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Modulation of brain state, e.g., by anesthesia, alters the correlation structure of spontaneous activity, especially in the delta band. This effect has largely been attributed to the ∼1 Hz slow oscillation that is characteristic of anesthesia and nonrapid eye movement (NREM) sleep. However, the effect of the slow oscillation on correlation structures and the spectral content of spontaneous activity across brain states (including NREM) has not been comprehensively examined. Further, discrepancies between activity dynamics observed with hemoglobin versus calcium (GCaMP6) imaging have not been reconciled. Lastly, whether the slow oscillation replaces functional connectivity (FC) patterns typical of the alert state, or superimposes on them, remains unclear. Here, we use wide-field calcium imaging to study spontaneous cortical activity in awake, anesthetized, and naturally sleeping mice. We find modest brain state-dependent changes in infraslow correlations but larger changes in GCaMP6 delta correlations. Principal component analysis of GCaMP6 sleep/anesthesia data in the delta band revealed that the slow oscillation is largely confined to the first three components. Removal of these components revealed a correlation structure strikingly similar to that observed during wake. These results indicate that, during NREM sleep/anesthesia, the slow oscillation superimposes onto a canonical FC architecture.

Purpose: Visual search using volumetric images is becoming the standard in medical imaging. However, we do not fully understand how eye movement strategies mediate diagnostic performance. A recent study on computed tomography (CT) images showed that the search strategies of radiologists could be classified based on saccade amplitudes and cross-quadrant eye movements [eye movement index (EMI)] into two categories: drillers and scanners. Approach: We investigate how the number of times a radiologist scrolls in a given direction during analysis of the images (number of courses) could add a supplementary variable to use to characterize search strategies. We used a set of 15 normal liver CT images in which we inserted 1 to 5 hypodense metastases of two different signal contrast amplitudes. Twenty radiologists were asked to search for the metastases while their eye-gaze was recorded by an eye-tracker device (EyeLink1000, SR Research Ltd., Mississauga, Ontario, Canada). Results: We found that categorizing radiologists based on the number of courses (rather than EMI) could better predict differences in decision times, percentage of image covered, and search error rates. Radiologists with a larger number of courses covered more volume in more time, found more metastases, and made fewer search errors than those with a lower number of courses. Our results suggest that the traditional definition of drillers and scanners could be expanded to include scrolling behavior. Drillers could be defined as scrolling back and forth through the image stack, each time exploring a different area on each image (low EMI and high number of courses). Scanners could be defined as scrolling progressively through the stack of images and focusing on different areas within each image slice (high EMI and low number of courses). Conclusions: Together, our results further enhance the understanding of how radiologists investigate three-dimensional volumes and may improve how to teach effective reading strategies to radiology residents.

The scientific, clinical, and pedagogical significance of devising methodologies to train nonprofessional subjects to recognize diagnostic visual patterns in medical images has been broadly recognized. However, systematic approaches to doing so remain poorly established. Using mammography as an exemplar case, we use a series of experiments to demonstrate that deep learning (DL) techniques can, in principle, be used to train naïve subjects to reliably detect certain diagnostic visual patterns of cancer in medical images. In the main experiment, subjects were required to learn to detect statistical visual patterns diagnostic of cancer in mammograms using only the mammograms and feedback provided following the subjects’ response. We found not only that the subjects learned to perform the task at statistically significant levels, but also that their eye movements related to image scrutiny changed in a learning-dependent fashion. Two additional, smaller exploratory experiments suggested that allowing subjects to re-examine the mammogram in light of various items of diagnostic information may help further improve DL of the diagnostic patterns. Finally, a fourth small, exploratory experiment suggested that the image information learned was similar across subjects. Together, these results prove the principle that DL methodologies can be used to train nonprofessional subjects to reliably perform those aspects of medical image perception tasks that depend on visual pattern recognition expertise.

Recent studies with infants and adults demonstrate a facilitative role of labels in object categorization. A common interpretation is that labels highlight commonalities between objects. However, direct evidence for such a mechanism is lacking. Using a novel object category with spatially separate features that are either of low or high variability across the stimulus set, we tracked 12‐month‐olds’ attention to object features during learning and at test. Learning occurred in both conditions, but what was learned depended on whether or not labels were heard. A detailed analysis of eye movements revealed that infants in the two conditions employed different object processing strategies. In the silent condition, looking patterns were governed exclusively by the variability of object parts. In the label condition, infants’ categorization performance was linked to their relative attention to commonalities. Moreover, the commonality focus persisted after learning even in the absence of labels. These findings constitute the first experimental evidence that labels induce a persistent focus on commonalities.

