stimulus and 121±22  ms for the B-Y one. The average N-wave amplitude in the ON group was 9.3±7.1  μV for the R-G stimulus and 5.1±3.9  μV for the B-Y one, whereas in the nON group, it was 10.8±8.3  μV for the R-G stimulus and 6.4±4.3  μV for the B-Y one. A significant difference between the ON and the nON group was found: in the ON group, ES was higher (p=0.01) and N-wave latency was longer (p=0.01) compared with those in the nON group. The study showed that color vision is expectedly more affected in the ON group, but also often in the nON group, which may indicate increased parvocellular visual pathway vulnerability in demyelinating diseases.

Object recognition deficit in early- and adult-onset schizophrenia regardless of age at disease onset

Perceptual closure is the ability of the brain to recognize a complete object based on fragmentary information and has been known to be impaired in schizophrenia. Here, the neural integrity of perceptual closure in schizophrenia with different disease onsets was evaluated by examining the generation of event-related potential (ERP) components (P₁₀₀, N₁₈₀, and N(cl)). ERPs were recorded from 40 patients (19 early-onset schizophrenia, "EOS" and 21 adult-onset schizophrenia, "AOS") and 40 age-matched healthy volunteers. Brain electric source analysis (BESA) was applied to localize the cerebral generators underlying perceptual closure. Patients showed an impaired generation of N(cl) and P₁₀₀ components. P₁₀₀ and N(cl) amplitudes were significantly reduced in both AOS and EOS (P<0.01). Moreover, N180 and N(cl) amplitudes were significantly increased with age in controls and patients (P<0.01). In the case of the N(cl), there was also a significant interaction (P<0.001) between age and group, indicating a greater age-dependent N(cl) increase in controls compared to patients. Visual information processing during perceptual closure is impaired in schizophrenia, regardless of age at disease onset. The combined influence of age and group on the amplitude of the N(cl) might support the idea of neurodevelopmental deficits in schizophrenia.

Waveform variance and latency jitter of the visual evoked potential in childhood

PURPOSE

Recording the visual evoked potential (VEP) in young children is challenging due to movement artifacts with variable fixation or attention. This study examined the effects of latency jitter, noise, and waveform consistency on the averaging of the VEP across childhood age.

METHODS

Stimuli were contrast-reversing (1.4 Hz) checkerboards of 163 arc minutes and pattern-onset-offset of 0.5 cycle/degree horizontal sine-wave gratings. Subjects were 79 normal children (0.3-16 years age; mean 6.9). Results were compared to recordings of EEG noise only (noise controls). Epochs underwent four averaging methods: (1) latency jitter correction using cross-correlation, (2) correction of phase shifts across a limited bandwidth in the Fourier domain, (3) selection of epochs based on consistency in the time domain, and (4) selection of epochs based on phase consistency in the Fourier domain. Signal-to-noise ratios (SNR) were estimated in both the time and Fourier domains.

RESULTS

Compared to standard averaging, all methods improved the amplitude of the primary peak (P100) while generating mild changes in latency. All methods also increased amplitudes of residual peaks in noise controls. In VEPs with an adequate SNR, selective averaging in the Fourier domain provided the greatest improvement in amplitude (61 % increase; p < 0.0001) without prolongation in latency. Correction of latency jitter did not consistently improve amplitude but caused latency prolongation in 24 % of subjects. There was no age-related effect of any averaging method for either stimulus.

CONCLUSIONS

Since latency jitter correction does not improve VEP amplitude more than selective averaging, recording artifacts in children are dominated by random phase components rather than inducing latency jitter.

Maturation of visual evoked potentials across adolescence

Adolescence represents the period of transition from childhood to adulthood and is characterized by significant changes in brain structure and function. We studied changes in the functional visual processing in the brain across adolescence. Visual evoked potentials (VEPs) to three types of pattern reversal checkerboard stimuli were measured in 90 adolescents (10-18 years) and 10 adults. Across adolescence, the N75 and P100 VEP peaks decreased in size while the N135 peak increased slightly in size. The latency of VEP peaks showed no reliable change across adolescence. The results suggest that even very basic visual sensory function continues to develop throughout adolescence. The results indicate significant changes in visual parvocellular and magnocellular pathways across adolescence.

