 |
| Volume 4, Number 6, Article 10, Pages 509-523 |
doi:10.1167/4.6.10 |
http://journalofvision.org/4/6/10/ |
ISSN 1534-7362 |
Retinotopic organization in children measured with fMRI
Ian P. Conner |
Department of Neurobiology & Anatomy, West Virginia University
School of Medicine, Morgantown, WV, USA |
|
Saloni Sharma |
Department of Radiology, West Virginia University
School of Medicine, Morgantown, WV, USA |
|
Susan K. Lemieux |
Departments of Radiology, Neurobiology, Anatomy, &
Ophthamology, West Virginia University School of Medicine,
Morgantown, WV, USA |
|
Janine D. Mendola |
Departments of Radiology, Neurobiology, Anatomy, &
Ophthamology, West Virginia University School of Medicine,
Morgantown, WV, USA |
|
Abstract
Many measures of visual function reach adult levels by about age 5, but some visual abilities continue to develop throughout adolescence. Little is known about the underlying functional anatomy of visual cortex in human infants or children. We used fMRI to measure the retinotopic organization of visual cortex in 15 children aged 7–12 years. Overall, we obtained adult-like patterns for most children tested. We found that significant head motion accounted for poor quality maps in a few tested children who were excluded from further analysis. When the maps from 10 children were compared with those obtained from 10 adults, the magnitude of retinotopic signals in visual areas V1, V2, V3, V3A, VP, and V4v was essentially the same between children and adults. Furthermore, one measure of intra-area organization, the cortical magnification function, did not significantly differ between adults and children for V1 or V2. However, quantitative analysis of visual area size revealed some significant differences beyond V1. Adults had larger extrastriate areas (V2, V3, VP, and V4v), when measured absolutely or as a proportion of the entire cortical sheet. We found that the extent and laterality of retinotopic signals beyond these classically defined areas, in parietal and lateral occipital cortex, showed some differences between adults and children. These data serve as a useful reference for studies of higher cognitive function in pediatric populations and for studies of children with vision disorders, such as amblyopia.
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|
History
Received October 13, 2003; published June 18, 2004
Citation
Conner, I. P., Sharma, S., Lemieux, S. K., & Mendola, J. D. (2004). Retinotopic organization in children measured with fMRI.
Journal of Vision, 4(6):10, 509-523,
http://journalofvision.org/4/6/10/,
doi:10.1167/4.6.10.
Keywords
vision, development, pediatric, neuroimaging, neurons, visual areas, hemispheric laterality
for related articles by these authors
for papers that cite this paper |
Psychophysical measurements in humans have established
that the visual system depends extensively on postnatal experience to guide
developmental mechanisms and eventually reach a mature state. Although perhaps
the most dramatic improvements in performance occur in the first year of life,
some abilities require many years of visual experience to achieve the adult-like
state. For example, some measures of basic vision, such as grating acuity, do
not reach adult values before age 6. Temporal contrast sensitivity at high
frequencies (20 and 30 Hz) and critical flicker fusion frequency are adult-like
at age 4, although contrast sensitivity for lower temporal frequencies and
static gratings matures between ages 4 and 7 (Ellemberg, Lewis, Liu, &
Maurer, 1999).
Even later maturation of several visual functions that require global
integration across distance in the visual field has been recently documented.
For example, texture segregation does not reach adult levels until between ages
14 and 18 (Sireteanu, 2000). Contour
integration has been shown to have a protracted development when tested with
oriented Gabor element textures, and with the Ebbinghaus illusion (Kovacs,
Kozma, Feher, & Benedek, 1999; Kovacs, 2000). Finally, Vernier hyperacuity undergoes a
steep improvement during childhood until adult levels are reached at age 14
(Skoczenski & Norcia, 2002).
Much
less is known about the physiological maturation of the visual system during
childhood. One of the few available techniques is noninvasive electrical
recording from the scalp, and such data indicate ongoing neural development
through childhood. For example, the checkerboard onset evoked potential does not
obtain its adult form before puberty (Ossenblok De Munck, Wieringa, Reits, &
Spekreijse, 1994). Evoked potentials and
visual performance measures sometimes show nice parallels, but not always (Regan
& Spekreijse, 1986; Tyschen, 1992). Interestingly, some evidence suggests
that the responses of visual neurons are often more mature than behavioral
measures would predict (e.g., Kiorpes & Movshon, 2003), although the reasons for this
discrepancy are still unclear.
The
advent of noninvasive functional neuroimaging (fMRI) provides new opportunities
to improve understanding of the functional neuroanatomy of humans in health and
in disease. Although the source of the measured signal is hemodynamic, not
neural, it is coupled to neural activity (e.g., Logothetis, Pauls, Augath,
Trinath, & Oeltermann, 2001) with an
impressive spatial (2-4 mm) and temporal (1-2 s) resolution. These techniques
can be applied to pediatric populations, and have been done so increasingly
(e.g., Casey et al., 1995; Kwon et al., 2002; Temple et al., 2003; Turkeltaub, Gareau, Flowers, Zeffiro, &
Eden, 2003). Most efforts have focused on
cognitive functions, such as reading ability and memory. The majority of such
studies provide stimuli through the visual modality. Therefore, it is important
to understand the state of maturity of early visual areas in this age range for
better interpretation of cognitive studies, as well as to directly investigate
human visual system development.
Retinotopic
organization of human visual cortex has been mapped using functional magnetic
resonance imaging (fMRI) in adults. Multiple visual areas have been shown to
exist, each with its own representation of visual space (Sereno et al., 1995, DeYoe et al., 1996; Engel, Glover, & Wandell, 1997). This type of mapping of visual cortex is
important for several reasons. 1. The technique allows for rapid delineation of
a large expanse of visual cortex. 2. The boundaries of several visual areas can
be defined by the representations of the horizontal and vertical meridians of
visual space. Such objective boundaries guide the creation of regions of
interest that can be applied in a statistically independent way to the results
of other experiments. 3. By mapping a fundamental and continuously changing
variable across the cortical sheet, significant information can be acquired
about
intra-areal
function.
These powerful noninvasive methods for mapping
retinotopic function have not previously been extended to children. Here we show
that visually normal children have essentially achieved an adult-like pattern of
many retinotopic visual areas mapped with functional magnetic resonance
techniques, at least by age 9. However, quantitative differences were detected
between the adult and child groups in the size of visual areas. To extend our
results beyond these well-known areas, we also employed new
cortical-surface-based methods for achieving inter-subject averaging. Different
patterns of activation in parietal and lateral occipital cortices were observed.