Instruments for assessing visual function are valuable tools for optometry, ophthalmology, vision science, education, and public health. Inspired by my observations in the Teller lab, with Dobson, on the process of developing a useful clinical tool from laboratory work, I present four examples of functional vision tests that are made of paper and currently used in the field: the Amsler Grid, the Pelli-Robson Contrast Sensitivity Chart, the Teller Acuity Cards, and the Developmental Eye Movement Test. All are characterized by ease of use and rigorous design. All are either being used with children or have the potential to be so. Each tool is reviewed in terms of its development, with a view toward similarities in the steps or process taken. The goal is to encourage the further development of the functional vision assessments already in existence, and to urge scientists and clinicians alike to consider ways in which their own work can be translated into clinically useful, simple paper tools.

Background: Blindness of a visual half-field (hemianopia) is a common symptom after postchiasmatic cerebral lesions. Although hemianopia severely limits activities of daily life, current clinical practice comprises no training of visual functions in the blind hemifield. Objective: To find out whether flicker sensitivity in the blind hemifield can be improved with intensive training, and whether training with flicker stimulation can evoke changes in cortical responsiveness. Methods: Two men with homonymous hemianopia participated in the experiments. They trained with flicker stimuli at 30° or with flickering letters at 10° eccentricity twice a week for a year, and continued training with more peripheral stimuli thereafter. Neuromagnetic responses were registered at 1–2-month intervals, and the Goldmann perimetry was recorded before, during and after training. Results: Flicker sensitivity in the blind hemifield improved to the level of the intact hemifield within 30° eccentricity in one participant and 20° eccentricity in the other. Flickering letters were recognised equally at 10° eccentricity in the blind and intact hemifields. Improvement spread from the stimulated horizontal meridian to the whole hemianopic field within 30°. Before training, neuromagnetic recordings showed no signal above the noise level in the hemianopic side. During training, evoked fields emerged in both participants. No changes were found in the Goldmann perimetry. Discussion: Results show that sensitivity to flicker could be fully restored in the stimulated region, that improvement in sensitivity spreads to the surrounding neuronal networks, and that, during training, accompanying changes occurred in the neuromagnetic fields.

Objective: To determine whether unilateral activation of the vestibular labyrinth by brief air conducted tones can elicit disconjugate reflex eye movements in healthy subjects. Methods: 40 normal volunteers, one patient with bilateral congenital sensorineural deafness, and four patients with an acoustic neuromas were subjected to monoaural air conducted tones (125 to 6000 Hz; 132 dB SPL; 3–4 ms). Eye movements were recorded by averaged EOG. Results: The stimuli elicited bi- or triphasic transient EOG responses with a duration of about 10 ms and a 7–8 ms latency in 16 of 40 tested volunteers and in the patient with congenital deafness. In patients with acoustic neuromas the responses were induced only by stimuli to the healthy ear. The responses in the vertical EOG were recorded predominantly from the eye contralateral to the stimulated ear and were negligible ipsilaterally. These responses were similar to those found in patients with only one functioning labyrinth reported in a previous study. In the remaining subjects the responses were absent or barely discernible. Conclusions: (1) Disconjugate eye movements in response to brief mechanical stimuli in this audio frequency range always indicated the side of the activated vestibular labyrinth. (2) In contrast to longer stimuli used by conventional vestibular activation methods, brief stimuli may activate only the direct monocular vestibulo-ocular pathway. This may be because the responses elicited by brief stimuli cease well before the slower indirect vestibulo-ocular subsystem can align the eyes.

We describe a novel rehabilitation tool for patients with homonymous hemianopia based on a visual search (VS) paradigm that is portable, inexpensive, and easy to deploy. We hypothesised that by training patients to improve the efficiency of eye movements made in their blind field their disability would be alleviated.Twenty nine patients with homonymous visual field defects (HVFD) without neglect practised VS paradigms in 20 daily sessions over one month. Search fields comprising randomly positioned target and distracter elements, differing by a single feature, were displayed for three seconds on a dedicated television monitor in the patients' homes. Improvements were assessed by examining response time (RT), error rates in VS, perimetric visual fields (VFs) and visual search fields (VSFs), before and after treatment. Functional improvements were measured using objective visual tasks which represented activities of daily living (ADL) and a subjective questionnaire.As a group the patients had significantly shorter mean RT in VS after training (p0.001) and demonstrated a variety of mechanisms to account for this. Improvements were confined to the training period and maintained at follow up. Three patients had significantly longer RT after training. They had high initial error rates which improved with training. Patients performed ADL tasks significantly faster after training and reported significant subjective improvements. There was no concomitant enlargement of the VF, but there was a small but significant enlargement of the VSF.Patients can improve VS with practice. This usually involves shorter RTs, but occasionally a longer RT in a complex speed-accuracy trade-off. These changes translate to improved overall visual function, assessed objectively and subjectively, suggesting that they represent robust training effects. The underlying mechanism may involve the adoption of compensatory eye movement strategies.