Chromatic visual evoked potential responses in preschool children

The purpose of the study was to analyze chromatic visual evoked potential (VEP) responses to isoluminant red-green (R-G) and blue-yellow (B-Y) stimuli in 30 preschool children (1.5-6 years). The predominant part of the response consisted of a positive (P) wave, which showed age-related latency changes (linear decrease). P wave latency was shorter when using 21° compared to 7° R-G (p=0.004) and B-Y (p=0.044) stimulus and also when using 21° R-G compared to 21° B-Y stimulus (P=0.000). P wave amplitude did not show age-related changes. However, a lower amplitude was recorded when using 7° R-G stimulus (p=0.0013) and also when using B-Y compared to R-G stimulus. We may conclude that chromatic VEP to R-G and B-Y stimuli is reliably recorded in preschool children and that P wave to R-G stimulation shows a higher amplitude and shorter latency than to B-Y stimulus.

Keep your eyes on development: the behavioral and neurophysiological development of visual mechanisms underlying form processing

Visual form perception is essential for correct interpretation of, and interaction with, our environment. Form perception depends on visual acuity and processing of specific form characteristics, such as luminance contrast, spatial frequency, color, orientation, depth, and even motion information. As other cognitive processes, form perception matures with age. This paper aims at providing a concise overview of our current understanding of the typical development, from birth to adulthood, of form-characteristic processing, as measured both behaviorally and neurophysiologically. Two main conclusions can be drawn. First, the current literature conveys that for most reviewed characteristics a developmental pattern is apparent. These trajectories are discussed in relation to the organization of the visual system. The second conclusion is that significant gaps in the literature exist for several age-ranges. To complete our understanding of the typical and, by consequence, atypical development of visual mechanisms underlying form processing, future research should uncover these missing segments.

To prescribe or not to prescribe? Guidelines for spectacle prescribing in infants and children

This paper discusses the considerations for prescribing a refractive correction in infants and children up to and including school age, with reference to the current literature. The focus is on children who do not have other disorders, for example, binocular vision anomalies, such as strabismus, significant heterophoria or convergence excess. However, refractive amblyogenic factors are discussed, as is prescribing for refractive amblyopia. Based on this discussion, guidelines are proposed, which indicate when to prescribe spectacles and what amount of refractive error should be corrected. It may be argued that these are premature because there are many questions that remain unanswered and we do not have the quality of evidence that we would like; the clinician, however, must make decisions on whether and what to prescribe when examining a child. These guidelines are to aid clinicians in their current clinical decision making.

Chromatic and luminance contrast sensitivity in fullterm and preterm infants

In order to investigate the contributions of visual experience vs. preprogrammed mechanisms on visual development, the current study compared contrast sensitivity in preterm vs. fullterm infants. If development is tied to time since conception, preterm infants should match the developmental trajectories of fullterm infants when plotted in postterm age. By contrast, if development is influenced by visual experience, preterm and fullterm infants should match when plotted in postnatal age. Luminance (light/dark) and chromatic (red/green) contrast sensitivities (CS) were measured in 25 preterm (born, on average, 6.6 weeks early) and 77 fullterm infants, between 1 and 6 months postterm. In the first few months, luminance CS was found to be predicted by postterm age, suggesting that preprogrammed development is sufficient to account for luminance CS. By contrast, chromatic CS exceeded that predicted by postterm age, which suggests that time since birth confers a benefit on chromatic CS. The preterms' 6.6 weeks of additional time since birth is roughly equivalent to 3.7 weeks of development in chromatic CS. In sum, these results suggest that chromatic CS is more influenced by early postnatal visual experience than luminance CS, which may have implications for development of parvocellular and magnocellular pathways.

Age Effects on the Perception of Motion Illusions

Anomalous motion illusions represent a popular class of illusions and several studies have made an effort to explain their perception. However, understanding is still inconsistent. Age-related differences in susceptibility to illusory motion may contribute to further clarification of the underlying processing mechanisms. We investigated the effect of age on the perception of four different anomalous motion illusions. The Enigma illusion, the Rotating-Snakes illusion, the Pinna illusion, and the Rotating-Tilted-Lines illusion were tested on a total of one hundred and thirty-nine participants covering an age range from 3 to 82 years. In comparison with young adults, children showed a lower likelihood of perceiving motion in all illusions with the exception of the Rotating-Tilted-Lines illusion. For adult subjects, we found significant age effects in the Rotating-Snakes illusion and the Rotating-Tilted-Lines illusion: occurrence of the illusory effect decreased with age. The other two illusions turned out to be unaffected by aging. Finally, inter-correlations between different motion illusions revealed that only the Pinna illusion and the Rotating-Tilted-Lines illusion correlated significantly with each other. The results confirm that anomalous motion illusions should not be considered as a homogeneous group. Possible links between perceptual data and neurophysiological changes related to age are discussed. Perceptual differences due to age provide the opportunity to improve our understanding of illusory motion and point to specific underlying mechanisms.