These data can serve as an important baseline from which to compare the
retinotopic maps of normal children to those with visual disorders.
We studied 10
adults aged 21 to 30 years (6 male, 4 female) and 15 children aged 7 to 12 years
(7 male, 8 female). Seven child subjects were less than 10 years and 8 were
greater than or equal to 10 years. After excluding from analysis subjects
exhibiting significant head motion, 10 subjects remained, and their ages were 9,
9, 10, 10, 10, 11, 12, 12, 12, and 12 years. With regard to the handedness of
our subjects, 9/10 adults were right-handed, and 8/10 children were
right-handed.
Our subjects were recruited from the local community
surrounding West Virginia University (WVU). Informed consent was obtained from
all subjects in a project approved by the WVU Institutional Review Board for the
Protection of Human Subjects (protocol
#14788). 2.2 Cortical surface reconstruction
Surface reconstructions of each subject's cerebral
cortex were generated from high-resolution anatomical images obtained in a
General Electric 1.5 Tesla MR scan session separate from the retinotopic mapping
experiments. Previously validated techniques (Dale, Fischl, & Sereno, 1999;
Fischl, Sereno, & Dale, 1999a)
were employed. Briefly, brain reconstruction was begun by collecting whole-head
3D fast spoiled grass gradient echo (FSPGR) scans, optimized for contrast
between gray and white matter, for each subject. Specific parameters were fast
IR prep (prep time = 300 ms), TE = 1.9 ms, flip angle = 20 deg, FOV = 24 cm,
axial slices, 256 × 256 matrix, resolution 0.94
× 0.94 × 1.2 mm.
The surface reconstructions were created using the
FreeSurfer software package available at http://www.nmr.mgh.harvard.edu/freesurfer.
Voxels containing white matter in an intensity-normalized volume were labeled
using an anisotropic planar filter. A region-growing algorithm was then used to
ensure that each cortical hemisphere was represented by a single connected
component with no interior holes. The surfaces of these components were
tessellated
( ~150,000
vertices), refined against the MRI data using a deformable template technique,
and manually inspected for topological defects (i.e., departures from spherical
topology). Automated techniques for optimizing topological correctness while
maintaining geometrical accuracy were employed (Fischl, Liu, & Dale, 2001).
In a separate step, the cortical surface was computed
by expanding the gray/white surface by 3 mm and refining it against the FSPGR MR
images. The sampled functional signal included most of cortical gray matter, but
it was centered just above the gray/white boundary to avoid the pial surface
where macrovascular fMRI artifacts are greatest, and to ensure that functional
signals were assigned to the correct sulcal bank. The surface reconstruction of
each subject’s brain was "inflated" by an iterative algorithm that reduced
local curvature while approximately preserving local areas and angles by
minimizing metric distortion.
Once a cortical surface is reconstructed, it becomes
possible to calculate the surface area of the entire cortical sheet, or of
smaller cortical areas defined as regions of interest (ROI). Although the ROIs
can be drawn (i.e., defined) on the flattened surface, the ROIs are mapped back
to the folded cortical surface when measurements are made, avoiding the areal
distortion created by inflation and flattening. Measures of surface area are
made at the gray/white boundary, as this best represents the location of
recorded functional signals. We compute the area associated with the polygonal
surface model, which is very densely sampled. The area of each triangular vertex
is approximately 0.5 mm 2. The area of an ROI is the sum of the area
of n triangles. Due
to the inherent difficulty of segmentation of white from gray matter,
segmentation is a potential source of error in the reconstructions. However, the
accuracy of the programs has been validated (e.g., by test-retest comparisons)
(Dale et al., 1999) and the accurate estimates
of cortical thickness (Fischl & Dale, 2000; Rosas et al., 2002). Furthermore, each reconstruction is
manually inspected for errors.
2.3 Functional magnetic resonance imaging
Subjects were scanned in a GE 1.5 Tesla MR scanner
using techniques described previously (Mendola, Dale, Fischl, Liu, &
Tootell, 1999). After a sagittal localizing
scan was obtained, a T1-weighted inversion recovery sequence (TR = 400 ms) was
used to acquire 20 interleaved 4-mm slices with 0.86
× 0.86 mm in-plane resolution, oriented
perpendicular to the calcarine sulcus. These anatomical scans were later used to
register the functional scans to the FSPGR slices that were used to define the
cortical surface.
The next step was to acquire multiple functional scans
using the same slice prescription selected in the anatomical scans, but with
3.44 × 3.44 mm in-plane resolution. Functional signals reflecting neural
activity via local oxygen consumption and blood flow were acquired (after Kwong
et al., 1992; Ogawa et al., 1992) using a spiral gradient echo sequence (TE =
40 ms, TR = 4000 ms, flip angle = 65 deg, FOV = 22 cm, matrix 64
× 64 (Glover, 1999).
For the adults, functional
scans had a duration of 8 min and 32 s, and
128 time points were collected from each slice in all scans. Four scans of this
type were administered in one session, two scans for eccentricity and two scans
for polar angle. For the children, functional scans
had a duration of 4 min and 16 s, and 64
time points were collected from each slice in all scans. Six scans of this type
were administered in one session, three scans for eccentricity and three scans
for polar angle. The entire scanning procedure typically lasted about 2 hr.
Head movement (within and between scans) was minimized
by the use of one of two methods. Most subjects used a bite bar, in which
subjects stabilized their jaw in a rigid, deep individual dental impression,
mounted in an adjustable frame. For children who were not comfortable using a
bite bar, we used a rigid chin cup that greatly restricted movements in all
planes. Although we did not monitor eye movements, the good quality of our
retinotopic maps indicates adequate fixation during the functional scans. Our
use of radial motion and symmetric stimuli also helps to minimize translational
eye position drifts.
During the fMRI experiments, the visual stimuli were
generated by a Silicon Graphics O2 computer with an output resolution of 640 x
480 pixels. The video output was converted to a 60-Hz interlaced composite S-VHS
signal, which served as input to an Epson Powerlite
500c LCD projector. The projector's image
passed into the bore of the magnet, and appeared on a paper rear-projection
screen in front of the subject. The subjects viewed the screen by looking
straight up at a mirror placed at an approximately 45-deg angle to both the
screen and the subject's line of sight. The stimuli subtended an area of about
25-deg horizontal by 15-deg vertical.