Objective: To investigate the role right foveal/parafoveal sparing plays in reading single words, word arrays, and eye movement patterns in a single case with an incongruous hemianopia. Methods: The patient, a 48 year old right handed male with a macular sparing hemianopia in his left eye and a macular splitting hemianopia in his right eye, performed various reading tasks. Single word reading speeds were monitored using a "voice-trigger" system. Eye movements were recorded while reading three passages of text, and PET data were gathered while the subject performed a variety of reading tasks in the camera. Results: The patient was faster at reading single words and text with his left eye compared with his right. A small word length effect was present in his right eye but not his left. His eye movement patterns were more orderly when reading text with his left eye, making fewer saccades. The PET data provided evidence of "top-down" processes involved in reading. Binocular single word reading produced activity in the representation of foveal V1 bilaterally; however, text reading with the left eye only was associated with activation in left but not right parafoveal V1, despite there being visual stimuli in both visual fields. Conclusions: The presence of a word length effect (typically associated with pure alexia) can be caused by a macular splitting hemianopia. Right parafoveal vision is not critically involved in single word identification, but is when planning left to right reading saccades. The influence of top-down attentional processes during text reading can be visualised in parafoveal V1 using PET.

Background: The integrity of frontal systems responsible for voluntary control and their interaction with subcortical regions involved in reflexive responses were studied in patients with Parkinson’s disease (PD). Previous studies have shown that patients with PD have impaired executive function, including deficits in attention, motor planning and decision making. Methods: Executive function was measured through eye movements: reflexive (stimulus driven) prosaccades and voluntary (internally guided) antisaccades. Patients with advanced idiopathic PD, off and on their optimal levodopa therapy, were tested on a prosaccade and an antisaccade task and compared with matched controls. Results: Levodopa significantly increased response time for reflexive prosaccades and reduced error rate for voluntary antisaccades. Conclusions: Consistent with our proposed model, patients with PD in the medicated state are better able to plan and execute voluntary eye movements. These findings suggest levodopa improves function of the voluntary frontostriatal system, which is deficient in PD.

Objectives: To investigate whether vibrational impulse stimuli applied to the skull can be used to evoke the vestibulo-ocular reflex (VOR) and detect vestibular lesions. Methods: Twenty four patients with unilateral vestibular loss (UVD), five with bilateral vestibular loss, two with ocular palsies, and 10 healthy subjects participated. Vibrations of the skull were induced with head taps and with a single period of 160 Hz tone burst on the inion, vertex, and the mastoids while the patients viewed a distant target. Several patients were also examined while viewing a near target, with eccentric gaze and in tilted postures. Responses were recorded by EOG. Results: Responses occurred between 5 ms and 20 ms and seemed to be compensatory to the second phase of the sine wave of vibration impulse and were greatly diminished/absent in patients with bilateral VD and ocular palsies. The patients with UVD had asymmetrical responses in the vertical EOG with stimuli applied on the inion and vertex, with enhancement of the response amplitude on the side of vestibular loss and/or diminution on the healthy side. The asymmetry ratios between the healthy subjects and patients with UVD, and among patients with UVD were statistically significant. Some gaze and positional influences could be demonstrated consistent with otolithic reflexes. Conclusion: If the asymmetric responses to skull vibration in UVD result from passive oscillatory movements of the orbital tissues they may reflect the otolith mediated sustained skew torsion. Conversely, if generated by active eye movements, their likely origin is a phasic VOR.

E-readers are fast rivaling print as a dominant method for reading. Because they offer accessibility options that are impossible in print, they are potentially beneficial for those with impairments, such as dyslexia. Yet, little is known about how the use of these devices influences reading in those who struggle. Here, we observe reading comprehension and speed in 103 high school students with dyslexia. Reading on paper was compared with reading on a small handheld e-reader device, formatted to display few words per line. We found that use of the device significantly improved speed and comprehension, when compared with traditional presentations on paper for specific subsets of these individuals: Those who struggled most with phoneme decoding or efficient sight word reading read more rapidly using the device, and those with limited VA Spans gained in comprehension. Prior eye tracking studies demonstrated that short lines facilitate reading in dyslexia, suggesting that it is the use of short lines (and not the device per se) that leads to the observed benefits. We propose that these findings may be understood as a consequence of visual attention deficits, in some with dyslexia, that make it difficult to allocate attention to uncrowded text near fixation, as the gaze advances during reading. Short lines ameliorate this by guiding attention to the uncrowded span.

Horizontal and vertical EOG recordings of eye movements were analyzed to determine the spatial and temporal distribution of blinks and the patterns of eye movements (saccades and fixation pauses) exhibited by six subjects during the reading of stories presented in two formats (on paper and on a VDT). The frequency and placement of blinks was not affected by the presentation condition. Blinks were determined to be non-randomly distributed during reading. Significantly more blinks (36%) occurred in conjunction with saccades than the proportion of time consumed by saccades (12%) would predict. Significantly more blinks (36%) occurred in the vicinity of line change saccades, which accounts for 15% of reading time, and with fixation pauses associated with regressions (42%), which accounts for 26% of reading time, than with fixation pauses during normal reading (22%), which accounts for 60% of reading time. The results of the study suggest that blink behavior during reading is under perceptual and cognitive control.