Parent-reported problems in children with Cerebral Visual Impairment:Improving the discriminative ability from ADHD and dyslexia using screening inventories

Daily problems of children with Cerebral Visual Impairment (CVI) are often misinterpreted as symptoms of behavioural disorders or learning disabilities instead of higher order visual function (HOVF) deficits. It is difficult to differentiate between various paediatric clinical groups based on daily manifestations. We used two CVI inventories (V-CVI-I, HVFQI) and an ADHD questionnaire (AVL) to compare parent-reported visual and behavioural problems of children with CVI, ADHD, dyslexia and neurotypical children (Age 6–15, Verbal Intelligence &gt; 70). Our results show a higher percentage of parent-reported visual problems in children with CVI compared to all other groups, which was not affected by their visual acuity levels. On most HOVF categories, a higher percentage of parent-reported visual problems was also found in children with ADHD or dyslexia compared to neurotypical children. Children with ADHD had significantly more parent-reported behavioural problems, but more behavioural problems were reported by the parents of children with CVI compared to neurotypical children as well. Our findings complicate using the existing inventories for initial screening and referral of children with potential CVI. We propose a shortened screening list to improve the potential differentiation between CVI and ADHD or dyslexia based on parent-reported visual problems in everyday life.</p

Cerebellar tDCS does not affect performance in the N-back task

The N-back task is widely used in cognitive research. Furthermore, the cerebellums role in cognitive processes is becoming more widely recognized. Studies using transcranial direct current stimulation (tDCS) have demonstrated effects of cerebellar stimulation on several cognitive tasks. Therefore, the aim of this study was to investigate the effects of cerebellar tDCS on cognitive performance by using the N-back task. The cerebellum of 12 participants was stimulated during the task. Moreover, the cognitive load was manipulated in N = 2, N = 3, and N = 4. Every participant received three tDCS conditions (anodal, cathodal, and sham) divided over three separated days. It was expected that anodal stimulation would improve performance on the task. Each participant performed 6 repetitions of every load in which correct responses, false alarms, and reaction times were recorded. We found significant differences between the three levels of load in the rate of correct responses and false alarms, indicating that subjects followed the expected pattern of performance for the N-back task. However, no significant differences between the three tDCS conditions were found. Therefore, it was concluded that in this study cognitive performance on the N-back task was not readily influenced by cerebellar tDCS, and any true effects are likely to be small. We discuss several limitations in task design and suggest future experiments to address such issues

Cerebellar tDCS does not enhance performance in an implicit categorization learning task

Background: Transcranial Direct Current Stimulation (tDCS) is a form of non-invasive electrical stimulation that changes neuronal excitability in a polarity and site-specific manner. In cognitive tasks related to prefrontal and cerebellar learning, cortical tDCS arguably facilitates learning, but the few studies investigating cerebellar tDCS, however, are inconsistent. Objective: We investigate the effect of cerebellar tDCS on performance of an implicit categorization learning task. Methods: Forty participants performed a computerized version of an implicit categorization learning task where squares had to be sorted into two categories, according to an unknown but fixed rule that integrated both the size and luminance of the square. Participants did one round of categorization to familiarize themselves with the task and to provide a baseline of performance. After that, 20 participants received anodal tDCS (20 min, 1.5 mA) over the right cerebellum, and 19 participants received sham stimulation and simultaneously started a second session of the categorization task using a new rule. Results: As expected, subjects performed better in the second session than in the first, baseline session, showing increased accuracy scores and reduced reaction times. Over trials, participants learned the categorization rule, improving their accuracy and reaction times. However, we observed no effect of anodal tDCS stimulation on overall performance or on learning, compared to sham stimulation. Conclusion: These results suggest that cerebellar tDCS does not modulate performance and learning on an implicit categorization task

Superposition violations in the compensatory eye movement system

PURPOSE. Compensatory eye movements (CEM) maintain a stable image on the retina by minimizing retinal slip. The optokinetic reflex (OKR) and vestibulo-ocular reflex (VOR) compensate for low and high velocity stimuli, respectively. The OKR system is known to be highly nonlinear. The VOR is generally modeled as a linear system and assumed to satisfy the superposition and homogeneity principles. To probe CEM violation of the superposition principle, we recorded eye movement responses in C57BL/6 mice to sum of sine (SoS) stimulation, a combination of multiple nonharmonic inputs. METHODS. We tested the VOR, OKR, WOR (visually enhanced VOR), and SVOR (suppressed VOR). We used stimuli containing 0.6 Hz, 0.8 Hz, 1.0 Hz, and 1.9 Hz. Power spectra of SoS stimuli did not yield distortion products. Gains and delays of SoS and single sine (SS) responses were compared to yield relative gains and delays. RESULTS. We find the superposition principle is violated primarily in the OKR, VOR, and SVOR conditions. In OKR, we observed relative gain suppression of the lower SoS stimulus frequency component irrespective of the absolute frequency. Conversely, SVOR and VOR results showed gain enhancement of the lower frequency component and overall decrease in lead. Visually enhanced VOR results showed trends for overall gain suppression and delay decrease. CONCLUSIONS. Compensatory eye movements arguably depend on predictive signals. These results may reflect better prediction for SS stimuli. Natural CEM system stimulation generally involves complex frequency spectra. Use of SoS stimuli is a step toward unravelling the signals that really drive CEM and the predictive algorithms they depend on