The cortical representation of retinotopic visual space
was mapped with a phase-encoded design in which the cardinal axes of space
(eccentricity and polar angle) were mapped separately (Engel et al., 1994; DeYoe et al., 1996; Engel et al., 1997). The stimuli consisted of high-contrast,
chromatic, flickering checkerboard patterns of two specific types. The
“rotating wedge” stimulus would sweep through polar angles much like
a hand on a clock, and the “expanding ring” stimulus mapped
eccentricity by starting from the center of the visual field and expanding
outward ( Figure 1). Eccentricity stimuli
traversed space with a logarithmic transformation, as has been used previously
(Sereno et al., 1995; Tootell et al., 1997). Both stimuli attempted to compensate for
the cortical magnification factor by increasing in size as they approach the
periphery. These phase-encoded stimuli always used a cycle length of 64 s, which
corresponds to 8 cycles per scan for adults and 4 cycles per scan for children.
Adults were shown 16 cycles of each stimulus type, whereas children were shown
12 cycles. The lower number of cycles was used for the children due to concerns
about their stamina for accurate fixation and minimal head motion. However, the
number of cycles was equated between groups at the subsequent analysis stage by
excluding a portion of the adult
data. Figure 1. Depiction of dynamic eccentricity and
polar angle stimuli. Top. The eccentricity stimulus was an annular ring that
slowly expanded in size. Three isolated example frames are shown. Bottom. The
polar angle stimulus was a wedge that rotated around the fixation point.
A central fixation mark was present at all times for
all stimuli. Subjects were clearly instructed to maintain fixation on this mark
at all times during an fMRI scan. Subjects were also instructed to perform a
task monitoring the appearance of the fixation point to aid fixation stability.
The fixation point briefly changed color from white to red with an inter-trial
interval that randomly ranged from 4-32 s (in 4-s multiples) during the course
of an fMRI scan, and the subjects pressed a key upon detecting such a change.
The children were able to perform this task at a very accurate level (mean = 98%
correct).
2.5.1 Individual subject analysis
The functional analysis was completed using the FS-FAST
software tools freely available at ftp://ftp.nmr.mgh.harvard.edu/pub/flat/fmri-analysis.
A brief description of the processing steps follows. For each subject, raw MR
images were first motion-corrected using an iterated, linearized,
weighted-least-squares method through the FS-FAST implementation of the AFNI
3dvolreg algorithm (Cox & Jesmanowicz, 1999), and then intensity-normalized using the
average in-brain voxel intensity. The residual, uncorrectable head motion was
measured as the root mean square (RMS) difference between motion-corrected
output and a target volume defined from the middle time point of each scan. This
value was computed for each subject, and values exceeding a RMS of 60, which
corresponded to the grossly observed image artifacts, were used as a criterion
for exclusion of some of the children (5/15) from further processing. For the
remaining 10 subjects, the average corrected motion in all three planes was
quantified as the vector magnitude of translational motion.
After
the preprocessing steps, a fast Fourier analysis was conducted on the time
series of each voxel to statistically correlate retinotopic stimulus location
with visual cortical anatomy. To equate the children and adults for data
analysis, only the first 12 cycles were analyzed for the adults. This analysis
rejects low frequencies due to subject head motion or baseline drift and
extracts functional signals in the form of magnitude and phase relative to the
stimulus cycle frequency (8 or 4 cycles per scan; period = 64 s). Signal
magnitude reflects the degree of retinotopic specificity, which can be low due
to either a lack of visually induced response or to an equal response to all
retinotopic locations. The phase component of the signal was used to code
retinotopic location. Activation significance
( F) values were computed for each voxel
by using a comparison between the Fourier domain amplitude at the stimulation
frequency and the average amplitude at other (nonharmonic) frequencies. For
these types of calculations, the phase/magnitude data are converted from polar
coordinates to the equivalent data in rectilinear coordinates (i.e., complex
numbers with real and imaginary components). The
F statistic accommodates this
multivariate analysis. The F statistic
is computed as the sum of the squared real and imaginary signal components
divided by the noise variance. Finally, a registration procedure within
Freesurfer was used to align (in all 3 planes) the T1 contrast anatomical images
collected in each functional session with the cortical surface model. The same
registration matrix was then applied to the functional images to view the
results on the cortical surface.
The data from the paired eccentricity and polar angle
scans were combined to yield field sign maps. The field sign maps the polarity
of the visual field representation as either similar to the actual visual field
geometry or mirror symmetrical to it. The field sign for each cortical area was
objectively calculated from the vector product of the constituent phase-encoded
maps of polar angle and eccentricity as in Sereno et al. ( 1995). Visual area naming conventions are as
described in Tootell et al. ( 1997), and are
consistent with previous studies. The superior portions of V1, V2, and V3
contain representations of the contralateral lower visual field, whereas the
inferior portions of V1, V2, VP, and V4v represent the contralateral upper
visual field. V3A represents both the lower and upper contralateral field. Areas
V1, V2, VP, V3, V3A, and V4v are classical retinotopic areas that have been
described previously. We did not attempt to explicitly identify retinotopic
areas anterior to these areas. There are additional retinotopic areas, including
V7 and V8, whose cruder retinotopy has been demonstrated only with high-field
scanning (Hadjikhani, Liu, Dale, Cavanagh, & Tootell, 1998; Tootell et al., 1998a;
Wade, Brewer, Rieger,& Wandell, 2002). Also, there is still debate regarding the
appropriate definition of visual areas in this region. This fringe retinotopy
region has also been shown to be activated by both left and right visual fields
(Tootell, Mendola, Hadjikhani, Liu, & Dale, 1998b). Thus, the evidence suggests that areas
V7 and V8 lie near the end of a continuum of decreasing retinotopy and
increasing receptive field sizes.
