When seeing depends on knowing: Adults with Autism Spectrum Conditions show diminished top-down processes in the visual perception of degraded faces but not degraded objects

Behavioural, neuroimaging and neurophysiological approaches emphasise the active and constructive nature of visual perception, determined not solely by the environmental input, but modulated top-down by prior knowledge. For example, degraded images, which at first appear as meaningless ‘blobs’, can easily be recognized as, say, a face, after having seen the same image un-degraded. This conscious perception of the fragmented stimuli relies on top-down priming influences from systems involved in attention and mental imagery on the processing of stimulus attributes, and feature-binding [Dolan, R. J., Fink, G. R., Rolls, E., Booth, M., Holmes, A., Frackowiak, R. S. J., et al. (1997). How the brain learns to see objects and faces in an impoverished context. Nature, 389, 596-599]. In Autism Spectrum Conditions (ASC), face processing abnormalities are well-established, but top-down anomalies in various domains have also been shown. Thus, we tested two alternative hypotheses: (i) that people with ASC show overall reduced top-down modulation in visual perception, or (ii) that top-down anomalies affect specifically the perception of faces. Participants were presented with sets of three consecutive images: degraded images (of faces or objects), corresponding or non-corresponding grey-scale photographs, and the same degraded images again. In a passive viewing sequence we compared gaze times (an index of focal attention) on faces/objects vs. background before and after viewers had seen the undegraded photographs. In an active viewing sequence, we compared how many faces/objects were identified pre- and post-exposure. Behavioural and gaze tracking data showed significantly reduced effects of prior knowledge on the conscious perception of degraded faces, but not objects in the ASC group. Implications for future work on the underlying mechanisms, at the cognitive and neurofunctional levels, are discussed.     

Event Schemas in Autism Spectrum Disorders: The Role of Theory of Mind and Weak Central Coherence

Event schemas (generalized knowledge of what happens at common real-life events, e.g., a birthday party) are an important cognitive tool for social understanding: They provide structure for social experiences while accounting for many variable aspects. Using an event narratives task, this study tested the hypotheses that theory of mind (ToM) deficits and weak central coherence (WCC, a local processing bias) undermine different aspects of event knowledge in people with autism spectrum disorder (ASD). Event narratives of ASD ToM-failers were overall significantly impaired. ASD ToM-passers showed more specific abnormalities relating to variable activities, and some of these were significantly associated to WCC. Abnormalities in event knowledge might help linking ASD-typical social deficits in real-life situations and the adherence to inflexible routines.     

Neonatal alloimmune thrombocytopenia caused by human leucocyte antigen-B27 antibody

Neonatal alloimmune thrombocytopenia (NAIT) occurs when maternal alloantibodies to antigens presented on foetal platelets cause their immune destruction. Whether human leucocyte antigen (HLA) antibodies can cause NAIT is controversial. Here, a patient was described who suffered from a NAIT caused by an HLA-B27 antibody. Sera from the mother and the newborn were tested for human platelet antigen antibodies and HLA antibodies by monoclonal antibody-specific immobilization of platelet antigens (MAIPA) assay, solid phase-linked immunosorbent assay (ELISA), lymphocytotoxicity assay (LCT) and flow cytometric analysis. No antibodies against cluster designation (CD)109 and platelet glycoproteins of the father were found in patient's and mother's serum. However, HLA ELISA was used to identify HLA antibody in both sera. The antibody was specified as HLA-B27 antibody. Typing results showed that the father descended HLA-B27 antigen on patient and his brother. The mother was HLA-B27 negative. It is most conceivable that the previous pregnancy of the mother induced the production of anti-HLA-B27 antibody, which crossed the placenta and subsequently caused an NAIT in the case presented.     

MR-Intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study

PURPOSE: To develop a noninvasive method for intracranial elastance and intracranial pressure (ICP) measurement. MATERIALS AND METHODS: Intracranial volume and pressure changes were calculated from magnetic resonance (MR) imaging measurements of cerebrospinal fluid (CSF) and blood flow. The volume change was calculated from the net transcranial CSF and blood volumetric flow rates. The change in pressure was derived from the change in the CSF pressure gradient calculated from CSF velocity. An elastance index was derived from the ratio of pressure to volume change. The reproducibility of the elastance index measurement was established from four to five measurements in five healthy volunteers. The elastance index was measured and compared with invasive ICP measurements in five patients with an intraventricular catheter at MR imaging. False-positive and false-negative rates were established by using 25 measurements in eight healthy volunteers and six in four patients with chronically elevated ICP. R:ESULTS: The mean of the fractional SD of the elastance index in humans was 19.6%. The elastance index in the five patients with intraventricular catheters correlated well with the invasively measured ICP (R:(2) = 0.965; P: <.005). MR imaging-derived ICPs in the eight healthy volunteers were 4.2-12.4 mm Hg, all within normal range. Measurements in three of the four patients with chronically elevated ICP were 20.5-34.0 mm Hg, substantially higher than the normal limit. CONCLUSION: MR imaging-derived elastance index correlates with ICP over a wide range of ICP values. The sensitivity of the technique allows differentiation between normal and elevated ICP.     

Hemodynamics of in-tandem stenosis of the internal carotid artery: when is carotid endarterectomy indicated?

BACKGROUND: Recent publications have pointed out the importance of evaluating patients with in-tandem stenosis and in particular the association of moderate stenosis of the extracranial internal carotid artery (ICA) with moderate or severe stenosis of the intracranial internal carotid artery. Such evaluations are needed in symptomatic patients before planning carotid endarterectomies because observations have shown that in some cases the removal of an extracranial lesion does not necessarily improve these symptoms. This paper examines the hemodynamic effects of in-tandem stenosis in the internal carotid artery. METHODS: Equations describing flow in arteries are modified to accommodate two regions of stenosis in tandem. An equivalent value of stenosis is derived such that two stenoses in tandem behave as a single stenosis with similar hemodynamic properties. The solution to this problem is solved mathematically and this was used to analyze the observations made in five studies published on in-tandem stenosis of the internal carotid artery. RESULTS: Equivalent stenoses for various values of extracranial and intracranial stenoses are presented. It was found that two stenotic lesions in tandem are not equivalent to a simple summation of both values. A graphical solution is presented to show the hemodynamic effects of both stenoses. CONCLUSIONS: The most critical determinant of hemodynamic compromise when two lesions are in tandem is the larger one. Hence removal of a more proximal lesion may have little effect on a larger distal lesion if the symptoms are due to hypoperfusion. It is important that one distinguish between hypoperfusion and thromboembolic causes of the symptoms. No conclusions about the risk of thromboembolic events after a carotid endarterectomy in the setting of a distal stenosis can be made from this study.