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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
11

Sensibilité cérébrale à la lumière en fonction du vieillissement et d’aspects physiologiques fonctionnels de l’œil

Daneault, Véronique 05 1900 (has links)
Outre ses effets sur le système visuel classique permettant la formation des images, la lumière agit sur plusieurs fonctions « non-visuelles ». Celles-ci incluent la constriction pupillaire, la température corporelle, la sécrétion hormonale, le cycle veille-sommeil, la vigilance et les performances cognitives. Les fonctions non-visuelles sont préférentiellement sensibles aux lumières à longueurs d’ondes courtes (lumière bleue) en comparaison aux longueurs d’ondes plus longues (lumière verte). Il est proposé que le vieillissement s’accompagne d’une diminution de la sensibilité des fonctions non-visuelles à la lumière. Cette recherche vise à évaluer les effets de l’âge sur la constriction pupillaire et la sensibilité cérébrale à la lumière lors de l’exécution de tâche cognitive. Deux groupes de sujets, 16 jeunes (18-30 ans) et 14 âgés (55-70 ans), ont suivis un protocole de pupillométrie visant à mesurer la dynamique pupillaire lors d’exposition à des lumières bleues et vertes monochromatiques de trois intensités différentes. Les résultats ont montré davantage de constriction en bleu qu’en vert et des effets plus importants suivant l’augmentation de l’intensité lumineuse. Nos résultats ne montrent cependant pas de différence d’âge sur la constriction pupillaire à la lumière suggérant la préservation de cette réponse non-visuelle. Dans un deuxième temps, les mêmes sujets ont exécuté une tâche cognitive en imagerie par résonance magnétique fonctionnelle (IRMf) tandis qu’ils étaient maintenus dans la noirceur, ou exposés à des lumières bleues. Les résultats ont montré une diminution des effets de la lumière avec l’âge dans le thalamus, l’amygdale, l’insula et l’aire ventrale tegmentale, régions engagées dans la vigilance, l’attention et les processus émotionnels. Les modifications qui s’opèrent sur les différentes fonctions non-visuelles avec l’âge ne semblent pas homogènes. Ces résultats corroborent les évidences animales qui montrent différents seuils de sensibilités à la lumière et la présence de réseaux neuronaux partiellement indépendants pour les diverses réponses non-visuelles. De plus, ils sont les premiers à démontrer que les effets neuronaux stimulants de la lumière bleue sur la cognition sont diminués avec l’âge. Les recherches devront évaluer si cette diminution de sensibilité influence les performances cognitives au cours du vieillissement. Enfin, un raffinement de nos connaissances permettra de mieux adapter l’environnement lumineux avec l’âge. / Notwithstanding its effects on the classic visual system allowing image formation, light acts upon several «non-visual» functions including body temperature, hormonal secretions, sleep-wake cycle, alertness and cognitive performances. Results have shown that non-visual functions are maximally sensitive to blue wavelength (460-480nm), in comparison the longer light wavelengths (i.e. green: 550nm). Changes as to the sensitivity of these responses during the aging process were reported. In our research project, two groups of subjects, 16 young (18-30) and 14 older (55-70), followed a pupillometry protocol in order to measure the pupillary dynamic while being exposed to three different intensities of blue and green monochromatic lights. Results revealed more constrictions in blue than in green lights, and significant effects following the increase of light intensity. Our results also demonstrated a similar pupillary constriction between the two age groups, suggesting that this non-visual response remains intact with age. In the second phase, the same subjects executed cognitive tasks involving functional magnetic resonance imaging while maintained in darkness, or exposed to blue monochromatic lights. Results indicate a decrease of the impact of light with age namely, at the level of the thalamus, amygdala, insula and in the tegmental ventral area. These brain regions are involved in alertness, awakeness, attention and emotional processes. Consequently, the modifications which occur in the different non-visual responses during the aging process do not appear to be homogeneous. Our results are coherent with animal evidences which demonstrate different sensitivity thresholds to light and the presence of neuronal networks partially independent for various non-visual responses. In addition, they are the first indications of a decrease of the stimulating neuronal effects of light during the aging process. Future studies will help to verify whether the brain sensitivity reduction is linked to age-related behavioral differences. A better understanding of light effects on non-visual functions will permit an adapted light exposure in healthy aging and will also contribute to optimal lighting environment.
12