Developmental neuroimaging of the human ventral visual cortex

Here, we review recent results that investigate the development of the human ventral stream from childhood, through adolescence and into adulthood. Converging evidence suggests a differential developmental trajectory across ventral stream regions, in which face-selective regions show a particularly long developmental time course, taking more than a decade to become adult-like. We discuss the implications of these recent findings, how they relate to age-dependent improvements in recognition memory performance and propose possible neural mechanisms that might underlie this development. These results have important implications regarding the role of experience in shaping the ventral stream and the nature of the underlying representations.

Transient VEP and psychophysical chromatic contrast thresholds in children and adults

It has been found that humans are able to distinguish colours without luminance cues by about 2-4 months of age and that sensitivity to colour difference develops during childhood, reaching a peak around adolescence. This prolonged period of maturation is reflected by improvements in psychophysical threshold measures and by the VEP characteristics of morphology, latency and amplitude. An intra-individual comparison of VEP and psychophysical responses to isoluminant colour stimuli has not been made in children, however, and this was the aim of the present study. VEPs were recorded from 49 subjects, children (age range: 4.8-12.6 years) and adults (age range: 25.7-33.2 years). Psychophysical and VEP thresholds were both measured in 40 of those subjects. Nominally isoluminant chromatic (L-M) sinewave gratings were presented in onset-offset mode and identical stimuli were used for psychophysical and VEP recordings to allow comparison. In agreement with previous reports, morphology of the transient VEP in response to this stimulus differed considerably between children and adults. There was a significant difference between psychophysical and VEP thresholds in children, but not in adults. Our findings support and expand on previous work on maturation of the L-M chromatic pathway and indicate a larger discrepancy between VEP and psychophysical chromatic thresholds in children than in adults.

Visual evoked potentials to red-green stimulation in schoolchildren

The aim is to study chromatic visual evoked potentials (VEP) to isoluminant red-green (R-G) stimulus in schoolchildren. Sixty children (7–19 years) with normal color vision were examined, 30 binocularly and 30 monocularly. The isoluminant point was determined for each child subjectively by using heterochromatic flicker photometry, and objectively from recordings. The stimulus was a 7° circle composed of horizontal sinusoidal gratings, with spatial frequency 2 cycles/degrees and 90% contrast, presented in onset-offset mode. VEP were recorded from Oz (mid-occipital) position. Age-dependent waveform changes and changes of the positive and negative wave were studied to both binocular and monocular R-G stimulation. Age-dependent waveform changes were observed to binocular and monocular R-G stimulation. In younger children the positive wave was prominent, whereas in older children also the negative wave became more evident. The latency of the positive wave decreased linearly with age to R-G binocular stimulation. To monocular stimulation no significant changes of the latency were observed. The amplitude of the positive wave dropped exponentially with age to binocular and monocular stimulation. The latency of the negative wave increased linearly with age to binocular and monocular stimulation, whereas the amplitude did not show age-dependent changes. These findings suggest that the chromatic VEP response undergoes evident age-dependent changes during the school-age period.

Development of visual-evoked potentials to radially modulated concentric patterns

The visual processing of radially modulated concentric patterns was studied in human participants, aged 3-22 years, by recording event-related potentials. These stimuli are known to activate the fusiform face area as well as area V4 in normal adults. The electrophysiological data showed a P1 latency that reached a maturation asymptote before 3 years of age, whereas that of N1 and P2 became adultlike by 13 years of age. In addition, the distribution of the P2 component over the scalp was focalized in the primary visual cortex before adolescence and became distributed over the entire brain after adolescence. Radially modulated concentric stimuli thus induce brain activation that is not mature until 13 years of age.

