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Linking Multi-Modal MRI to Clinical Measures of Visual Field Loss After Stroke

Beh, Anthony; McGraw, Paul V.; Webb, Ben S.; Schluppeck, Denis

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Authors

Anthony Beh

PAUL MCGRAW paul.mcgraw@nottingham.ac.uk
Professor of Visual Neuroscience

Ben S. Webb



Abstract

Loss of vision across large parts of the visual field is a common and devastating complication of cerebral strokes. In the clinic, this loss is quantified by measuring the sensitivity threshold across the field of vision using static perimetry. These methods rely on the ability of the patient to report the presence of lights in particular locations. While perimetry provides important information about the intactness of the visual field, the approach has some shortcomings. For example, it cannot distinguish where in the visual pathway the key processing deficit is located. In contrast, brain imaging can provide important information about anatomy, connectivity, and function of the visual pathway following stroke. In particular, functional magnetic resonance imaging (fMRI) and analysis of population receptive fields (pRF) can reveal mismatches between clinical perimetry and maps of cortical areas that still respond to visual stimuli after stroke (Papanikolaou et al., 2014). Here, we demonstrate how information from different brain imaging modalities-visual field maps derived from fMRI, lesion definitions from anatomical scans, and white matter tracts from diffusion weighted MRI data-provides a more complete picture of vision loss. For any given location in the visual field, the combination of anatomical and functional information can help identify whether vision loss is due to absence of gray matter tissue or likely due to white matter disconnection from other cortical areas. We present a combined imaging acquisition and visual stimulus protocol, together with a description of the analysis methodology, and apply it to datasets from four stroke survivors with homonymous field loss (two with hemianopia, two with quadrantanopia). For researchers trying to understand recovery of vision after stroke and clinicians seeking to stratify patients into different treatment pathways, this approach combines multiple, convergent sources of data to characterize the extent of the stroke damage. We show that such an approach gives a more comprehensive measure of residual visual capacity-in two particular respects: which locations in the visual field should be targeted and what kind of visual attributes are most suited for rehabilitation.

Citation

Beh, A., McGraw, P. V., Webb, B. S., & Schluppeck, D. (2022). Linking Multi-Modal MRI to Clinical Measures of Visual Field Loss After Stroke. Frontiers in Neuroscience,

Journal Article Type Article
Acceptance Date Dec 3, 2021
Online Publication Date Jan 5, 2022
Publication Date Jan 5, 2022
Deposit Date Dec 15, 2021
Publicly Available Date Jan 5, 2022
Print ISSN 1662-4548
Electronic ISSN 1662-453X
Publisher Frontiers Media
Peer Reviewed Peer Reviewed
Keywords stroke; visual cortex; fMRI; DTI; perimetry
Public URL https://nottingham-repository.worktribe.com/output/7018658
Publisher URL https://www.frontiersin.org/articles/10.3389/fnins.2021.737215/full

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