Emotion effects in visual language processing

Bayer, Mareike 19 December 2011 (has links)
Emotionale Bedeutung erleichtert die Verarbeitung geschriebener Sprache. Dies zeigt sich sowohl in Verhaltensmaßen als auch in ereigniskorrelierten Potenzialen (EKPs) und resultiert vermutlich aus automatischer Aufmerksamkeitszuweisung auf Grund der hohen intrinsischen Relevanz von emotionalen Reizen. Die vorliegende Arbeit untersucht die Mechanismen von Emotionseffekten in geschriebener Sprache, insbesondere den Zeitverlauf der Emotionseffekte, die Beteiligung des peripheren Nervensystems, sowie die Rolle der Emotionsdimensionen Valenz und Erregung. Emotionseffekte in EKPs beginnen mit einer Latenz von 100 ms nach Stimulusonset. Dies deutet auf die Existenz eines schnellen und automatischen Erkennungssystems für emotionale Wörter hin. Zeitverlauf und Verteilung der Emotionseffekte weisen große Ähnlichkeit zu Befunden für emotionale Bilder auf und lassen auf ein domänenübergreifenden System zur Emotionserkennung schließen. Übereinstimmend mit dieser Annahme zeigen sich weitere Ähnlichkeiten in der Verarbeitung emotionaler Wörter und Bilder in einer Studie, die die Interaktion von stimulusbasierter Aufmerksamkeit und Emotion in der Wortverarbeitung untersuchte. Die Ergebnisse dieser Studie legen auf Grund des arbiträren Charakters von Schriftsprache den Schluss nahe, dass der Verarbeitungsvorteil für emotionale Reize zu einem geringeren Anteil als bisher vermutet auf biologischer Relevanz beruht. Neben diesen Ähnlichkeiten zeigt sich ein domänenspezifischen Unterschied in der Emotionsverarbeitung. Während die Darbietung emotionaler Bilder oft mit erhöhter Aktivierung des autonomen Nervensystems einhergeht, zeigen Befunde zur Pupillenaktivität, dass die Verarbeitung emotionaler Wörter nicht zwangsläufig zu autonomer Aktivierung führen muss; stattdessen scheint der Verarbeitungsvorteil für emotionale Wörter darauf zu beruhen, dass weniger kognitive Ressourcen für deren Verarbeitung notwendig sind. / Emotional meaning impacts the processing of written words, leading to facilitated processing that is visible not only in behavioral parameters, but also in event-related potentials (ERPs). It has been suggested that this processing benefit occurs because emotional stimuli involuntarily attract attention, possibly based on their higher intrinsic relevance. The present work investigates the conditions of emotion effects in word recognition, focusing on the time course of emotional processing, on the involvement of autonomic activation, and on contributions of emotional dimensions valence and arousal. In ERPs, emotion effects were evident from approximately 100 ms after stimulus onset, providing evidence for a fast and automatic detection and facilitation of emotional words. The time course and topography of emotion effects is in parallel to findings for affective pictures and suggests the existence of a common system for the extraction of emotional content across stimulus domains. In line with these findings, interactions of stimulus-triggered attention and emotion during word recognition are highly similar to interactions in picture processing. Due to the symbolic nature of words, this finding implies that emotion detection is less dependent on biological relevance than previously assumed. Apart from these analogies, the present results revealed a difference in emotional processing across stimulus domains. While affective pictures have frequently been reported to elicit augmented activity in the autonomic nervous system, evidence from pupillary responses indicates that emotional words do not mandatorily trigger autonomic activation. Instead, the processing advantage visible in behavioral measures seems to result from cognitive facilitation of emotional words.
13

The role of melanopsin containing retinal ganglion cells in the pupillary responses of human and non-human primates

McDougal, David H. January 2008 (has links) (PDF)
Thesis (Ph. D.)--University of Alabama at Birmingham, 2008. / Title from first page of PDF file (viewed Feb. 12, 2009). Includes bibliographical references (p. 136-146).
14