Estimating chromatic contrast thresholds from the transient visual evoked potential

Chromatic contrast thresholds may be estimated from transient VEPs by measuring the peak-to-peak amplitude at a range of stimulus levels followed by extrapolation to zero amplitude. However, there have been reports of failure of this technique when applied to the transient chromatic VEP due to variability of amplitude, difficulties with component identification and poor correlation of amplitude with stimulus level. The aim of our study was to compare methods of transient VEP chromatic contrast threshold estimation in terms of success rate and comparison with psychophysical threshold. We found each of the methods we investigated to have a high success rate, and in most cases VEP and psychophysical thresholds did not differ significantly.

Differential aging of chromatic and achromatic visual pathways: behavior and electrophysiology

Aging of visual pathways was measured psychophysically and physiologically in subjects aged 20-89 years. Contrast thresholds for the chromatic pathways increased with age, but there were no significant changes for thresholds of the achromatic pathway at low spatial frequencies. For visual evoked potential (VEP) responses, again only the chromatic pathways were significantly affected by age. Age-related changes in chromatic responses were not apparent when stimuli were adjusted by age-related contrast thresholds. This suggests that the chromatic and achromatic visual pathways age differently and that the VEP accurately and objectively reflects behavioral changes with age.

Long latency evoked potential database for clinical applications: justification and examples

We summarize our experience with the clinical utility of long latency evoked potential (EP) data in clinical QEEG studies. In contrast to common wisdom, such EP data are consistent across appropriately chosen age groups. In a healthy adult population, EP data correlate consistently with independently collected psychological variables. In our pediatric referral population, EP data are of greatest and most unique value in the learning disabilities but also augment detection of abnormality in epilepsy and behavioral abnormality. Selection of subjects for a clinical database on the basis of examined medical, neurological and behavioral health, forms adequately consistent groupings for clinical utility. The use of the Z-SPM is essential for detection of EP abnormality. A minimum of three replications within a clinical study protects against chance/false positives. Also, the true data dimensionality within EP data sets is far less than the total number of variables typically collected.

The influence of cortical maturation on the BOLD response: an fMRI study of visual cortex in children

We performed blood oxygenation level-dependent (BOLD) functional MR imaging in 11 children younger than 5 y of age and 10 children older than 5 y of age. All but five of the children in the older age group were tested under light anesthesia. We examined the cerebral oxidative metabolism (CMRO(2)) associated with the processing of a flashed and a reversing checkerboard stimulus. These stimuli had been shown in a previous study to induce identical vascular responses. The reversing checkerboard activated twice the neuronal population of the flashed checkerboard, doubling the CMRO(2) associated with it. We compared the extent of activation for the positive BOLD response and found that it did not differ between the different age groups. We estimated the oxidative metabolism by examining the change in the local deoxyhemoglobin (HbR) concentration using Delta R2*. Because both stimuli induced the same vascular response, any increase in oxygen requirement would have to be met by the identical blood volume. Increasing CMRO(2) will therefore result in an increase in the oxygen extraction fraction (OEF), which raises the local HbR concentration. In the younger children, both checkerboard stimuli produced identical, high HbR concentrations. In the older children, the HbR concentration to the flashed stimulus was significantly lower than to the reversing stimulus. We conclude that, for identical stimuli, the oxidative energy requirement associated with the cortical processing is higher in young children than in older children because the presence of superfluous synaptic connections in the immature visual system activates a larger neuronal population.

Asynchronies in the Development of Electrophysiological Responses to Motion and Color

Recent reports have documented greater plasticity in the dorsal visual stream as compared with the ventral visual stream. This study sought to test the hypothesis that this greater plasticity may be related to a more protracted period of development in the dorsal as compared with the ventral stream. Age-related effects on event-related potentials (ERPs) elicited by motion and color stimuli, designed to activate the two visual streams, were assessed in healthy individuals aged 6 years through adulthood. Although significant developmental effects were observed in amplitudes of ERPs to both color and motion stimuli, marked latency effects were observed only in response to motion. These results provide support for the hypothesis that the dorsal stream displays a longer developmental time course across the early school years than the ventral stream. Implications for neural and behavioral plasticity are discussed.