2.5.2 Region of interest analysis
To generate ROIs specific to a given visual area,
patches of flattened cortex that corresponded to each retinotopic area were
defined based on the retinotopic field sign map for each subject (Mendola et
al., 1999). These objectively defined borders
were available for visual areas V1, V2 (superior and inferior), V3, VP, V3A, and
V4v. The eccentricity range of these ROIs was approximately
1-15 º. Specifically, the vertical
eccentricity was 7.5 º and the horizontal eccentricity was
12.5 º, making the maximum (diagonal) eccentricity
15 º. The outer extent of the ROI was based on the actual
activation present. Because the resolution of these maps is typically too low to
measure the extremely high cortical magnification factor in the central foveal
representation, the ROIs did not include the entire foveal representation. The
minimum eccentricity value varied slightly from subject to subject, but was
between 1-2 deg for most (see Figure 5). For
each subject, the Freesurfer software program was used to draw the outline of
each visual area for each hemisphere. In this way, we defined the boundaries of
six visual areas for the 10 adults and 10 children with interpretable field sign
maps. For visual area V2, an ROI was drawn for the superior/dorsal branch and
another for the inferior/ventral branch (see Figure 2), although the results for these
branches were combined in subsequent analysis. For all RO1s except V1, the
flattened cortex was used for visualization. For V1, the inflated cortex was
used for visualization so that the split along V1 in the flattened view did not
interfere with definition. Regardless of the view chosen for visualization, all
ROIs exist in native (folded) coordinates when measurements are
made. Figure 2. Retinotopic mapping results from one
child. A. Eccentricity representation is shown on a flattened representation of
the right occipital pole. Light and dark grays indicate the unfolded gyri and
sulci, respectively. Red, green, and blue indicate the central 1.5-deg,
1.5-5-deg, and 5-15-deg eccentricity. The adjacent semicircular logo depicts
this color scheme in the corresponding left visual field. B. Polar angle
representation is shown in the same subject. As indicated in the adjacent logo,
red and green indicate the upper and lower vertical meridians, and blue
indicates the horizontal meridians. C. Data sets in A and B are combined to
yield the field sign map that indicates the boundaries of multiple visual areas.
Yellow indicates areas with quarter or hemi-field representation; blue areas
have the opposite field sign (i.e., a mirror-reversed map).
2.5.3 Cortical magnification factor analysis
To further compare the internal organization of the V1
and V2 retinotopic map in children and adults, we computed the cortical
magnification function as has been done previously by others for adult subjects
(Sereno et al., 1995; Engle et al., 1997; Duncan & Bonton, 2003). This first required definition of an
approximately iso-polar ROI along the representation of the horizontal meridian
within V1 for every subject. This was done by applying a filter to the V1 ROI to
accept voxels with polar angle phase values at the horizontal meridian (90 deg)
± 15 deg. We then determined the eccentricity phase values of all voxels in
this ROI. These voxels were sorted according to distance from a reference point
at the occipital pole defined in every subject. The distance was computed as the
arc distance along the inflated cortical surface in spherical space, allowing us
to express distance along the cortical sheet, regardless of cortical folding
pattern. The distance of each voxel was then plotted against its eccentricity
phase value (or the equivalent degrees of visual angle). Finally, this curve was
fit with an exponential function that best fit the least square data.
Specifically,
where
x is the cortical
distance and y is
the eccentricity. The process for V2 was equivalent, except that the 30-deg
filter was centered on oblique polar angles (135 deg for V2v and 45 deg for
V2d), so as to fall along the center of those areas. One adult subject and one
child subject, with poor quality polar angle maps, did not satisfy our criteria
of least squares R2 fit
greater than 0.5, and were excluded from this
analysis. 2.5.4 Across-subject analysis
Directly averaging fMRI data across subjects is an
inherently difficult task, due to the differences in the size, shape, and even
functional organization of subjects’ individual brains. Using common
spaces, such as the traditional neurosurgical space of Talairach and Tournoux
( 1988) or even more modern versions such as the
space defined by 152 adult subjects at the Montreal Neurological Institute
(Evans et al., 1993), introduces a large
amount of spatial blurring into the data set. Typical variability between
presumably homologous points in subjects is of the order of 1 cm in Talairach
space. Given that individual visual areas have a (flattened) width of about 1
cm, such averaging procedures seriously degrade the quality of retinotopic maps.
Nonetheless, across-subject averaging remains a desirable goal. Specifically, to
compare the retinotopic maps obtained beyond the 6 defined visual areas in
parietal and temporal cortex, we need a strategy that does not require
ROIs.
Thus,
to compare the adult and child groups, we used a new technique for
across-subject analysis, adapted to the folding pattern of each subject, that is
significantly more accurate (Fischl, Sereno, Tootell, & Dale, 1999b). Each adult's inflated cortical surface
was first registered to a standardized average inflated unit-sphere based on
alignment of gyral and sulcal patterns using techniques described elsewhere
(Fischl et al., 1999b). To combine
functional data across individuals for a group comparison,
F-value
data sets were then re-sampled into spherical space and subsequently averaged
across subjects using a fixed-effects model (i.e.,
F ratio numerator is summed real plus
imaginary components squared, and denominator is the summed noise variance
divided by number of subjects). Extension of these methods to random effects is
desirable, but will require accounting for multiple comparisons on the surface,
and clustering approaches may not be appropriate for retinotopic data. Finally,
the average F-value map was painted (via the spherical transformation) onto the inflated surface of one adult. Separate maps were created for the eccentricity and polar angle stimulus in each hemisphere. The entire analysis was subsequently repeated for the group of children.
It should be noted that the standardized spherical
template currently available in Freesurfer was created with adult brains.
Therefore, the children’s brains require somewhat more distortion than the
adult’s when placed into spherical space. To document this, the Jacobian
determinant of each vertex can be computed to indicate how much the
transformation expands or shrinks each vertex in the brain (expansion results in
values greater than 1, whereas contraction produces values less than 1). For the
entire right hemisphere, the mean adult variance from 1 was 1.5, whereas the
child variance was 2.1, whereas left hemisphere values were 1.4 and 2.1. The
comparison of variances across groups with a
t test approached significance
(p = .06 and
p = .05,
respectively).
3.1 Individual phase-encoded maps
Maps of eccentricity and of polar angle were obtained
as has been reported previously for adult subjects (Sereno et al., 1995). Eccentricity maps showed the well-known
organization, with central vision represented at the pole and peripheral vision
more anteriorly. Polar angle maps were obtained with vertical meridian
representation separating V1 and V2, and horizontal meridian separating V2 from
V3 and VP. V3 and VP were separated from V3A and V4v by lower and upper vertical
meridian, respectively. Similar maps were obtained from the children ( Figure 2A and 2B).
To better localize the
boundaries between areas, we used the eccentricity and polar angle data to
compute a field sign map (Sereno et al., 1995). All adult subjects produced maps of
sufficient quality to identify the six retinotopic areas described for humans
(V1, V2, V3, VP, V3A, and V4v). We obtained interpretable maps in 10 of 15
children, and these maps were qualitatively similar to those seen in adult
subjects. An example is shown of one 11-year-old subject (see Figure 2C).