Gaze Gestures in Interaction with Problem-Solving / Gaze Gestures in Interaction with Problem-Solving

Vrzáková, Hana January 2011 (has links)
Tato diplomová práce byla vypracována při studijním pobytu na University of Eastern, Finland. Tato práce se zabývá analýzou pohybů očí jakožto charakteristiky lidských úmyslů. Během hraní hry 8Puzzle byly extrahovány pohyby očí a rozděleny na základě stisku tlačítka, které ve hře symbolizovalo hráčův úmysl pohnout herní kostičkou. Takto rozdělené sekvence představují reflexivní chování oka, tzv. pohledové gesto, které představují zdroj příznaků. Příznaky extrahované z pohybů očí pak popisují pohledová gesta spojená jak s úmysly a tak bez úmyslů. Nově bylo do analýzy zahrnuto také pozorování změn v zorničce jakožto zdroj informací, který by mohl pomoci v rozlišení úmyslných pohledů od pohledů bez záměru. Tento úkol zahrnuje binární klasifikaci, která byla realizována pomocí navrženého predikčního modelu s využitím SVM a RBF jádra. Tato práce se také zaměřuje na studium vlivu normalizace na celkové výsledky. Vyhodnocení modelu bylo realizování pomocí křivky pod grafem. Z výsledků bylo dobře patrné, že datová sada příznaků založená na fixacích a sakádách lépe rozlišila úmyslné sekvence od neúmyslných, zatímco úspěšnost sad příznaků postavených na odezvách pupily se pohybovala na hranici náhodného klasifikátoru. Přestože dosažené výsledky vyzývají k dalšímu studiu lidských úmyslů pomocí pohybů očí, přestože klasifikace v reálném čase na základě takto navržených příznaků by prozatím nebyla 100% spolehlivá.
15

Etudes des mécanismes de régulation émotionnelle chez les individus alcoolo-dépendants abstinents à l'alcool à court et à long terme / Studies of the mechanisms of emotional regulation in alcohol-impaired individuals who are alcohol-abstinent in the short and long term

