Assessment of epilepsy using noninvasive visual psychophysics tests of surround suppression.

Powerful endogenous inhibitory mechanisms are thought to restrict the spread of epileptic discharges in cortical networks. Similar inhibitory mechanisms also influence physiological processing. We reasoned, therefore, that useful information about the quality of inhibitory restraint in individuals with epilepsy may be gleaned from psychophysical assays of these physiological processes. We derived a psychophysical measure of cortical inhibition, the motion surround suppression index (SSI), in 54 patients with epilepsy and 146 control subjects. Multivariate regression analyses showed that SSI was predicted strongly by age and seizure type, but not by seizure frequency. Specifically, we found that patients with exclusively focal epilepsy, and no history of generalization, showed significantly stronger cortical inhibition as measured by the SSI compared to all other groups, including controls. In contrast, patients with focal seizures evolving into generalized seizures, and patients with generalized genetic epilepsy, showed similar levels of cortical inhibition to controls. The presumptive focus, when one could be identified, was rarely found in visual cortex, meaning that the relationship with the epilepsy subtype is likely to reflect some global difference in inhibition in these subjects. This is the first reported instance of raised SSI in any patient cohort, and appears to differentiate between patients with respect to the likelihood of their experiencing generalization of their seizures. These results suggest that such simple psychophysical assays may provide useful aids to clinical management, particularly at the time of diagnosis.

Two common psychophysical measures of surround suppression reflect independent neuronal mechanisms.

Psychophysical surround suppression is believed to reflect inhibitory neuronal mechanisms in visual cortex. In recent years, two psychophysical measures of surround suppression have been much studied: (i) duration thresholds on a motion-discrimination task (which are worse for larger than for smaller stimuli) and (ii) contrast thresholds on a contrast-detection task (which are worse when grating stimuli are surrounded by a stimulus of the same orientation than when they are presented in isolation or surrounded by a stimulus of orthogonal orientation). Changes in both metrics have been linked to several different human conditions, including aging, differences in intelligence, and clinical disorders such as schizophrenia, depression, and autism. However, the exact nature of the neuronal correlate underlying these phenomena remains unclear. Here, we use an individual-differences approach to test the hypothesis that both measures reflect the same property of the visual system, e.g., the strength of GABA-ergic inhibition across visual cortex. Under this hypothesis we would expect the two measures to be significantly positively correlated across individuals. In fact, they are not significantly correlated. In addition, we replicate the previously reported correlation between age and motion-discrimination surround suppression, but find no correlation between age and contrast-detection surround suppression. We conclude that the two forms of psychophysical surround suppression arise independently from different cortical mechanisms.

Moderate acute alcohol intoxication has minimal effect on surround suppression measured with a motion direction discrimination task.

A well-studied paradox of motion perception is that, in order to correctly judge direction in high-contrast stimuli, subjects need to observe motion for longer in large stimuli than in small stimuli. This effect is one of several perceptual effects known generally as "surround suppression." It is usually attributed to center-surround antagonism between neurons in visual cortex, believed to be mediated by GABA-ergic inhibition. Accordingly, several studies have reported that this index of surround suppression is reduced in groups known to have reduced GABA-ergic inhibition, including older people and people with schizophrenia and major depressive disorder. In this study, we examined the effect on this index of moderate amounts of ethanol alcohol. Among its many effects on the nervous system, alcohol potentiates GABA-ergic transmission. We therefore hypothesized that it should further impair the perception of motion in large stimuli, resulting in a stronger surround-suppression index. This prediction was not borne out. Alcohol consumption slightly worsened duration thresholds for both large and small stimuli, but their ratio did not change significantly.