Observation during the
experiments, subjective reports from the children, and head motion artifacts
indicated that head motion likely contributed to the poor quality of maps in the
other five subjects. Four of these subjects were among the youngest subjects,
7-9 years old. These subjects were excluded from further
analysis.
To quantify the head motion in each of the experimental
scans, we used the motion-correction algorithm in AFNI. For each subject we
extracted the average motion in all three directions as the vector magnitude of
translational motion. This value ranged from 0.2-0.5 mm for adults and 0.3-2.0
mm for children ( Figure 3). Pearson Product
correlations were performed to look for any consistent relation between age and
corrected head motion, especially in the young group. We did not find a
significant correlation in the child group
( R2 = 0.07) or the adult
group ( R2 =
0.34). Figure 3. Comparison of average head motion
during the fMRI scans for adults and children. Each data point represents the
vector magnitude of translational head motion detected by the motion-correction
algorithm. Adults are indicated with blue diamonds, children with red squares.
As a population, children produced more movement, but some children were
indistinguishable from adults. The thick horizontal black line serves as a
reference mark.
3.3 Region of interest analysis for across group comparisons
Thus far,
qualitative inspection of the
retinotopic maps from representative children and adults did not suggest
consistent differences between groups. However, it is important to be able to
quantify measures from individual
visual areas that can be averaged across subjects to address any systematic
group differences. For the 10 adults and 10 children with interpretable field
sign maps, regions of interest were created for the six visual areas (V1, V2,
V3, V3A, VP, and V4v). A seventh ROI entitled "All" was defined to include all
six visual areas. These ROIs were used to separately extract from our data the
average fMRI signal Fourier magnitude of all voxels located in each of the six
visual areas. We also directly calculated the surface area of visual area ROIs
as described in Section 2.2.
3.3.1 Measures of signal magnitude
The average Fourier magnitude was calculated for all
voxels in a given visual area, for the left and the right hemispheres
separately. The results are listed in Tables 1 and 2.
|
Visual Area
|
Child LH polar
|
Adult LH polar
|
Sig.
p LH polar
|
Child LH eccen
|
Adult LH eccen
|
Sig.
p LH eccen
|
|
V1
|
3.1
|
2.6
|
-
|
7.6
|
5.4
|
-
|
|
V2
|
3.7
|
3.3
|
-
|
9.5
|
6.7
|
-
|
|
V3
|
5.7
|
4.7
|
-
|
12.4
|
9.3
|
-
|
|
V3A
|
5.3
|
4.1
|
-
|
9.3
|
7.2
|
-
|
|
VP
|
4.0
|
3.9
|
-
|
9.8
|
6.4
|
-
|
|
V4v
|
3.9
|
4.1
|
-
|
5.7
|
5.6
|
-
|
|
All
|
25.7
|
22.7
|
-
|
54.3
|
40.6
|
-
|
Table 1 . Left hemisphere
differences between children and adults for polar angle and eccentricity Fourier
magnitude across visual areas.
|
|
Child
RH
polar
|
Adult
RH
polar
|
Sig.
p
RH
polar
|
Child
RH
eccen
|
Adult
RH
eccen
|
Sig.
p
RH
eccen
|
|
V1
|
2.0
|
3.0
|
-
|
5.8
|
4.9
|
-
|
|
V2
|
3.1
|
4.0
|
-
|
8.4
|
7.1
|
-
|
|
V3
|
6.3
|
5.1
|
-
|
13.0
|
7.6
|
-
|
|
V3A
|
4.5
|
3.1
|
-
|
7.8
|
6.6
|
-
|
|
VP
|
3.2
|
5.2
|
0.007
|
8.6
|
8.3
|
-
|
|
V4v
|
4.9
|
4.1
|
-
|
8.9
|
5.8
|
-
|
|
All
|
24.0
|
24.5
|
-
|
52.4
|
40.3
|
-
|
Table 2. Right hemisphere differences between
children and adults for polar angle and eccentricity Fourier magnitude across
visual areas.
Direct comparison between evoked fMRI signal in each
area for adults and children was performed with
t tests. For the polar angle stimulus,
only the right VP was significantly different, having a larger value in adults.
Next section we consider this difference in relation to the size of the visual
areas.
Pearson Product correlations were also performed to
look for any developmental relation between age and Fourier magnitude, as well
as between corrected head motion and signal magnitude, especially in the young
group. There were no significant correlations between magnitude and head motion
for either group. There were several visual areas that showed a significant
correlation between magnitude and age within the child group. However, the
magnitude was negatively correlated with age, and may be due, in part, to the
unusual coincidence that four of our youngest children were scanned on the same
day. Also, the areas showing this correlation were not consistent between
hemispheres. No correlations with age were significant for the adult
group. 3.3.2 Measures of visual area size
For each subject in both groups, the size of the six
visual areas was analyzed in terms of absolute surface area in mm 2,
and as a relative proportion of the total cortical sheet. The adult group and
the child group were then directly compared. The results are listed in Tables 3 and 4.
|
|
Child
LH
mm2
|
Adult
LH
mm2
|
Sig.
p
LH
mm2
|
Child
LH
%
|
Adult
LH
%
|
Sig. p
LH
%
|
|
V1
|
1102
|
1182
|
-
|
1.3
|
1.4
|
-
|
|
V2
|
851
|
1194
|
0.02
|
1.0
|
1.4
|
0.02
|
|
V3
|
417
|
580
|
0.04
|
0.5
|
0.7
|
0.05
|
|
V3A
|
513
|
678
|
-
|
0.6
|
0.8
|
-
|
|
VP
|
496
|
678
|
-
|
0.6
|
0.8
|
-
|
|
V4v
|
484
|
738
|
0.01
|
0.6
|
0.9
|
0.02
|
|
All
|
3865
|
5049
|
0.02
|
4.7
|
5.5
|
0.03
|
Table 3. Left hemisphere differences between
children and adults for visual area size.
|
|
Child
RH
mm2
|
Adult
RH
mm2
|
Sig.
p
RH
mm2
|
Child
RH
%
|
Adult
RH
%
|
Sig. p
RH
%
|
|
V1
|
1219
|
1155
|
-
|
1.5
|
1.4
|
-
|
|
V2
|
866
|
1161
|
0.02
|
1.1
|
1.4
|
0.04
|
|
V3
|
381
|
502
|
0.04
|
0.5
|
0.6
|
0.07
|
|
V3A
|
549
|
540
|
-
|
0.7
|
0.6
|
-
|
|
VP
|
462
|
667
|
0.003
|
0.6
|
0.8
|
0.02
|
|
V4v
|
597
|
648
|
-
|
0.7
|
0.8
|
-
|
|
All
|
4073
|
4673
|
0.07
|
5.1
|
5.6
|
-
|
Table 4. Right hemisphere differences between children and adults for visual area size.