Claisse, Caroline 17 May 2017 (has links)
Les dérèglements émotionnels ont été largement avancés dans le développement et le maintien des conduites addictives. Ces perturbations des processus émotionnels sont associées à l’utilisation privilégiée de stratégies compensatoires mal adaptées qui vont à leur tour entériner les conduites addictives et entraver une consolidation de l’abstinence. Ce travail vise une meilleure compréhension des facteurs de vulnérabilité de la rechute à l’alcool par l’étude de l’évolution des compétences émotionnelles avec l’abstinence à travers trois volets expérimentaux. Pour cela, nous étudierons spécifiquement les mécanismes de régulation émotionnelle considérés comme centraux dans la problématique addictive. Nous utiliserons des outils particuliers pour étudier ces mécanismes que sont des indicateurs physiologiques du système nerveux autonome.Dans un premier volet, nous avons étudié les réponses du système sympathique par la mesure du diamètre pupillaire en réponse à la présentation d’images neutres etémotionnelles (positives et négatives). Nous avons démontré qu’en situation d’induction émotionnelle les patients abstinents à court terme présentent une activation plus forte du système d’alerte sympathique que les abstinents à long terme et les participants contrôles. Le niveau intermédiaire de la réponse pupillaire observé chez les abstinents à long terme suggère une amélioration partielle dans l’activation sympathique à la présentation d’une information émotionnelle (étude 1). La variabilité de la fréquence cardiaque (VFC) est un indicateur du système parasympathique, est reconnue comme marqueur de la régulation émotionnelle. L’étude de la VFC avant pendant et après une situation d’induction émotionnelle a montré une normalisation de la VFC en réponse aux stimuli émotionnels avec une abstinence à long terme. Cependant, les résultats pour les stimuli à valence négative ne sont pas différents entre les groupes abstinents à court et à long terme. Ce pattern de réponse appuie l’hypothèse d’un maintien de vulnérabilité aux émotions négatives en dépit d’une abstinence prolongée. De plus, une corrélation négative a été observée pour les deux groupes de patients entre les scores de craving et une augmentation de la VFC (étude 2). Enfin, dans un dernier volet expérimental, nous avons investigué les compétences et difficultés de régulation émotionnelle par des autoquestionnaires(CERQ et DERS) auprès de patients abstinents de quelques semaines à plusieurs années. Les résultats supportent l’hypothèse d’une limite de récupération capacités après deux ans d’abstinence (étude 3). L’étude de l’étendue des récupérations des compétences émotionnelles est une piste majeure dans la consolidation de l’abstinence. Ces trois études confirment la récupération des compétences émotionnelles avec l’abstinence mais surtout la persistance d’une vulnérabilité dans les processus émotionnels. Le caractère partiel des récupérations de ces mécanismes suppose non seulement le maintien d’une vulnérabilité en dépit d’une abstinence prolongée et met également en évidence la nécessité d’un travail d’accompagnement dans la remédiation de ces compétences à long terme. Un ensemble de perspectives de recherches et d’applications cliniques s’ouvrent au regard de ces résultats, et seront ici discutées. / Emotional disorders are recognized as a major factor of development andcontinuity of addictive behavior. These perturbations of the emotional processes areassociated with the preference given to ill-suited compensatory strategies which will inturn perpetuate addictive behaviors and interfere with the consolidation of abstinence.This study aimed to give a better understanding of the vulnerability factors of alcoholrelapse by studying the evolution of emotional competence with abstinence over threeexperimental chapters. For this purpose, we looked more closely at the mechanisms ofemotional regulation, which are considered as crucial in the addiction problem. In orderto study these mechanisms we used specific tools like the physiological cues of theautonomic nervous system.In a first chapter, we studied sympathetic system response by measuringpupillary diameter after exposure to neutral and emotional pictures (positive andnegative). We showed that when exposed to emotional induction, short-term abstinentpatients showed a stronger activation of the sympathetic nervous system than long-termabstinent patients as well as the control group. The intermediary level of pupillaryresponse found among long-term abstinent patients suggests a partial improvement ofsympathetic activation when exposed to emotional information (study 1). Heart RateVariability (HRV) is an indicator of the parasympathetic system and is viewed as amarker of emotional regulation. The study of HRV before, during and after a situation ofemotional induction showed a normalization of HRV in response to emotional stimuliwith long-term abstinence. However, results for stimuli with negative valence are notdifferent between the long-term and short-term abstinence groups. This responsepattern supports the hypothesis that there is still a vulnerability to negative emotionsdespite the prolonged abstinence. Moreover, a negative correlation between cravingscores and increase of HRV has been observed for the two patient groups (study 2).Finally, in a last experimental chapter, emotional competence and emotional regulationdifficulties were assessed by presenting the Difficulties in Emotion Regulation Scale(DERS) and the Cognitive Emotion Regulation Questionnaire (CERQ) to few weeks tofew years abstinent patients. Results support the hypothesis of a recovery shift of twoyears of abstinence for these abilities (study 3).The study of the extent of the recoveries of emotional competence is a major leadfor the consolidation of abstinence. Those three studies confirm the retrieval ofemotional competence with abstinence but they particularly show the persistence of avulnerability in the emotional processes. The fact that there is a recovery shift for thosemechanisms not only involves the continuity of a vulnerability despite a prolongedabstinence, but also underlines the need of a work of support for the remediation ofemotional competence in the long term. These results can lead to several researchprospects and clinical applications that will be discussed here.
16

Pupilometria na investigação de diabetes mellitus tipo II / Pupilometry in the Investigation of diabetes mellitus type II