Human Gaze Following Response Is Affected by Visual Acuity

The present study investigated how gaze following eye movements are affected by stimulus contrast and spatial frequency and by aberrations in central visual acuity due to refractive errors. We measured 30 healthy subjects with a range of visual acuities but without any refractive correction. Visual acuity was tested using a Landolt-C chart. Subjects were divided into three groups with low, intermediate, or good visual acuity. Gaze following responses (GFR) to moving Gabor patches were recorded by video-oculography. In each trial, the subjects were presented with a single Gabor patch with a specific spatial frequency and luminance contrast that moved sinusoidally in the horizontal plane. We observed that GFR gain decreased with increasing spatial frequency and decreasing contrast and was correlated with visual acuity. GFR gain was lower and decreased more for subjects with lower visual acuity; this was especially so for lower stimulus contrasts that are not tested in standard acuity tests. The largest differences between the groups were observed at spatial frequencies around 4 cpd and at contrasts up to 10%. Aberrations in central visual acuity due to refractive errors affect the GFR response depending on the contrast and spatial frequency of the moving stimulus. Measuring this effect may contribute to a better estimate of changes in visual function as a result of aging, disease, or treatments meant to improve vision

Selective processing of clinical information related to correct and incorrect diagnoses:An eye-tracking experiment

Introduction: Diagnostic errors are often attributed to erroneous selection and interpretation of patients' clinical information, due to either cognitive biases or knowledge deficits. However, whether the selection or processing of clinical information differs between correct and incorrect diagnoses in written clinical cases remains unclear. We hypothesised that residents would spend more time processing clinical information that was relevant to their final diagnosis, regardless of whether their diagnosis was correct. Methods: In this within-subjects eye-tracking experiment, 19 internal or emergency medicine residents diagnosed 12 written cases. Half the cases contained a correct diagnostic suggestion and the others an incorrect suggestion. We measured how often (i.e. number of fixations) and how long (i.e. dwell time) residents attended to clinical information relevant for either suggestion. Additionally, we measured confidence and time to diagnose in each case. Results: Residents looked longer and more often at clinical information relevant for the correct diagnostic suggestion if they received an incorrect suggestion and were able to revise this suggestion to the correct diagnosis (dwell time: M: 6.3 seconds, SD: 5.1 seconds; compared to an average of 4 seconds in other conditions; number of fixations: M: 25 fixations, SD: 20; compared to an average of 16-17 fixations). Accordingly, time to diagnose was longer in cases with an incorrect diagnostic suggestion (M: 86 seconds, SD: 47 seconds; compared to an average of 70 seconds in other conditions). Confidence (range: 64%-67%) did not differ depending on residents' accuracy or the diagnostic suggestion. Discussion: Selectivity in information processing was not directly associated with an increase in diagnostic errors but rather seemed related to recognising and revising a biased suggestion in favour of the correct diagnosis. This could indicate an important role for case-specific knowledge in avoiding biases and diagnostic errors. Future research should examine information processing for other types of clinical information

Cerebellar tDCS does not improve performance in probabilistic classification learning

In this study, the role of the cerebellum in a cognitive learning task using transcranial direct current stimulation (tDCS) was investigated. Using a weather prediction task, subjects had to learn the probabilistic associations between a stimulus (a combination of cards) and an outcome (sun or rain). This task is a variant of a probabilistic classification learning task, for which it has been reported that prefrontal tDCS enhances performance. Using a between-subject design, all 30 subjects learned to improve their performance with increasing accuracies and shortened response times over a series of 500 trials. Subjects also became more confident in their prediction during the experiment. However, no differences in performance and learning were observed between subjects receiving sham stimulation (n = 10) or anodal stimulation (2 mA for 20 min) over either the right cerebellum (n = 10) or the left prefrontal cortex (n = 10). This suggests that stimulating the brain with cerebellar tDCS does not readily influence probabilistic classification performances, probably due to the rather complex nature of this cognitive task