The size of visual areas in both adults and children
covers a range of about 400-700 mm2, except for V1 and V2, which
ranged from 800-1200 mm2. The results indicated some small but
significant differences between the adults and children. Adults showed a
slightly larger extent of visual areas V2, V3, and V4v in the left hemisphere.
In the right hemisphere, visual areas V2, V3, and VP were significantly larger
in adults. In contrast, there was no difference in the extent of V1 between
groups.
One concern with the use of an absolute measure of
visual area ROI size is that children's brains might be globally smaller than
adult's. Hence, we compared cortical surface area for the entire neocortical
reconstruction of each hemisphere between children and adults. The left and
right hemisphere reconstructions yielded a mean measure of 81,734 and 81,128
mm 2 for the children, and 87,009 and 86,011 mm 2 for
adults. The adult's brains were larger than the children's brains, but the
effect was not significant ( p = 0.12
for left hemisphere; p = 0.13 for right
hemisphere). Nevertheless, given the obvious
developmental trend, a measure of ROI size relative to the total neocortical
sheet may be a valuable measure ( Tables 3 and 4). Overall, individual visual areas range from 0.5-1.5% of
the cortical sheet, and all six visual areas combined occupy about 5% of the
neocortex in one hemisphere. When the adults and children were compared, the
results were highly consistent with the comparisons of absolute size in that
similar extrastriate areas proved to be slightly larger in adults. The total
proportional size of the visual areas of both hemispheres in children and adults
is shown graphically ( Figure
4). Figure 4. Comparison of size of visual areas in
children and adults. The total combined area (as a percentage of the entire
cortical sheet) of homologous visual areas in both hemispheres is plotted. A
significant difference between groups is indicated with an asterisk.
Pearson Product correlations were performed to look for
any consistent developmental relation between age and surface area, especially
in the young group. However, we found no significant correlations for the child
or the adult group.
It is interesting to consider the fact that the mean
level of Fourier magnitude did not differ between children and adults, yet we
observed a correlation between Fourier magnitude and children's age. In
contrast, mean areal size did differ between children and adults, yet no
correlation was found between size and age.
This suggests that the Fourier magnitude measure was more variable than
areal size, and this is indeed the case. To document this efficiently, we
calculated the coefficient of variance (CV) as the
SD divided by the mean. Fourier
magnitude measures for children's visual areas had a CV in the range of 50-55%;
adults produced values ranging from 35-45%. Measures of areal size (absolute and
normalized) had a CV in the range of 15-30% for both children and adults.
It is well known in the neuroimaging field that
magnitude of fMRI signals cannot typically be separated from the extent of
activation. However, in the case of phase-encoded retinotopy, the situation is
different. Signal magnitude is not directly used to determine the size of the
visual areas, although a minimal magnitude is required to carry the
phase-encoded signals. The preceding paragraph certainly documents that these
two variables showed different patterns in our results. For a few visual areas,
we did observe a significant correlation between Fourier magnitude and area
size, but these did not dominate the data set and showed no clear consistency.
Specifically, for children, normalized area was correlated with magnitude for
left V4v and right V2 for eccentricity, and right All for polar angle. For
adults, normalized area was correlated with magnitude for left VP for
eccentricity, and left V4v for polar
angle. 3.4 Cortical magnification function for across-group comparisons
In addition to measures of Fourier magnitude, our
methods provide information about the phase of the MRI signal for each voxel
within a visual area. A smooth progression of phase values is produced by the
eccentricity and polar angle stimuli (the retinotopic map). An important feature
of this map is the amount of cortex devoted to representing a unit of visual
space, and this can be plotted as a cortical magnification function. We computed
the cortical magnification function for areas V1 and V2 in children and adults.
For each subject, we plotted stimulus eccentricity versus cortical distance from
the occipital pole along the horizontal meridian in V1.
The curves from each subject were well fit by
exponential functions ( R2
> 0.5). Moreover, the average adult and children curves were fit with
R2 values of 0.94 and 0.96,
respectively ( Figure 5). The mean fitted
exponent was 0.74 for the adults and 0.71 for the children. The two subject
groups did not have a different distribution of exponential values. This was
true when the fit was done after placing data in 1-deg bins to make Figure 5
( p = .66) and in the case of the
non-binned data ( p = .96). Thus, our
data indicate no difference in the precise retinotopic mapping function,
although it can be seen that the variance of the child group was somewhat
greater. Figure 5. Comparison of cortical magnification
functions in area V1 for children and adults. Eccentricity is plotted against
cortical distance from the occipital pole along the horizontal meridian.
For V2, we measured the cortical magnification function
for both the ventral and dorsal branch, V2v and V2d ( Figure
6). The results were similar to those for V1. Specifically, for V2v we
obtained R2 values of 0.98
and 0.97 for adults and children. The mean fitted exponential value is 0.073 for
the adults and 0.057 for the children. For V2d,
R2 values are 0.96 and 0.92
for adults and children. The mean fitted exponential value is 0.081 for the
adults and 0.080 for the children. The two subject groups do not have a
different distribution of exponential values for V2v
( p = .66) or V2d
( p = .99). With regard to any
differences between the exponential function for V2v and V2d, there is a
significant difference for the children
( p = .01) with V2d showing a steeper
slope than V2v. The same trend is observed in
adults. Figure 6.
Comparison of cortical magnification functions in areas V2v and V2d for children
and adults. Eccentricity is plotted against cortical distance from the occipital
pole.
3.5 Cortical surface averaging for across-group comparisons
The parietal, lateral occipital, and temporal cortical
regions are not thought to contain precise retinotopic maps, but cruder
retinotopic biases may, in fact, exist (e.g., Malach, Levy, & Hasson, 2002; Hasson, Levy, Behrmann, Hendler, &
Malach, 2002). To compare phase-encoded
retinotopic signals in these regions, we could not use the ROI strategy because
the field sign maps do not extend into these cortices, and thus do not provide a
method for identifying visual area boundaries. Using anatomically defined ROIs
to directly compare children and adults was rejected due to uncertainty
regarding homologous points in the cortex of these two groups. The two groups
could nevertheless be compared by creating maps that show the average activation
pattern for all children and for all adults.