Silva, Cleyton Rafael Gomes 28 September 2018 (has links)
Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-11-14T12:45:33Z No. of bitstreams: 2 Dissertação - Cleyton Rafael Gomes Silva - 2018.pdf: 3259568 bytes, checksum: 21f7d8194e8929ef29e8df95ef8f6a0a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-11-14T13:02:15Z (GMT) No. of bitstreams: 2 Dissertação - Cleyton Rafael Gomes Silva - 2018.pdf: 3259568 bytes, checksum: 21f7d8194e8929ef29e8df95ef8f6a0a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-11-14T13:02:15Z (GMT). No. of bitstreams: 2 Dissertação - Cleyton Rafael Gomes Silva - 2018.pdf: 3259568 bytes, checksum: 21f7d8194e8929ef29e8df95ef8f6a0a (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-09-28 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Examining human pupillary behavior is a non-invasive, low-cost method for assessing neurological activity. Changes in this behavior are correlated to various health conditions, such as: Parkinson’s, Alzheimer’s, autism and diabetes. In order to obtain information about the pupillary behavior, it is necessary to measure the pupil diameter in procedures that induce pupillary reflexes, known as Pupilometry. Pupillary measurement is made by filming the procedures when applying computer vision techniques for pupil recognition. The objective of this research was to develop an Automated Pupilometry System (SAP) to support the investigation of patients with type II diabetes mellitus. SAP was able to record, induce, and extract 96 pupil features. In the experiment with 15 healthy patients and 16 diabetics, a 94% accuracy in the identification of diabetics type II was obtained, demonstrating the efficiency of SAP for the performance of examinations, and evidencing the potential of pupil use in the investigation of diabetes mellitus type II. / Examinar o comportamento pupilar humano é um método não-invasivo e de baixo-custo para avaliar atividade neurológica. Alterações neste comportamento são correlacionadas a várias condições de saúde, como: Parkinson, Alzheimer, autismo e diabetes. Para se obter informações do comportamento pupilar é necessário medir o diâmetro da pupila em procedimentos que induzem os reflexos pupilares, conhecidos como Pupilometria. A medição pupilar é feita por meio da filmagem dos procedimentos ao aplicar-se técnicas de visão computacional para reconhecimento da pupila. O objetivo desta pesquisa foi desenvolver um Sistema Automatizado de Pupilometria (SAP) para apoiar a investigação de pacientes com diabetes mellitus tipo II. O SAP foi capaz de gravar, induzir, e extrair 96 característicaspupilares. No experimento com 15 pacientes saudáveis e 16 diabéticos foi obtida uma acurácia de 94% na identificação de diabéticos tipo II, demonstrando a eficiência do SAP para a performance de exames, e evidenciando o potencial do uso da pupila na investigação de diabetes mellitus tipo II.
17

Estudo da resposta da melanopsina na neuropatia óptica e no distúrbio de sono através do reflexo pupilar à luz / Study of melanopsin responses in optic neuropathy and sleep disturbance by means of the pupillary light reflex