What effect does measuring children under anesthesia have on the blood oxygenation level-dependent signal? A functional magnetic resonance imaging study of visual cortex

We performed functional magnetic resonance measurements involving visual stimuli on 10 children. Half of the children were measured awake, the other half were measured under light Sevoflurane anesthesia corresponding to 0.5 mean alveolar concentration. Each child was presented with a flashed and a reversing checkerboard, which previous investigations have shown to induce identical increases in cerebral blood flow. The latter stimulus activated double the number of neurons as the former so that cerebral metabolic rate of oxygen consumption (CMRO(2)) was doubled, leading to an effective rise of the oxygen extraction fraction. We measured the extent of activation by counting the number of activated pixels and assessed the change in CMRO(2) by measuring the change in the local deoxyhemoglobin (HbR) concentration, using change in spin relaxivity. In both groups of children, the extent of activation was larger for the flashed than the reversing checkerboard, although the absolute number of activated voxels was smaller for the children who were measured under anesthesia. The HbR concentration was significantly higher during the presentation of the reversing compared with the flashed checkerboard. The relative change in the HbR concentration to the flashed and reversing checkerboard was the same in the children who were measured under anesthesia as in the children who were measured awake. We conclude that light levels of anesthesia may reduce the extent of activation but does not unduly influence either CMRO(2) or cerebral blood flow, thus preserving the blood oxygenation level-dependent signal amplitude.

Pattern-reversal visual-evoked potentials in children with migraine and other primary headache: evidence for maturation disorder?

Recently, evidence for a disturbed maturation of cerebral information processing in migraine came from studies investigating the auditory-evoked contingent negative variation and the auditory-evoked potential from childhood to adulthood. This study is to clarify whether age-dependent development is altered also for the processing of visual stimuli in migraine. Components of pattern-reversal visual-evoked potentials at four different spatial frequencies (which can preferentially activate the magno- and the parvocellular visual system) were compared between children aged 6 and 18 years with primary headache (N = 123; 67 migraine without aura, MO; 32 migraine with aura, MA; 24 tension-type headache, TH) in the headache-free interval and healthy controls (N = 82). Children were divided into two age groups: 6-11 years (pre- and early puberty) and 12-18 years (late and post-puberty). Age-dependent development was normal for N80 and P100 latency in children with primary headache, but altered for N135 latency as indicated by a significant interaction among the factors diagnosis, spatial frequency and age group (P < 0.01). In headache-free controls, N135 latency reduction between pre- and post-puberty age was most pronounced at high spatial frequency. The main 'decline' of N135 latency with increasing age was shifted to lower spatial frequencies in the headache subgroups. The results give evidence that maturation of visual processing is partly disturbed in migraineurs.

Transient pattern Visual Evoked Potentials in children with Down's syndrome

Visual acuity and contrast sensitivity are lower in children with Down's syndrome than in those developing normally. In many cases, this difference might be accounted for by the relatively high incidence of ocular abnormalities (including refractive error and strabismus) in Down's syndrome. However, abnormal spatial vision persists in children with Down's syndrome in the absence of ocular abnormality, suggesting that abnormal retino-cortical visual processing explains reduced visual function in this group. The aim of the present study was to assess retino-cortical function in children with Down's syndrome by recording transient visual evoked potentials (VEPs) in response to pattern stimuli. Responses from children with Down's syndrome were compared with those recorded from children developing normally. Response latency is similar in the two groups, but morphology differs, with the N75 component being clearly present in the normal responses, but diminished or undetectable in responses from children with Down's syndrome. Our findings may suggest a cortical abnormality specific to the source of the N75 component of pattern-reversal achromatic VEPs.

Multifocal VEP in children: its maturation and clinical application

AIM

To study the maturation of multifocal visual evoked potentials (multifocal VEP) in normal children between the ages of 5 and 16 years and to apply the results clinically in selected cases to the diagnosis of optic pathway diseases.

METHOD

70 normal children were recruited from the community and multifocal VEP (Accumap ObjectiVision, Sydney, Australia) was recorded. The waveform of the evoked responses, the latency and amplitude were analysed. Using these data, an age matched comparison was made with three children with advanced optic nerve disease; two had optic nerve glioma and one had congenital glaucoma.

RESULTS

The full field amplitude did not correlate with age and varied greatly within each age group (coefficient of variability 28%). When scaled with respect to the background electroencephalogram the intra-age group variability decreased to 15% and a sigmoid relation was found between amplitude and age. The scaled amplitude remained largely unchanged till 11 years, between 11 and 13 years there was a rapid increase (40%), and remained stable thereafter. This relation was seen at all eccentricities tested. The latency decreased gradually with age and plateaued at 13 years. In the three children with vision abnormalities this test was able to detect scotomas consistent with their condition.