Specifically,
we used a new technique for performing across-subject averaging (Fischl et al.,
1999b). This new solution is based on a
spherical surface template, and provides significantly improved accuracy over
volume-template techniques. This method uses the cortical surface
reconstructions that we made for every subject, is based on localizing position
relative to the 2D cortical sheet, and is adapted to the folding pattern of each
individual subject.
We thus made across-subject
averages of the statistical measure of Fourier magnitude based on the
F statistic. Average
F-statistic maps were produced for the
adult group and the children’s group. The results for the eccentricity
stimulus indicate a larger extent of signal in the adult subjects in parietal
cortex ( Figure 7). Inspection of the
individual data revealed that this was a consistent trend in the groups, for
both hemispheres. Seven out of 10 adults showed some activation in the middle
and/or anterior extent of the intraparietal sulcus, whereas only three children
passed these criteria. Figure 7. Comparison of eccentricity signals in
lateral occipito-temporal cortex for adults and children. Top. The yellow-red
color scale shows the Fourier magnitude measured as an
F statistic averaged across 10 adults
and plotted on the lateral view of the inflated right and left hemispheres of
one representative adult. The central annular symbol indicates the geometry of
the eccentricity stimulus. Bottom. The equivalent data are shown for the group
of 10 children. The two groups appear qualitatively similar, except for weak
signals observed in the parietal cortex of adults that are not visible for the
children.
The results for the polar angle stimulus showed that
the children and adults differed in the direction of their hemispheric
laterality ( Figure 8). The adult group
produced more activity in the right hemisphere, whereas the children displayed
more activity in the left hemisphere. This finding was consistent at the level
of individual subjects. Five adults and six children showed asymmetric
activation in the direction stated above, with only one child and adult showing
the opposite. This one adult was left-handed, but the child was
right-handed. Figure 8. Comparison of polar angle signals in
lateral occipito-temporal cortex for adults and children. Top. The yellow-red
color scale shows the Fourier magnitude measured as an
F statistic averaged across 10 adults
and plotted on the lateral view of the inflated right and left hemispheres of
one representative adult. The central wedge symbol indicates the geometry of the
polar angle stimulus. Bottom. The equivalent data are shown for the group of 10
children. The adults and children differ with respect to which hemisphere shows
an advantage in the extent of significant signal (highlighted with green
arrows).
In contrast to these differences, the maps of Fourier
magnitude F statistic in adults and
children appeared qualitatively similar in the ventral temporal cortices of both
hemispheres ( Figure
9). Figure 9. Comparison of eccentricity and of polar
angle signals in ventral temporal cortex for adults and children. Top. The
yellow-red color scale shows the Fourier magnitude measured as an
F statistic averaged across 10 adults
and plotted on the ventral view of the inflated right hemisphere of one
representative adult. The annular or wedge symbols indicate when eccentricity or
polar angle data are shown. Bottom. The equivalent data are shown for the group
of 10 children. The two groups appear qualitatively similar.
The results of this study provide a quantitative
comparison of retinotopic mapping in adults and children. Retinotopic
organization in children older than 9 years and in adults is qualitatively
similar, and six classically reported visual areas could be readily identified
(V1, V2, V3, V3A, VP, and V4v). Small differences in regional signal magnitude
and areal size were documented, and suggest some developmental trends. According
to our experience, children younger than 9 years may require more training due
to greater head motion and less attention to task. Extra training may improve
success rates for this group.
Although motion artifact appeared to be the major
determinant of poor fMRI maps in our youngest subjects (aged 7 and 8 years), we
cannot completely exclude immaturity at the neural or hemodynamic levels. The
basic mechanism of image contrast in fMRI is known (called blood oxygenation
level dependent [BOLD]), but a detailed understanding of the coupling between
changes in neural activity and changes in blood oxygenation and flow has not yet
been achieved. It is not known if this mechanism changes during the course of
development. Some results have indicated a
negative BOLD response in the visual
cortex of sedated infants, raising the possibility of drastic developmental
changes in the BOLD mechanism (Born, Rostrup, Leth, Peitersen, & Lou, 1996, 1998;
Yamada, Sadato, & Konishi, 1997). Possible
reasons for differences in the BOLD signal in children include higher metabolic
rates at rest than in adults, perhaps supporting higher synaptic density (e.g.,
Chugani et al., 1988). However, sedation or
sleep may instead be the important variable here. Recently, a negative BOLD
response was obtained in children and in adults during slow wave sleep, as well
as in some cases of sedated adults (Born et al., 2002). Regardless of the precise role of these
factors in infants and young children, our own results and those of others
suggest that a positive BOLD response dominates in awake children by age 7-8
(Martin et al., 1999).
There
are several other concerns that apply to the comparison of children and adults
with fMRI, particularly comparison of magnitude measures. Many equipment-related
factors affect the exact magnitude of fMRI signals. Furthermore, unlike PET,
fMRI does not provide absolute measures of flow or oxygenation; only relative
changes can be detected. FMRI signal can be interpreted only with respect to
other "baseline" conditions, which is readily accomplished for within-group
comparisons (but see Friston et al., 1996).
However, a comparison between groups relies on the assumption that both the
baseline and the experimental brain states are the same (e.g., Bookheimer, 2000).
When
subjects perform a task during a scan, controlling for task difficulty becomes a
concern. If our groups did not perform the same task during the scanning, then
it naturally follows that differences in brain activation could be independent
of developmental state. In our case, it is possible that the children differed
in fixation stability or extrafoveal spatial attention. However, our fixation
task did not involve cognitively difficult reasoning or speeded reactions. To
reduce the demands on children with regard to sustained vigilance/attention, we
administered the scans in units of 4 min rather than 8 min. The adult-like
retinotopic maps we obtained from the children suggest that they did indeed
maintain fixation and attention. Moreover, for the six retinotopic areas, the
main effect was the normalized size of several extrastriate areas, and this
selective topographic effect is unlikely to be due solely to one of these
confounds.
Minimal differences in signal magnitude between
children and adults were observed in the ROI analysis, so we can probably
exclude major group differences due to head position in the coil or head motion.
Once we excluded the subjects with gross head motion artifacts, we observed no
correlation between head motion and Fourier magnitude. We did, however, find
that the Fourier magnitude measure was variable in children.