Duque-Chica, Gloria Liliana 24 September 2015 (has links)
Dentre as células ganglionares da retina existe uma pequena população de células que contem melanopsina e respondem diretamente à luz. Estas são as células ganglionares intrinsecamente fotossensíveis (ipRGCs), cujas funções são principalmente não visuais. Dentre as funções não visuais das ipRGCs sua influência na resposta pupilar dependente da luz foi o objeto central desta tese. Tanto a retina interna, através das ipRGCs, quanto a retina externa, através dos bastonetes e cones, fornecem uma informação neural que regula a resposta pupilar à luz (RPL). Este estudo avaliou a integridade das ipRGCs através do RPL em pacientes com glaucoma primário de ângulo aberto (GPAA), leve, moderado e avançado, e em pacientes com síndrome da apnéia obstrutiva do sono (SAOS), moderada e grave. Também foi avaliada a discriminação cromática e a sensibilidade ao contraste espacial de luminância (SC), a perimetria visual e a espessura da retina avaliada por tomografia de coerência óptica (OCT). Foram avaliados 98 participantes: 45 pacientes com GPAA ( 27, 18; idade média = 65,84 + 10,20), 28 pacientes com SAOS ( 14, 14; idade média = 52,93 + 7,13), e 25 controles ( 17, 8; idade média = 54,27 + 8,88). Após o exame oftalmológico foram avaliadas a SC de grades e a discriminação de cores através do Cambridge Colour Test (CCT). A avaliação do RPL foi feita apresentando-se flashes de 470 e 640 nm, de 1s de duração, em 7 luminâncias desde -3 até 2.4 log cd/m2 em um Ganzfeld Q450 SC (Roland Consult). O RPL foi registrado pelo sistema de eye tracker View Point System (Arrington Research Inc.). Os testes foram realizados em ambos os olhos, de forma monocular e no escuro. Para a comparação dos dados entre os grupos, utilizou-se um modelo de equações de estimação generalizada (GEE), para correção da dependência entre os dois olhos. O RPL dos pacientes com GPAA moderado e avançado apresentou redução significativa na amplitude do pico, dependente da severidade do glaucoma, nas diferentes luminâncias tanto para 470 nm quanto para 640 nm, evidenciando redução das contribuições dos cones e bastonetes ao RPL. As contribuições das ipRGCs ao RPL (avaliadas pela amplitude da resposta sustentada entre 6-8 s) foram também significativamente menores em GPAA moderado e avançado. No estado inicial do GPAA as contribuições das ipRGCs para o RPL encontram-se preservadas. No entanto, o GPAA parece afetar o processamento espacial desde o inicio da doença. Nos pacientes com GPAA leve foi observada uma perda acentuada nas faixas baixas de frequência espacial, compatível com prejuízo seletivo das células ganglionares do tipo M. A SC de pacientes com GPAA moderado e avançado mostrou perdas nas faixas baixas e altas de frequência espacial, apontando um prejuízo nas vias parvo- e margnocelulares. Uma perda significativa da discriminação de cores no eixo azul-amarelo foi observada em todos os estágios do GPAA. O RPL nos pacientes com SAOS está parcialmente preservado, não obstante, as respostas da amplitude do pico para o flash de 470 nm diminuem conforme aumenta a severidade da SAOS. As contribuições dos fotorreceptores da retina externa ao RPL, foram significativamente menores em algumas das luminâncias. Não foram observadas diferenças significativas de SC ou discriminação de cores nos pacientes com SAOS. Em conclusão, no estágio moderado e avançado do glaucoma tanto as contribuições das ipRGCs ao RPL quanto as vias M e P, se encontram mais afetadas do que no inicio do GPAA, quando a via parvocelular e as contribuições das ipRGCs ao RPL parecem estar mais preservadas / Among the retina ganglion cells there are a small population of cells containing melanopsin and which respond directly to light. They are the intrinsically photosensitive ganglion cells (ipRGCs), whose functions are mainly non-visual. Among these non-visual functions of the ipRGCs, their influence on the pupillary response as a function of light was the central subject of this thesis. Both the inner retina through the ipRGCs and the outer retina through the rods and cones, provide neural information that regulates the pupillary light response (PLR) to light. This study evaluated the integrity of ipRGCs through PLR in patients with Primary Open Angle Glaucoma (POAG), mild, moderate and advanced, and in patients with Obstructive Sleep Apnea Syndrome (OSAS), moderate and severe. We evaluated also the color discrimination and achromatic spatial contrast sensitivity (CS), visual perimetry and retinal thickness evaluated by Optical Coherence Tomography (OCT). 98 participants were evaluated, 45 patients with POAG ( 27 18; mean age = 65.84 + 10.20), 28 with OSAS ( 14 14; mean age = 52.93 + 7.13) and 25 controls ( 17 8; mean age = 54.27 + 8.88). After the ophthalmological exam it was evaluated the contrast sensitivity and color discrimination measures using the Cambridge Colour Test (CCT). Pupil responses were elicited by Ganzfeld (Q450 SC, Roland Consult) presentation of 1-sec flashes of 470- and 640-nm at 7 luminance from -3 to 2.4 log cd/m2. PLR was measured with the eye tracker system View Point (Arrington Research Inc.). The tests were performed monocularly, on both eyes, in a darkened room. In order to compare data across groups, we used a General Estimating Equations (GEE) to adjust for within subject inter-eye correlations. Patients with moderate and advanced POAG had a significantly decreased PLR that depends on the severity of the glaucoma, for both the 470- and 640-nm stimuli, making evident the reduction of the contributions of the cones and rods to the PLR. The contributions of ipRGCs to PLR (assessed by the amplitude of the sustained response between 6 8 sec) were also significantly lower in patients with moderate and advanced POAG. In the initial and mild stages of POAG the contribution of ipRGCs to the PLR is preserved. However, POAG appears to affect spatial processing from the early stages of the disease. Mild-POAG patients showed a marked loss in the low spatial frequency bands, compatible with selective loss of magnocellular ganglion cells. The CS of patients with moderate and advanced POAG showed losses at both low and high spatial frequencies, suggesting a loss in both parvo- and margnocellular channels. A significant loss of color discrimination along the blue-yellow axis was observed in all stages of POAG. The PLR in patients with OSAS is partially preserved, however the peak amplitude responses for the 470-nm flash decreased with increased severity of OSAS. The contributions of the photoreceptors of the outer retina to the PLR were significantly lower at some of the luminance. Significant differences in CS or color discrimination were not observed in patients with OSAS. In conclusion, in moderate and advanced stages of glaucoma, both the contributions of ipRGCs to PLR as well as the M- and P channels, were found more affected than at the beginning of POAG, in contrast the parvocellular channel and the contributions of ipRGCs on the PLR would be more preserved
18