CONCLUSION

Multifocal VEP perimetry shows an age related maturation in the visual pathway, characterised by distinctive timeframe of development for amplitude and latency. It can be performed by children as young as 5 years of age and holds promise as a diagnostic test capable of documenting children's visual fields objectively, even before they are able to perform subjective field tests.

Magnocellular and parvocellular developmental course in infants during the first year of life

The visual system undergoes major modifications during the first year of life. We wanted to examine whether the magnocellular (M) and parvocellular (P) pathways mature at the same rate or if they follow a different developmental course. A previous study carried out in our laboratory had shown that the N1 and P1 components of pattern visual evoked potentials (PVEPs) were preferentially related to the activity of P and M pathways, respectively. In the present study, PVEPs were recorded at Oz in 33 infants aged between 0 and 52 weeks, in response to two spatial frequencies (0.5 and 2.5 c deg(-1)) presented at four contrast levels (4, 12, 28 and 95%). Results indicate that the P1 component appeared before the N1 component in the periods tested and was unambiguously present at birth. The P1 component showed a rapid gain in amplitude in the following months, to reach a ceiling around 4-6 months. Conversely, the N1 component always appeared later and then gained in amplitude until the end of the first year without reaching a plateau. Latencies were also computed but no developmental dissociation was revealed. Results obtained on amplitude are interpreted as demonstrating a developmental dissociation between the underlying M and P pathways, suggesting that the former is functional earlier and matures faster than the latter during the first year of life.

Assessment of visual functions following prenatal exposure to organic solvents

Prenatal exposure to organic solvents has been previously associated with increased risk of color vision deficits and reduced visual acuity in young children. These findings prompted us to evaluate visual functioning in solvent-exposed infants using more sensitive non-invasive visual evoked potential (VEP) techniques. VEP techniques are described in the context of an ongoing prospective longitudinal cohort study of infants exposed to organic solvents in utero. VEPs are recorded via three active electrodes fitted over the occipital cortex while infants view changing visual stimuli. The sweep VEP is used to assess contrast detection and visual acuity by presenting sinusoidal gratings that "sweep" across a range of contrasts and spatial frequencies. Transient VEPs are used to assess responses to equiluminant chromatic- and luminance-modulated sinusoidal gratings presented in pattern onset-offset format. A single case study is presented showing abnormal chromatic responses and reduced contrast sensitivity in a 2.5-year-old boy following prenatal exposure to perchloroethylene (PCE). These VEP techniques therefore appear promising for the clinical assessment of visual toxicity in pediatric populations.

FPL and sweep VEP to tritan stimuli in young human infants

Young infants can distinguish red from green without brightness cues which shows that neural pathways processing color information (the 'red-green' color-opponent pathway) are functional early in life. There is some doubt over whether the 'blue-yellow' pathway is functional in young infants. Here, we show that infants behave like tritanopic adults until 2-3 months post-term age. By 3-4 months, infants distinguish tritan stimuli, and therefore, the 'blue-yellow' pathway must be functional by that age. Our sweep visual evoked potentials to identical stimuli, however, are not significantly above noise levels, in disagreement with the behavioral responses. We discuss several possible explanations for the discrepancy.

Aging of the chromatic onset visual evoked potential

PURPOSE

To examine changes in the chromatic onset visual evoked potential (VEP) as a function of aging.

METHODS

VEP's were measured in response to chromatic sinusoidal gratings (1.0 and 0.5 cpd), selectively chosen to modulate the L-M channel and S - (L+M) channel and presented in onset-offset mode. Responses to achromatic gratings presented in a reversal mode were also measured. Twenty subjects were tested, ranging in age from 21 to 93 years.

RESULTS

Unlike changes observed earlier in life, the general shape of the chromatic onset wave-form changed little with age; however, latencies increased significantly as a function of age. Amplitude changes revealed a decreasing trend that was not statistically significant. There was little change in the achromatic responses with age.

CONCLUSIONS

Our results demonstrate a systematic slowing of the chromatic onset VEP with age. The gradual nature of the latency changes and the lack of dramatic and complex wave-form shape changes may allow development of age-based normative data for use in clinical settings.