To compare the organization of primary visual cortex in
more detail, we computed the cortical magnification function in both children
and adults. We found that the children’s data did not differ from the
adult’s for V1 or V2. Our values were highly consistent with those
reported by previous studies (Engel et al., 1997). For example, the exponent fitted to the V1
data of Engel et al. was 0.063 for two adults, and the data from Sereno et al.
is approximately 0.082. These values are close to our value of 0.074 for 10
adults. Interestingly, the V1 cortical magnification factor has been shown to be
correlated with behavioral performance on Vernier acuity tasks (e.g., Duncan
& Boynton, 2003). Given that Vernier
acuity does not reach adult levels until age 14, the adult-like cortical
magnification factor we found for the child group is notable. This may be
another example in which development of complex sensorimotor behaviors may lag
relative to isolated physiological indices (in visual cortex).
We measured the surface area of retinotopic visual
areas in terms of absolute and proportional size. Similar data have recently
been reported for absolute size for three visual areas in adults only (Dougherty
et al., 2003). These authors obtained mean
sizes of 1470, 1115, and 819 mm for V1, V2, and V3. The value for V2 is the same
as our measurements, although our estimates for V1 and V3 are lower. There are
several methodological differences that could provide an explanation: cortical
flattening techniques, our use of field sign computations, and our use of manual
versus automatic tracing of visual boundaries. Nonetheless, all of our methods
were applied consistently to the adults and children, and should allow
meaningful comparison between the two groups.
Our data indicate that
extrastriate cortex was measurably smaller in children compared to adults. This
result was obtained for both absolute size and percentage of the entire
reconstructed neocortical sheet, suggesting that gross brain size is not a
relevant factor. Consistently, previous literature indicates no significant
change in cerebral volume after age 5 (Giedd et al., 1996; Reiss, Abrams, Singer, Ross, &
Denckla, 1996). The idea that extrastriate
cortex could mature later than striate cortex is confirmed by the results of
some previous reports. Ossenblok et al. ( 1994) concluded that striate activity dominates
the checkerboard onset evoked potential of the children aged about 4–8
years, whereas extrastriate activity grows later in life. A
posterior-to-anterior maturation gradient is also suggested by the few available
anatomical studies of children's brains (Garey & de Courten, 1983; Thompson et al., 2000; Sowell et al., 1999). Nonetheless, the fact that our data showed
adult-like cortical magnification functions in V2 despite its smaller size in
children may indicate that the overall size difference has limited functional
significance. Future studies of extrastriate cortical areas in children may help
clarify these issues.
We
performed whole brain across-subject averaging to assess the regional extent of
retinotopic activity in higher level cortex of the parietal, lateral occipital,
and temporal cortex. Based on gross anatomical homologies, the eccentricity
stimulus results suggest a slight trend toward greater activity in parietal
lobes of the adults. However, we cannot easily separate fixation task-related
activity from a true difference in retinotopy. Further study of spatial
perception and attention in children would be warranted. The most striking
difference between children and adults was seen for the polar angle stimulus ( Figure 8). However, caution is required when
interpreting these data, given that we could not directly compare the
hemispheres of adults and children. However, we can still see that within the
adult group, the right hemisphere produced more activity, whereas in the child
group, the opposite bias was seen. Furthermore, these suggestive differences
occur in the absence of differences elsewhere (e.g., ventral temporal
cortex).
There is only a small literature that speaks to
hemispheric lateralization during human cortical development, but there is
evidence that developmental rates do differ between hemispheres. However, no
simple left-right gradient is likely to exist, rather, regionally specific
effects have often been found at different ages (Thatcher, Walker, &
Giudice, 1987; Sowell, Thompson, Tessner,
& Toga, 2001). Given our lateralized
findings with the moving polar angle stimulus, one study that measured cortical
activity during a form-from-motion task in the left or right hemifield is quite
relevant (Hollants-Gilhuijs, Ruijter, & Spekreijse, 1998). This cross-sectional ERP study of children
and adults concluded that "maturation of motion sensitive areas of the
extrastriate cortex in children's right hemisphere is delayed with respect to
that of the homologous regions of the left hemisphere." The convergence of their
conclusion with our own is suggestive, although clearly more studies that
measure visual performance along with brain activity are required. Finally, it
may be relevant that cognitive tasks such as analysis of global versus local
object structure, when measured with fMRI, do not produce the adult-like degree
of hemispheric lateralization in many children aged 12-14 years (Moses et al.,
2002).
Despite
the subtle differences between adults and children we documented here, the
overall similarity between the groups is evident. The rather mature visual maps
seen in children aged between 9 and 12 years contrast with many cognitive
functions that mature much later, and fMRI is increasingly being employed to
study such protracted neurological development. For example, the first pediatric
fMRI study focused on immature frontal lobe function as assessed by working
memory (Casey et al., 1995). Recent
cross-sectional studies of reading (Turkeltaub et al., 2003) and visuo-spatial working memory (Kwon et
al., 2002) have included extensive behavioral
measures and document impressive amounts of both age- and performance-related
change. The relatively stable retinotopic visual representations during the
childhood-adolescence period may serve as a baseline for comparison to the more
protracted development of anterior
regions.
In this study, we measured retinotopic organization in
children in multiple visual areas for the first time. We demonstrated the
feasibility of applying techniques developed for adults, with only slight
modifications. The children were not given separate training sessions, although
the reports of other investigators indicate that this is an effective strategy
and could improve the success rate even further. In the future, the fMRI
technique, especially with longitudinal designs, should contribute greatly to
studies of brain development because experiments can be repeated to document
change over time. Cortical flattening methods can further facilitate the
accumulation of data from multiple experiments onto individual maps of visual
cortex. It will be possible to compare retinotopic maps in normal children to
children with visual disorders and monitor the effect of treatment variables
over time, an approach that is already revealing neurological effects of
remediation in children with dyslexia (Temple et al., 2003).
Supported by COBRE Grant P20RR15574, Project 2, from
NIH/NCRR to JM. We thank Mathis Frick, Doug Greve, Bruce Fischl, Sean Marrett,
Ray Raylman, and Ruth Walsh for their valuable contributions. Portions of this
work were presented at the 2002 Vision Sciences Society Conference in Sarasota,
FL (Conner, Sharma & Mendola, 2002). Commercial
Relationships: None.
Corresponding author: Janine Mendola.
Email: jmendola@hsc.wvu.edu.
Address: WVU Health Sciences Center, PO Box 9236, Morgantown, WV 26506, USA.
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