Neurophysiological Correlates of Visual Motion Processing in Cerebral Visual Impairment

摘要 大脑(皮质)视力障碍(CVI)是美国先天性视力障碍的主要原因 各州。然而，关于如何观察到视觉知觉缺陷，我们的理解仍然存在一个令人震惊的差距 这些个体与围产期损害和中央视觉通路早期发育不良有关 结构。患有CVI的儿童和青少年在复杂的运动处理(A)中表现出显著的障碍 背流功能)，特别是在复杂动态环境场景的设置中。在受损的同时 运动知觉是发育易损性(称为背流)的重要标志 功能障碍假说)，标准的眼科临床评估不能捕捉和充分描述这些 视力缺陷。因此，在没有任何明显的眼睛异常的情况下，临床医生可能会驳回报告 感知上的困难，许多CVI患者会一直没有得到诊断，永远得不到及时的治疗 他们需要教育和康复支持。拟议研究的目的是调查 与CVI运动处理缺陷相关的潜在神经生理学。我们会进行心理物理治疗 结合多模式神经成像的行为测试(以表征结构和功能 连接性和脑网络激活)与CVI相关的儿童和青少年 脑室周围白质软化(PVL)。行为表现和神经成像结果的指数将是 与神经典型对照组相比。我们的主要假设是运动处理缺陷将是 与关键视觉处理通路发育不良有关。然而，改变了的图案 复杂运动知觉所涉及的大脑网络的功能连接和激活可能起到以下作用 代偿性神经可塑性指标。在我们的第一个目标中，我们将使用 随机点运动图、虚拟现实模拟和视觉搜索任务。在我们的第二个目标中，我们将 描述结构和功能连通性网络的完整性和拓扑结构(使用高角 分辨率扩散成像和静息状态fMRI)分别与视觉运动和注意有关 正在处理。第三个目标将研究大脑网络激活(使用功能磁共振)对我们的 行为任务评估。由拥有强大社区的多学科研究团队执行 参与，这种行为评估和多模式成像相结合的方法是一个关键 突出提案创新之处。这项研究将为我们提供关于 CVI患者视觉运动知觉障碍的神经生理学基础。建议的研究计划是 非常重要的是，在CVI的情况下，发现大脑与行为的关联代表着一个关键的 采取步骤建立专门为照顾这些儿童而设计的神经康复框架；a 尽管它很重要，但服务严重不足的人口

Summary Cerebral (cortical) visual impairment (CVI) is the leading cause of congenital vision impairment in the United States. Yet, there remains an alarming gap in our understanding as to how observed visual perceptual deficits in these individuals relate to perinatal damage and early maldevelopment of central visual pathways and structures. Children and adolescents with CVI show striking impairments in complex motion processing (a dorsal stream function), particularly in the setting of complex dynamic environmental scenes. While impaired motion perception is an important marker of developmental vulnerability (referred to as the dorsal stream dysfunction hypothesis), standard ophthalmic clinical assessments fail to capture and fully characterize these visual deficits. Thus, in the absence of any apparent ocular abnormality, clinicians may dismiss reported perceptual difficulties, and many individuals with CVI will remain undiagnosed and never receive the timely education and rehabilitative support they need. The objective of the proposed research is to investigate the underlying neurophysiology associated with motion processing deficits in CVI. We will carry out psychophysical behavioral testing combined with multimodal neuroimaging (to characterize structural and functional connectivity along with brain network activation) in children and adolescents with CVI associated with periventricular leukomalacia (PVL). Indices of behavioral performance and neuroimaging outcomes will be compared to neurotypical controls. Our overarching hypothesis is that motion processing deficits will be associated with the maldevelopment of key visual processing pathways. However, altered patterns of functional connectivity and activation of brain networks implicated in complex motion perception may serve as indicators of compensatory neuroplasticity. In our first aim, we will assess motion processing abilities using random dot kinematograms, virtual reality simulations, and visual search tasks. In our second aim, we will characterize the integrity and topology of structural and functional connectivity networks (using high angular resolution diffusion imaging and resting state fMRI respectively) implicated with visual motion and attention processing. The third aim will investigate brain network activation (using functional MRI) in response to our behavioral task assessments. Executed by a multidisciplinary research team with strong community involvement, this combined behavioral assessment and multimodal imaging approach represents a key distinguishing innovation of the proposal. This study will provide convergent and high-level insights into the neurophysiological basis of visual motion perceptual deficits in CVI. The proposed program of research is highly significant given that uncovering brain-behavioral associations in the case of CVI represents a crucial step in establishing a neurorehabilitative framework specifically designed for the care of these children; a population that has been greatly underserved despite its important