Estudo da resposta da melanopsina na neuropatia óptica e no distúrbio de sono através do reflexo pupilar à luz / Study of melanopsin responses in optic neuropathy and sleep disturbance by means of the pupillary light reflex

Gloria Liliana Duque-Chica 24 September 2015 (has links)
Dentre as células ganglionares da retina existe uma pequena população de células que contem melanopsina e respondem diretamente à luz. Estas são as células ganglionares intrinsecamente fotossensíveis (ipRGCs), cujas funções são principalmente não visuais. Dentre as funções não visuais das ipRGCs sua influência na resposta pupilar dependente da luz foi o objeto central desta tese. Tanto a retina interna, através das ipRGCs, quanto a retina externa, através dos bastonetes e cones, fornecem uma informação neural que regula a resposta pupilar à luz (RPL). Este estudo avaliou a integridade das ipRGCs através do RPL em pacientes com glaucoma primário de ângulo aberto (GPAA), leve, moderado e avançado, e em pacientes com síndrome da apnéia obstrutiva do sono (SAOS), moderada e grave. Também foi avaliada a discriminação cromática e a sensibilidade ao contraste espacial de luminância (SC), a perimetria visual e a espessura da retina avaliada por tomografia de coerência óptica (OCT). Foram avaliados 98 participantes: 45 pacientes com GPAA ( 27, 18; idade média = 65,84 + 10,20), 28 pacientes com SAOS ( 14, 14; idade média = 52,93 + 7,13), e 25 controles ( 17, 8; idade média = 54,27 + 8,88). Após o exame oftalmológico foram avaliadas a SC de grades e a discriminação de cores através do Cambridge Colour Test (CCT). A avaliação do RPL foi feita apresentando-se flashes de 470 e 640 nm, de 1s de duração, em 7 luminâncias desde -3 até 2.4 log cd/m2 em um Ganzfeld Q450 SC (Roland Consult). O RPL foi registrado pelo sistema de eye tracker View Point System (Arrington Research Inc.). Os testes foram realizados em ambos os olhos, de forma monocular e no escuro. Para a comparação dos dados entre os grupos, utilizou-se um modelo de equações de estimação generalizada (GEE), para correção da dependência entre os dois olhos. O RPL dos pacientes com GPAA moderado e avançado apresentou redução significativa na amplitude do pico, dependente da severidade do glaucoma, nas diferentes luminâncias tanto para 470 nm quanto para 640 nm, evidenciando redução das contribuições dos cones e bastonetes ao RPL. As contribuições das ipRGCs ao RPL (avaliadas pela amplitude da resposta sustentada entre 6-8 s) foram também significativamente menores em GPAA moderado e avançado. No estado inicial do GPAA as contribuições das ipRGCs para o RPL encontram-se preservadas. No entanto, o GPAA parece afetar o processamento espacial desde o inicio da doença. Nos pacientes com GPAA leve foi observada uma perda acentuada nas faixas baixas de frequência espacial, compatível com prejuízo seletivo das células ganglionares do tipo M. A SC de pacientes com GPAA moderado e avançado mostrou perdas nas faixas baixas e altas de frequência espacial, apontando um prejuízo nas vias parvo- e margnocelulares. Uma perda significativa da discriminação de cores no eixo azul-amarelo foi observada em todos os estágios do GPAA. O RPL nos pacientes com SAOS está parcialmente preservado, não obstante, as respostas da amplitude do pico para o flash de 470 nm diminuem conforme aumenta a severidade da SAOS. As contribuições dos fotorreceptores da retina externa ao RPL, foram significativamente menores em algumas das luminâncias. Não foram observadas diferenças significativas de SC ou discriminação de cores nos pacientes com SAOS. Em conclusão, no estágio moderado e avançado do glaucoma tanto as contribuições das ipRGCs ao RPL quanto as vias M e P, se encontram mais afetadas do que no inicio do GPAA, quando a via parvocelular e as contribuições das ipRGCs ao RPL parecem estar mais preservadas / Among the retina ganglion cells there are a small population of cells containing melanopsin and which respond directly to light. They are the intrinsically photosensitive ganglion cells (ipRGCs), whose functions are mainly non-visual. Among these non-visual functions of the ipRGCs, their influence on the pupillary response as a function of light was the central subject of this thesis. Both the inner retina through the ipRGCs and the outer retina through the rods and cones, provide neural information that regulates the pupillary light response (PLR) to light. This study evaluated the integrity of ipRGCs through PLR in patients with Primary Open Angle Glaucoma (POAG), mild, moderate and advanced, and in patients with Obstructive Sleep Apnea Syndrome (OSAS), moderate and severe. We evaluated also the color discrimination and achromatic spatial contrast sensitivity (CS), visual perimetry and retinal thickness evaluated by Optical Coherence Tomography (OCT). 98 participants were evaluated, 45 patients with POAG ( 27 18; mean age = 65.84 + 10.20), 28 with OSAS ( 14 14; mean age = 52.93 + 7.13) and 25 controls ( 17 8; mean age = 54.27 + 8.88). After the ophthalmological exam it was evaluated the contrast sensitivity and color discrimination measures using the Cambridge Colour Test (CCT). Pupil responses were elicited by Ganzfeld (Q450 SC, Roland Consult) presentation of 1-sec flashes of 470- and 640-nm at 7 luminance from -3 to 2.4 log cd/m2. PLR was measured with the eye tracker system View Point (Arrington Research Inc.). The tests were performed monocularly, on both eyes, in a darkened room. In order to compare data across groups, we used a General Estimating Equations (GEE) to adjust for within subject inter-eye correlations. Patients with moderate and advanced POAG had a significantly decreased PLR that depends on the severity of the glaucoma, for both the 470- and 640-nm stimuli, making evident the reduction of the contributions of the cones and rods to the PLR. The contributions of ipRGCs to PLR (assessed by the amplitude of the sustained response between 6 8 sec) were also significantly lower in patients with moderate and advanced POAG. In the initial and mild stages of POAG the contribution of ipRGCs to the PLR is preserved. However, POAG appears to affect spatial processing from the early stages of the disease. Mild-POAG patients showed a marked loss in the low spatial frequency bands, compatible with selective loss of magnocellular ganglion cells. The CS of patients with moderate and advanced POAG showed losses at both low and high spatial frequencies, suggesting a loss in both parvo- and margnocellular channels. A significant loss of color discrimination along the blue-yellow axis was observed in all stages of POAG. The PLR in patients with OSAS is partially preserved, however the peak amplitude responses for the 470-nm flash decreased with increased severity of OSAS. The contributions of the photoreceptors of the outer retina to the PLR were significantly lower at some of the luminance. Significant differences in CS or color discrimination were not observed in patients with OSAS. In conclusion, in moderate and advanced stages of glaucoma, both the contributions of ipRGCs to PLR as well as the M- and P channels, were found more affected than at the beginning of POAG, in contrast the parvocellular channel and the contributions of ipRGCs on the PLR would be more preserved

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